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HomeMy WebLinkAbout0040 PRUDENCE LANE 117 . \ ii 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map ®4 a Parcel} Application # ��� ' -Q Health Division Date Issued Conservation Division % Application Fee Planning Dept. Permit Fee GoO Date Definitive Plan Approved by Planning Board Historic - OKH Preservation /Hyannis Project Street Address FM MY)(A Village Owner eX�l (Y]OfAa YN Address R Telephone • Permit Request G c Y 5. Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Oroject Valuation �b v 0 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 3 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 XNo Fireplaces: Existing New Existing wood/coal stove: U;Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: M existing ❑ new size_ Attached garage�xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other:;, �� h � co Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR OMEOWNER) N^ ne Telephone Number o� `T,2 ��2 Address License # �(J'f�"► ► 01 C) 2 (P 2_ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE_,Ylose/1 } FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ti FOUNDATION FRAME INSULATION FIREPLACE _ 4. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE'CLOSED OUT_ , ASSOCIATION PLAN NO �` The Commonwealth of Massachusetts Department of Industrial Accidents Pig Office of Investigations 600 Washington Street t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): IA►/j IMCf(AF� Address: City/State/Zip:.. W O Phone 42 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part=time). * _ have hired the sub-contractors., 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. f 7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition No workers comp.insurance.$comp. insurance 10.❑ Electrical repairs or additions required.] 5. [] We are a corporation and its 3 1 am a homeowner doing all work officers have exercised their I I.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[1 Other K IGGC Q 4n ' comp.insurance required.] �� in T'A►t+ C *Any applicant that checks box#] 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. tContractors 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 thepolicy 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 certify"der the pains andpenalties ofperjury that the information provided above is true and correct; Si ature I�IDate: �^ Phone#: L�Z c 7 Official use only. Do not write in this area, to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: , Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, 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,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 dwelling 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." MGLJchapter 152, §25C(6)also states that"every 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 who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"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." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificates) of insurance, Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the , members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete 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 permi0license number which will be used as a.reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. 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 Tr,]. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia ToWn of Barnstable y�� op YHE rpy �egulatox� Services Thomas F. Geiler; Director . BARNSTA13LS, y� MASS. { •BuizdingDiviSioll ,e7P• N Pjfa µate Tom Perry,Building Comtrussioner` 200 Main Street, Hyannis., MA.02601 ))rwly.toii,n,b2riistable.ma.us f Fax; 508-790-6230•. fi Ofce: 508-862-4038 --_—_-- ------ --__- -_=-- —__ -=_ I30A2EOWN-CR LICENSE, EXEMPTION please Print DATE: JOB LOCATION: 0 street w' V4y1llage number "HOMEOWNER": I work phone# name home phone N CURRENT MAFLiNO ADDRESS: city/towel slate zip code ts or less The current exemption for"home'owners"was extended to include owner-o ipe d dwellings ovided that the ovrnez act Wads to allow homeowners to engage an individual for hire who does not posses . supervisor. DEFINITION OF HONTEOWNER Pcrson(s) who owns a parcel of land on'which kre/she resides or intends to zeo such useh to'and/or farm huctures,dori wich there is, or is A be, a one or two-family dwelling, attached or detached structures.accessory to uch person who constructs more than one home ffcial on.aaf rznlacdceptableoto the Building Official,t bo considered a hat he/she he shall be "homeowner"shall submit to the Building responsible for all suchWozk performed under the building permit, (Section 109,1,1) u The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other . applicable codes, bylaws, rules.and regulations. rp Th'e undersigned "homeovn�er' certifies that he/she understands the iowmpl with i is id P ocadurres�aud ent minimum inspection procedures and requirements and that he/she wr comply requirements, Signature of Homeowner Approval of Building-Official ining 35,000 cubic feet or larger will be required.to comply with tho Note; Three family dwellings conta State Building Code Section 127.0 Construction Control. HOMEo"ER'S EXEMPTION The Code states that: "Anyhomeo onstructiowner rn Supervisorso);provided thaI f the homeowner engages a PcTs n(s)l be exempt fforhirom ke cq ordo'su Such . of this section(Scc6on 1 o9•I,1 -Licensing of work, that such Homeowner shall act as supery=r,1.