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I W, , 'i, j iii-,,- 'v, -,,'Jll�I,,,")�1'1,,,,C"i'll 1­1", - "4,��­" '' ' `�'�i,�t!:I,"'�'�J`,e'�`�......41�,�'- j,,_j�, ­1,tl�,.,_ .1,11, ,;,1�4'iffiLi, gmy"Yowk I i 1 �,v,4s,l "Ill." ,. , il�_ !,;,. �,,i,.,, ', ,� ,� ,''! ��11 PwWww"wx 1.11 I 1" - , -jj I , �! 9 �� ;� , , - " ;, : � 77,::4 ,.; iiii�,­�O,I� .,I,',-,'iiii,�.�'j!�'B'�-1. , I � z- I !, ,,��,� ,. l�;!�j�,�r� My � ,,,f�,,� ,�Il I "I"; 11 ,��,: 11�1'�, h ,", J, - -% - ' WAM-­1514, , CIA sw to , �11 "A A WK ,,"", A M W - .1; 11 ,,, it I 11�� �,�2,,..�,,�,_i,,� ,,m'.1,/",.i',' 1111"�� 3; Akil /0 a Z/ �1 PERA0.17 Town of Barnstable *Permit_# r p Expires 6 months from issue dale 2010 Regulatory Services Fee �PT 039. p`0„ NSTABL Thomas F. Geiler, Director p 6W I?Pfi Building Division Tom Perry, CBO,.Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us 417l/0 Office: 508-862-4038 Fax: 50 -790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not-Valid without Red X-Press Imprint Map/parcel Number " 44a io 2 1$c� o3S Property Address / Z6 6 -F-A l W o(41-,A d d 1..,eo /e4l yl ll`' t'l tt 02 6 5 2. [ Zesidential Value of Work 00C) Minimum fee of$35:00 for work under$6000.00 Owner's Name&Address M-A U G2IC7e/ Contractor's Name Telephone Number 'S C �O®• 526_5 Home Improvement Contractor License# (if applicable) �/ `f 7 Construction Supervisor's License#(if applicable) coY ❑Workman's Compensation Insurance C 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) f �e.-roof(hurricane nailed) (stripping old shingles) All construction debris te will be taken to /Fff a / awal ❑ Re-roof(hurricane nailed) (not stripping. Going over existing layers of roof)' ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .35)# 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 re d. SIGNATU Q:\WPFILESTORMS\building permit forms\EXPRESS.doC Revised 072110 =! The C'orninorriveallh of-Massachuse/ts tom•,- - — Departineni oflndustrial Accidents �- J I Office of Invesfigalions 600 Washington S1reei' Boston, M-4 02111 - N n,31 winass.go)ldia 4forkers' Compensation Insurance Affi.clx6t: Builders/Colitractol•s,/Electr•icizns/Pl:iimbers Applicant Information / Please Print Legibly Name (BtisinesVOrgauizotiau,�dividrial): Ed,f C V G U LO'CL C4V Address: City/State/Zip: C , ��.r� � ®�' P lone C(O0 `--Lj S Are you an employer? Check the appropriate boa.: Type of project(rsquitvd).- 1.❑ I am a employer with 4• E] I am a general contractor and I f aTloyees(full and/or part-time).* have hired the sub-contractors 6- ❑New construction I f� I am at sole Proln or P etor artner- listed on the attached sheet. +7. D,Remodeling s1u. and have no employees These sub-coutrac:tors have P8. 0.DeJrwliriou ,arorking for the in any capacity. employees and have workers' l 9. Q.$uittlsng addition [No workers' camp.insmace comp.insurance.. � We area required.] 5. corporation. .and its 10.0 Electrical repairs or additions 3.❑ .1.am a.homeowner doing-all work officers have exercised their I L Plumbing repairs or additions myself. [No worker's' comp, right of exemptiGn per 1'IGL c- 152, 12 �Roof repairs an insurce:requir�ci.] T �1(4) and.we have no employees. [No workers' 13.:❑ Other comp.:insurance.required.] •Any applicant thstchec s box#1.must also h11 out the section below shaving their wwl-ers'compeusa:tioa policy infornrstion- Hanteownr ers who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a rrew efdaOt indicating saci fCm&actnrs fti check this:bex muq attached au sdditiorW:she.et shbreing the name of the sub-contractors and sure whether or not those entities have employees. If the sub-contranars:ha`Re employees,they,must provide their wurkeTs'comp.policy number. �ArJI IJ'JJ£�JIIplOy`FJr that isproi�idirrg Jtrork�rs':con'JpeJtsation iJzsJ.rrrrrr.ce fDY YJJy'elI'Cplo�atTas. :13�lOtI'[S tilR pt7'liCf'�'lTLXI�Ob S2tR IJlft7rNflLiLOJt. , Insurance Company Name: Policy#or Self--ins.Lic.