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Home My WebLink About1025 OLD STAGE ROAD Y r,fj' ., a .4 .,- .,X� -.. e, ;�_,.. - •ev F;�.} a p �. �� c �•� a„�4 "" ,�F K:. �, �� t��. '' �.y- �3.. .�.,�{,..o ►'-be g. . C e - n , 0 " o _ e � a ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION / ,o Map 1791 Parcel TO'�1� �� T�� Application � f Health Division Zopq JUL 1'8 AM 2- 29 Date Issued / Conservation Division Application Fee 50 DD Planning Dept. Permit Fee lf✓2 Date Definitive Plan Approved by Planning Board DIVISION Historic - OKH _ Preservation / Hyannis Project Street Address �®005 Village , 1� Owner L'01$�Aft)M Address ytltbs CI)i rb cl� M)kkl`j Telephone &7M Q361 It\pt CIA3� Permit Request M' l7 , i tfit 'GA Cep T elw a two �mm% cz.)W, Ao Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board'of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) "- Name �� Pt • �� `) Telephone Number Address R,� yF�%CYr c/ylb fow�\Yj License # Home Improvement Contractor# I Email e_{XC-r-ie(_cGU�c ft�� . YAQJ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY i APPLICATION# "DATE-ISSUED `MAP-,/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r :t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL a FWAL.B.UILDING DATE QLOS,ED;OUT A86OCIATION PLAN NO. .._._ cs crs c� NO �' F EAS11146 PROPOSAL- Ul�l f }. r w Cammonnwalth of?1arssachusetfs Departq�t of ladm3ftial Accidents Office off-rMlesagafie"s 60.0 Wa hru7gttrn.S`treet Boston,1 02111 r WFLI 111aS&gf dia Workers' Compensation Insm-;mce ffidav&$tinders(Contractors/FlectricianMumbers Aptpiicagt Iuformafiun �(� Please Print,LeeibW mes Na (S„sux�.asldrpnim ion&&vi(nal): ' ``�V�� " �C, Cyszip VN�� 1Q`�3��= Are you an.emplol ern 0i ck.the apprDpriate box: _ Type a# a'ect r Hire - - - --- - - _. _.. 1.❑ I am a employer with 4. I an.s general contractor and 1 6- Near construction employees(full andlorpart time)* vehiredthe su�onbmctors. 2_❑ listed an t I am a sale proprietor or partner- � the attached sheet; �- ❑IZemodeliug ship and hatre no emplayees snla contractors have g_ ❑Demolition, suod=g for me in any capacitir employees.a have workers' r 9- Building addition [o workers.comp.insurance comp_nisu'ance �_❑ We are a coiporafiaaand its 10-0 Electrical repairs or additions WIM homeowner doing all ward: officers have aucised their 11-0 Plumbing repairs or additions oWorl�rs' right ofC�M ioa per MGL 12�Roafrepaim myself[Ne.152, 1(4} and we have,no- ins insurance required-]1! 13.0 Outer employees_[No Wcakers' comp-insmince required,] "�3`aPP�t-tut ched:s trox�l mast also fll out t�sectioa below shnwiag ihea wakes'coz�ensstioa ptrlicy iaf�rma6ia� �Hnmeo•wners vrho submit this affidavit indicstiag ter Y aze doing s1I rr�sad then him o-utside contiactnrs�sY satimlt a aces ai�darit mei3cssn'sur5- �vsctnrs ttist check this box mast sttaclied sa adLitianal sheet shosciag the name of See sub- and state whether ocnat fr�nse eaiities fi� � �pluyees.. If the sn7a-caattacfurs Izare eanpIc�ee�the}Est provide their warkess'comp.palicp maaher_ .I cum aR empLv}}er#hrrtisprouidirrg rtrnrkers'ratt�ertsrrhvn utsrurarrtce far rrr}*RtngFal:ees. B�otr is the panic}and fob life uz}or�nation. � . Insurance Company Name: Expiration Date: . Policy;9 orSelf ins.Lim 4: � % �i Job Sttte Address- x Citylstatelzip: ' Attach a tppy of the workers'compensation policy dedaration gaga:(showing the policy number And elation date). Failure to secure coverage as req iredunder Section 2.5A of MGL L 152 can lead to the imposition of aiminal penaiiies of a fine up to$1,500.00 andlor one year impnsoument,as Weil as civil in the.four of a STOP WORK ORDER and a fine ofup to$250.00 a day against tile:violator. Be advised tiffit a copy of this statement may be forwarded to the Office of Intrestigations of the DM far insurance coverage v cation- .._ .__..-.. .._._ . ..__ ......_ . - ._. . .... .. ... ........... .