• 1 Many homeowners who use onstroct on Supervisorsr;Sectioaware n 2t 1 they This la k of awarene the sooftenlresultsrin serioussproblc",parti ulaarly , Rulcs &�Rcgulations for Licensing C case,our Board cannot proceed against the unlicensed person as it would with a licensed when the homcownerhires unlicensed persons. In this Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware otCT ofsi 8u'pcs, a y0n the lasll�pagc of this CS require,aissue is a`forn currcndy�used by that the homeowner certify that hdshe understands the responsibilities -A—i arinnt such a form�eertifieation for use in your community. , {. �oprH5r°�r Town of Barnstable Regulatory SerVzceS w KxsrAnt�, Thomas K Geiler, Director t679 g Buildin Division prop" Tom ferry, Building Commissioner 200 Main Street, Hyannis, MA 02601 w�Yw.torvn.barnstable.rne.us Office: S08-862= 03 8-- -- Fax; S08-790-6230 P>uopetty Ow.ne't Must Complete and. Sign. This Section If-Usilig A Builder 1 , as Owner of the subject property hereby authorize - - to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Addtess of Job) Signature of Owner Date Print Name If Property.Owner is applying for permit please complete the �Jomeowriets License Exemption porIli on the reverse side. v^ LAN MORTGA GE LL=TION P APPLICANT- MORGAN TO WN.• COTUIT LOT 82 LOT 81 1�p 00 LOT 85 LOT 80 LOT 84 0 0 ................ ........................ ;, f40"ssssss •o 0 LOT 86 ' p 0 A 0 y' �� ® tNQFM e p � r suwi ®� FLOOD PANEL 250001 0018 _D "C��__ V® _ FLOOD ZONE _ DATED. 07-02-92 & ,,�d d� I hereby certify that this mortgage inspection plan was prepared for. Plan is For TO BANKNORTH Hank Use Only The location of the building shown does _1V0_T_ fall within a special flood hazard zone. DEED REF = 154271___ Per taped inspection it appears the location of dwelling does _—___ conform to the local by-laws H_.'3 in effect at the time of construction with respect to horizontal dimensional setback requirements PLAN REF. = 22824D S or is exempt from violation enforcement action under Mass General laws CA 40A -Sec. 7. Scale I" = ___40—'-- FT Referenced Deed subject to and with the benefit of all rights, rights of way, easements, reservations and restrictions of record, if any there be and insofar as the same are of legal force and effect Da te: 07-13-05— ----- PLEASE NOM The structures on this inspection were located by tape not instrument and are approximate onty An actual survey is necessary for a precise determination of the building location and encroachments, ff any exist either way acraw property lines This inspection must not be used for recording purposes or for use In preparing deed descriptions and must not be used for variance or buildfrrg plan purposes This . Inspection must not be used to locate property!Ines: Verification of building locations, property line d1wenslang fences or lot conffguretlon can only be accomp/fshed by an accurate Instrument survey which may reflect different information than what is shown hereon 9795 inspection is not to be used for any purposes other than mortgage. Yankee Survey accepts no responsibility for damages resulting from said reliance. ` i j; PHONIC 50B-428-0055 YANKEE SURVEY CONSULTANTS FAX 508-420-5553 UNIT 1, 40 INDUSTRY RD, MARSTO NS MILLS, MA 02648 37773 JF. i r J Nfw p T (Wtu,&ff-(-,s cAtta(�cj +o or of Le,-�Wemxw �. N ew' jX 4 fos$ S SFck ce-d '7 a or" (avid IoL e r,7 Assessor's offioe (1st floor): THE Assessor's map.and lot number ........ . ...................................... (T kAL Board of Health (3rd floor): Sewage Permit number ...... 33AU9TABLE, NAB& Engineering Department (3rd floor): 039. Housenumber ........................................................................ APPLICATIONS PROCESSED 8:30-9:3CPXUV and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR / S7-014Y APPLICATION FOR PERMIT TO ................././`--`..Io ....... 7. . ... ..... ............ ...... TYPE OF CONSTRUCTION ..................... I.................................. ............... ............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit"O"C'cording to the following information: Location ........vjp<:�,......./W ul�� 9110........ ............................................................................... ProposedUse ..........................................................................................4........................ ZoningDistrict ..........................................................I.............Fire District .............................................................................. Name of Owner ....T\ ........ 