-A: Expiration.Date: Job Site Address: city/state/zip- Attach a copy of the of or leers' carnpensatiorr policy declaration page(shmiring the policy,number and expiration date). Failure to secure coverage as required under Section 2.5A of MGL c. 152 can lead to the imposition of criminal peaa.lt ies of a fine up to S1.,500.00 andlor one-year imprisontnen.t, as well was civil penalties in the form of a STOP'[VORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that copy of this statement may be forwarded to the Office of Intestiga:tions of the D.IA for insurance coverage verification. I do hem y cr'rti rder thepains and ponalf-es ofpedfiry drat fete iufortna ion provided aboipa is true and correct. Si ma Date: c 7 d Phone#: ' D 1 DC7 Cal LBoard only. Do not.ivrit-e in this area,to be completed by cif'or toit'it o�ciaL �n: PermitlLicense# hority'(circle one): Health 2.Buildin.g Department 3. C`ity/Toivn Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: 6 I of THE rosy + BARNSrABLE, MASS. Town of Barnstable 'DIED MAC A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO 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 as Owner of the subject property hereby authorize U a` to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form on the reverse side. QAWPFILESTORMSIbuilding permit formsTXPRESS.doc Revised 072110 �I �yotry Town of Barnstable Regulatory Services " i9aAss. >' lass. Thomas F. Geiler, Director .� $, a°;9, A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town,barnstable.ma.us Office: 518-862-4038 Fax: 508-790-6230 -------------------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER" name home phone# work phone# CURRENT MAILNG 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 ofconsiruction 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:IWPFILESIFORMSIbuilding permit forms\EXPRESS.doc Revised 072110 h ur .A - t _ �m lYlassaehusetts Department of Pu4kP.Safety `Boar(ff``Borld Regulations and� tandtrds C:onsttuction Supervisory icense S�s; - 60214 .License: CS : = Restricted to: 00 ERIC V LUBRANO 1 PO BOX 185 p E FALMOUTH, MA 02536 Expiration: 4/29/2911 Tr#: 14112 Oner - � Oear/ur. .Lscense o re�tStra �on va1Sd fo(^ntdtvidul use t aniy ✓�Ze r°anvm�mu'ealC� a ` aUon:date aIf.found return to��eSore'thxQ Mallon Office of Consumer Affairs $usiness RegufhtinU O ice of consumer Affairs and Busii►ess Reg HOME IMPROVEMENT CONTRACTOR 10 Park Plaza=Suite Registiat�om '�114047 Tr# 286946 Expiration* _ k TyPO�)ND It Z r ERiC V.LUBRPNO BLG€ REMOD. ERIC LUBRAN' 4' bk 85 BLUE CASTLP DR Undersecretary Nof valid without signature MASHPEE,MA 02 r . TaE'To�yo� TOWN OF BARNSTABLE i BAUSTABLE,MAM i am a' BUILDING INSPECTOR t APPLICATION FOR PERMIT TO �.......... ..... .... 211,..........� ...... ... .. .. TYPE OF CONSTRUCTION ....(!1 .....`�J,.2 ?-4-.9........... o� 19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Q Location .........A. .V.............. a/✓��=.�r� Clf.L�.4-......... y5 �........ 47 Proposed Use ..... .�� .L. ........ ....GLvSL� ZoningDistrict ........................................................................Fire District .............................................................................. Nameof OwnerAdarA.1 .........1 e... ... .............Address .................................................................................... Name of Builder/1/.Y(Of .... ......rl�.51t.:......................Address . .� ......�.�lUT�.�.. ...... XTlq. .VV.%. h�OA Nameof Architect ....74.,,v.. ..............................................Address .................................................................................... Number of Rooms .....f............................................................Foundation ... Oc Exierior .W..l7 emu...... .. ......... 5./....................................Roofing 4-7............:...........<<.......:..................... Floors ......................................................................................Interior y h�-OgxI ��4f1. L ...........................:.................. Heatingt':..�L�.(.cJi.............................................................Plumbing ......................................................................::.....:... Fireplace ...