7-F/0 ..............Address ....& ....... I—A44 re 71 z9e-bi� Nameof Builder ...............................�c ..........................Address ..................................1.11.......................................... Name of Architect .....10A11( ......001L " ...............................Address ...C......k-4 20?.:...... Number of Rooms Foundation ...... /)PO L" 0*I0/-(T 1.1��z ...................................... Exterior ...... 1--V�-(�.............Roofing .............Z4 5/'..1.......4IA6.7— .. .... ...........................I................. Floors ....... ...............................................Interior .......:....................................... .................................... Heating ... ....... ... .......... ......Plumbing ................2........................%.................................... • ............................. Fireplace ....../41.;F ........................Approximate Cost ........77-1......./............................................... Definitive Plan Approved by Planning Board --------------------------------19-------- - Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......20;.71�.. .............................................a.............. Construction Supervisor's License .... ................................ Steidler, James A=03.9-84-� 40 -, No ...3.Q.7.5.2... Permit for ......one.,.storY.......... ................... Location 40 Prudence Lane ................................................................ Cotuit .....................................................................I......... Owner James Steidler . .................................................................. Type of Construction frame .......................................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ...........Xay..15..."...........19 87 Date of Inspection ....................................19 Date Completed ......................................19 76 % 0/0 } 7j2-jj°; dA4. Town Barnstable *Permit# l�0 GFTHE 1py, Expires 6 months from issue date yl' * Regulatory Services Fee �.U��) BAMSTABIX, • 9 MASS' Thomas F.Geiler,Director rED t�e't Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 (.PRESS PERMIT Office: 508-862-4038 Fax: 508-790-6230 J U L 1 8 2003 EXPRESS PERART APPLICATION - RESIDENTIAL ONLY f� jJ Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number Property Address ICE UKesidential Value of Work Owner's Name&Address G �1 Y T� U ti'V Q�i ✓t� 1i � � O��� Contractor's Name Telephone Number `7 5" al y/S Nome Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) � oorkman's Compensation Insurance Check one: - ❑ I a a sole proprietor F ❑ the Homeowner I have Worker's Compensation Insurance - 1 5 . . Insurance Company Name Workman's Comp.Policy Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to e-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows: U-Value (maximum.44) *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. Ho e I ovem t Contractors License is required. I Signature Q:Forms:expmtrg Revise053003 O rJ y S WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 30 Days of Acceptance and Receipt of Deposit providing the Materials are Available. POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards, Plywood Sheathing or Other Carpentry Needing Replacement will be done and charged for as an Extra at the Rate of$40.00 per Hour Plus Materials Plus 20% Overhead Mark-up on the Total Extras. Payments accepted are : CASH--CHECK—MONEY ORDER , ,Make Checks Pavable to b CHARLES COREY CO SY & COREY Warranties the Shingles and Labor for 10 years. CERTAIN-TEED Warrrannxs the shingles and labor 100% for the First IO Years and then on a pro-rated basis for 30 Years Total if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a '70 MPH WLND WARRANTY. Any alteration or deviation from above specifications,will be executed only upon written orders and will become an extra charge;over and above the estimate.. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance upon the above work.. This proposal may be withdrawn by us if not accepted within thirty days. CORE} & COREY carries Worrman's Compensation and Public Liability Insurance on the?cbo-e work DATE OF ACCEPTANCE: �t ACCEPTED BY: SUBMITTED BY:, ELLA DlCARLO NHARLES COREY HOME OWNER C OREY &COREY r- I { ✓fie&ammzaiiuseai a��ac6uiaelld �I Board of Building Regulations and Standards HOME IM[QROVEMENT CONTRACTOR ' ReEstrator = 6066 �iratt� I r, � uw COREY&COREYpIafE 1p CFPWES COREY?`V; 73 LAFRANCE AVE. HYANNIS,MA 02601 Administrator .;.,i•.w,.,...-.q�.:-.+m^^ -.,^`-t✓.err.;::.. ..,�.,,.�,.,..+r.:i�+e�. ';:�y+�p..'s�g.:. ;..,,;..n!'.yt L�ryie�.'}K.•fFa�;*°!'ti'F�'}.�t+`ti�` '.�.'�-�`«-:.^.�-.' ,►.•.. - , 4�,.i w..� -.•.'S�-�.i;_-r �.� TOWN OF BARNSTABLE Permit No. .....30752,,,, (� BUILDING DEPARTMENT i D1YDl4 DNS � TOWN OFFICE BUILDING Cash ............... �9 .659• fit HYANNIS.MASS.02601 Bond ........... . CERTIFICATE OF USE AND OCCUPANCY Issued to JAMES STEIDLER Address 40 Prudence Lane, Cotuit USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND,IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE FF BUILDING CODE. April..29............. 