�;;?Ioo ..........................................................Approximate Cost ..... p.Ur.. ........................................... Difinitive Plan Approved by Planning Board -----------______-__-_ �C/ J1 - -19 -- --• G �� Diagram of Lot and Building with Dimensions j G THE PROPOSED METHOD OF PROVIDING FOk SANITARY WATER SUPPLY, SEWAGE DISPOSAL AND DRAINAGE IS/�EREBY VFBARNSTABLE. R` '�'V ED C TON BOARD OF HEALTH A LICENSED IP'S T ALLEk MUST OBTAIN SEWAGE PERMIT, AND- 5LJ- SYSTEM, I hereby agree to conform to all the Rules and Regulations of the To o Barnstable regarding the bove construction. Name .... ........ /......./........ Cameron, Mrs. G. A. 14761 add to single �4s) .................. Permit for .................................... family diwe I I J ng ............................................................................... Location ......1766...Falmouth...Road.................. ........ ................. ........ Centerville ............................................................................... Owner Mrs, G. A. Cameron .................................................................. Type of Construction ................rame.................. A ................................................................................ Plot ............................ Lot ................................ Permit Granted ..........Februax-Y- 7.......19 72 Date of Inspection ...... 19 Date Completed .......j�/ ....19 PERMIT REFUSED ................................................................ 19 ...................................................... ........................ ................................................................................ ............................................................................... ............................................................................... Approved ................................................. 19 ............................................................................... ............................................................................... -mot 1 I � i ; f I � � � i � � � f I ' I { �� I � � � , 1 � I � I � � I i i I 1 I � � � I � , ; � I I r I i � ` � � � ' � I ! I � i I � , i I I M I i i � I I . � i I i i I r P � I � 1 I r I i I f I I i I � � I 1 I i F � � , � I � i � � I I � � i I j f I � i � I - I � � � � � � , � � I � � i � l I � � I � I . I � � � , � � I � � � ! � � r � � � � � ' � � i I ' ! " ( � i f � � � � I � � � I � I c � � I � [ , � I I M � � � � I i � � I � � � � 4 j i � � � ' � � . I � i i � i � ' � � � � � ! I � � I z I � � I t `� � i I I ! � � i r I I 1 p ' � ...Assessors ma and lot number................ / pF THE to r ! ' wage Permit'number f' .. � ".,Q g V ' Z BARNSTABLE, i ouse number >.. NAM u�.a .....,. q� 16 000 O 9• � TOWN . OF. BARNSTABLE.1 BUILDING INSPECTOR Y . I , l��o - � APPLICATION FOR PERMIT TO ... .��.......�.....��..............�....�':.....c. ................ TYPE OF CONSTRUCTION ............. .!...l.�.0le%..................... ©f7 �1� /! ............ � .. � - ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according --tto the following information: Location .....� �.......... #.......).&............;. �. ..1. ..!..!............. ....................:........................................................... ProposedUse ......... ............................ ......... . ...................................................................................... T p T Zoning District ...:.:...... ... _..:............. ... .....................Fire District ...................�Py, S Name c Owner R,.... ....��. �a..?!>��Y•.° .............Address ..,.J. ..... rj.... ....... . .. j/........ me of Builder .�.�.....i�prY.-I � 1. Address ...���rrY►:!�!•p,w� �/�[/ �'�Na f '�.5.� .... ..... Name%f Architect ......................—:4......................................Address .................................................................................... e Number of Roo+s ........-.•......... ............................................Foundation .......... .a�1r c..JC C,xa '. ....f........ Exterior ......6v...f a Y d ....... �.........................Roofng // Floors `. PC f �' .4 ................................I................ W............_... ........:...._........:........................Interior .......... Heating ..i --':�� ........................................................Plumbing ..............:� . -:..�..... ............................ ........:.... Fireplace ........................................... ... ..........................Approximate. Cost .................... 0 ................ ..I. ............ Definitive Plan Approved by Planning Board --------------------------------19__)-__--. Area .....c.?.? ,..........:........... Diagram of Lot and Building with Dimensions Fee Q� ........ ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH - ` t . l 6- 1 l y S . 71 410 i ` y- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby"r`ee to conform to all the Rules and Regulations of the Town of Barnstable regarding the above constructrOn. Name � r, .. .?: .:�,. ..... .............................. Ab �Construction Supervisor's License .....®_............60..... ............ L � � Cameron, Cdleta A=189-35 No ..... Permit for ....cl t9.AW911!.r4E,' ................... ....... Location .......... ................. ............ ....... .................... Owner ............Cdleta...CalPer.M....-., ........... Type of Construction ...... .....frame.................... ...............................................................I.I.................. Plot ............................ Lot ................................ ZZ Permit Granted ...........March 28 ........ 84 ...................... 9 Date of Inspection .....19 Date Completed .....................................:19 �.f't• - ti .. F �, - ^ •� r r � Y t' ;.Y. �1 V - q .�Fr�:r f. 1 sYi. 1/ Asses`sor.'s map:and,lot numbe . .:r .. �: ..1. . . . . � I pF'T E ter 7 ' i6 l:wage Permit number ..................... ��Q�s ♦� louse number .. ............................................ ? +� 639 ♦� n o DmoA, TOWN OF .RARNSTABLE ij BUILDIH=G 1NSPECTORJ r -APPLICATION-FOR PERMIT TO TYPE' OF CONSTRUCTION .. 41:.!...�:'...° ... ,., ......... .................... ......................19........ TO THE INSPECTOR OF BUILDINGS: -- ; The undersigned hereby applies for a permit according -tto the following.information: Location .....i�..�.(':.. .. 9 ?. ...... .... ...... t'. '�.Y..�'.!.:f I -e ............. ..... ProposedUse .........3: . ........................................................ .... .......... ,......................:.................. Zoning District ....... e.� ..Fire' District .................................................... ........... .... Name of Owner. #.(.fT. !*.-.4a...... ...019.:e�n.............Address .41 4... �............C.16.A. .......... Name of Builder .�:E':�'),....h e'^�r.J.... Address ....�?Y. Y1.+�t.�.�:.Fl.. . !.C.... .L"��:.'� Name of Architect` ............................... ................. ddress .. . ...... ......... ..... 4 Number of Rooms ...............................................:..................Foundation• ..:......:`" vv ': '...} .ti?:.Yi..Cy................:..... Exierior .................... ..............S.h. .s.,.:.................................Roofing .............. Floors �`.. r C.71.�!1 Interior ...........�..? �!'`'�r .+....... �.............. ?..... '�............ ....., ... ... .. Heating �4 � .........Plumbin l / :. 4....:................... .................. g ...............�.. -...�'.. .1 .......... Fireplace ..... ...�el.................. :.Approximate. Cost ..... f tQ ............... ........ v .... .... Definitive-Plan Approved by Planning Board ______________________________19________. AreaG.... ...................... Diagram of .Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD .OF HEALTH ; OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS - t I hereby agree to,conform to all the Rules and Regulations of the Town of Barnstable regarding the above' construction. Y -Name ... .. . f� Construction Supervisor's License ...... ..... _ Ca�neron, Cdleta All No .... 262�5Permit for .........add..t©...dwell`r1g:�;I ;. Location ............... .... .....:f.......... Centerville d-• "`'. � �: � `�_ <`� --- " � ,'� �,�.,.' �• � �'�. �� �� << ,� Owner Cdleta Cameron . ....... ......... .. .................. Type of Construction` f:rame....t ........ Yp i8r ........... .._ ......................... .............. ...... .............................. Plot ..:. .. .... .... Lot . r F March 28 84 Permit Granted ......19 ' Date of'Inspecti A,. Date 'Completed ........... Sri��/� . - t - •.ry., ' _ ,• - • �. ,,,1 } T- - ... 4/✓.