19...58.......... ... s• ,......... Building Inspector THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A�-C&F 7- L DATA BARNSTABLE, MASSACHUSETTS BUILDING PERMIT DATE 19 PERMIT NO. APPLICANT ADDRESS (NO.I (SIN(:f.II ------ - (C01IT II'G I I(.1:l 11 NUMBER OF PERMIT TO (_) STORY DW-L"I. ING, UNITS ..,._ . _ ._ ....-_. (TYPE Of- IMPRUVI:ML NI) NU, (I'll Ul'U'>1:1) U:.LI AT (LOCATION) ZONING DISTRICT (N0.1 (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOTLOT BLOCK SIZE BUILDING IS TO BE FT, WIDE BY FT, LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPEI REMARKS: AREA OR VOLUME ESTIMATED COST $ FEEMIT (CUBIC/SQUARE FEET) — OWNER ADDRESS BUILDING DEPT. BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TFMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2, PRIOR T i COVLRING STRUCTUFAL QUIRED,S:_ICH BUILDING SHALL NOT 8E vCCUPIEOiJNTiL 3. FINAL INSPECTION BEFOREE P I MEMBERS(READY TO LATH FINAL INSECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET yz/ LDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS i t -- ---- --------------------— —-----__—---_ 2 '/ /� � -- 2 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER BARD OF HEALQ V:' e — URK ��H L� r!UTPh�10E�LJ UNTIL TH€ IhaSPCC-. I PERMIT BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE I'OR HAS APPROVED THE VARIODUS SIAGLS OF I WORK IS NOT STARTED WITHIN SI„ MONTHS OF DATE THE ARRANGED FOR 13Y TELEPHONE OR. 1NRITTE-N CONSTRUCTION i1 PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. l i 1 � 140.00 LOT 85 W, 22, 400 S. F. ;k f n EXISTING w FOUNDA TION io. .00 140.00 S 62'48'20"W PRUDENCE LANE 1 E' f PLOT PLAN OF LAND 4 f "TO THE BEST OF MY KNOWLEDGE, THE FOUNDATION L OCA TED IN SHOWN ON THIS PLAN IS AS IT ACTUALLY EXISTS AND BARNS TABL E THA T IT CONFORMS TO THE TOWN OF BARNSTABLE ZONII ; REGULATIONS, REGARDING YARD SETBACKS" `�>Ft�i��-t''°s;t '� PREPARED FOR �JA MES S TEIDL ER } ► DA •MA B, J9B7 /w (`±.p r� �� ,��R � Ve at t 7 R.L.S. ��tais. DATE.•MAY B . 19B7 SCALE.- t"— 40 FT. CAPE C ISLANDS SURVEYING FLOOD ZONE C`, dm�:. TEA TICKET — MASS. Assessor's offioe (1st floor): O$THETO r Asse^�or s m;ap and lot number ::.......................................... Board of Health (3rd floor): `�� ' , "-"TALLE CO WI d Sewage Permit number .................................................. .... �N v STADLE, S Engineering Department (3rd floor): � r -fir �1�� TS�OAN C o• e� House number ........�`...�...........` ..5✓.. �?sP �p� �p®� �� "� a� APPLICATIONS PROCESSED 8:30-9:30'A.M, and 1:00-2:00 P.M. only • TOWN OF BARNSTABLE r BUILDING INSPECTOR ' l APPLICATION FOR PERMIT TO �O �Gr/VL ...............................l �?' +.......... y TYPE OF CONSTRUCTION �Z d641 �'v ' f ...... ................................................. 4 ..............0..I ............................19.... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......Ft5. ......... ........................................................................... Proposed Use .........................Fire District ................... Zoning District ........................................................... .............................................. Name of Owner .... .. e/� 5/ F/•0(-t0� ©......n...5i�f� ............................./ ��......................... ..................Address ... .��..... ,l� ....... ...�!re r 1 AA4 �F/dc/FO"Z Nameof Builder ........Q.................... ......................................Address ....................................................................................... 6,4 Name of Architect / AI( �� ek�lS / �.;..,,.. !9�MOV .................................................................Address ................................ ............... Number of Rooms ..............//......................... Foundation ......�DUI?121� 00/�,Cv P? T'� ..................................�................. Exterio. !1........................................ . ............Roofing ..................... ............7................ ......� r IpE/ ....7�....L�✓vUC TZ .Interior . Floors f� ....................................................................... Heating ...�!V7 /-�C� ��.......CT!'15.....................Plumbing ...............�............................................................. ............... ............ . ey r Fireplace ......14,/: ��L tC5 I OS Approximate Cost UU p ............................................... pp /.........../....../......................��1 Definitive Plan Approved by Planning Board ________________________________19________ . Area ....`/��P.Q......5 !�.�...... co Diagram of Lot and Building with Dimensions Fee C 8 �*. — ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ®ffq0 �b 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of .the Town of Barnstable regarding the above construction. Name ...... ..... ...... a Construction Supervisor's License v "� ��