--- - ._-_ _. .. . . I do hEereEilr a under the irs atr Pena so. thatf$e irz otwildianprat2ded abm c iss Into and correct Date: V� V S.itnratuze: Phone 9: (7jfccz.aI use urt£y. Eta not write in fibs area,to bs completed by Gii�or fawn of�ciat I Cite or Town:. PermitlUcense 9 Issuing Authority(circle one): 1.Board of Health- 2.Building Department 3.CitylTown Clerk 4.Electrical Inspector 5.Pluurbing Inspector 6.Other Contact Person: Phone#- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provi workers'compensation for their employees. Pursuantto this statute,an employee is defined as".._every person in service of another under any contract of hire, express or imp h oral or written_" An employer is de as"an individual,partnership,association,. orporation or other legal entity,or any two or more of the foregoing eng in a joint enterprise,and including the 1 representatives of a deceased employer;or the receiver or trustee of an dividual,partnership,association or o er legal entity,employing employees. However the owner of a dwelling house ving not more than three apartm and who resides therein,or the occupant of the dwelling house of another employs persons to do mainten ce, construction or repair work on such dwelling house or on the grounds or building a urtenant thereto shall not bee use of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also ` s that"every state or Io I licensing agency shall withhold the issuance or renewal of a license or permit too rate a business or to onstruct buildings in the commonwealth for ally applicant who has not produced acc 4ble evidence of c rapliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7 tes"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance fpublic work tiI acceptable evidence of compliance with the insirrancE requirements of this chapter have been prese ed to the con sting authority" Applicants Please fill out the workers' compensation affidavit c in le ly,by checking the boxes that apply to your situ.aition and,if necessary,supply sub-contractors)name(s),address(e phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC) or Limit iability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' co ensation insurance. If an LLC or LLP does have employees, a policy is required Be advised that this affida may be submitted to the Depa�spent of Industrial Accidents for confirmation of insurance coverage. Also b su e to sign and date the a a-davit. The affidavit shoulld be retumed to the city or town that the application for the it r license is being requested,not the Department of Industrial Accidents. Should you have any questions re gar g th aw or if you are required to obtailn a workers' compensation policy,please call the Department at the n ber list below. Sell 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 Ie bly. The Dep ent has provided a space at the bottom of the affidavit for you to fill out in the event the Office o Investigations has'o contact you regarding the applicant_ Please be sure to fill in the permit/license number which - be used as a refer'` ce number. In addition,an applicant that must submit multiple peimitgicense applications in y given year,need o submit one affidavit indicating current policy information (if necessary) and under"Job Site Ad ss"the applicant sho d write"all locations in (city or town)."A copy of the affidavit that has been officially ped or marked by the ci or town may be provided to the applicant as proof that a valid affidavit is on file for futuz permits or licenses. A ne affidavit must be filled out each year.Where a home owner or citizen is obtaining a lice or permit not related to an business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said peas n is NOT required to complet this affidavit; The Office of Investigations would like to thank you in vane for your cooperation and s ould you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. n�. Commonwean of Massachusetts DEpat9_ineut of 1ndustdal Aocidtnts Office oI.Mvest?gations 600 Washingtan Street BGston=MA 02111 Td.iu 617-727-49-00 W 406 or 1-a I AS 'E Revised 4-24-07 Fax# 61 '27-T749 WWW_mas&gov/dia 17ze Conr;<r 6infwkh o,f Massaehms De�tine�t of liuk a l Accidents - - (KWi of_rnvestigrfians 600 Waykington Street Rosfar�,MA 02 U1 -'` YVFkr}7?71ifIS�.go'F3lf�rL� Workers' Compensationlnsurance Affidavit:Builders/Contra:cturslF-Iectricians{Plumbers � s AppEcant Infarmation r"pease Print IxVbfy Name 03u6vm1 . nip tionffi dividua0: CitylStat&Zip_ `N�l l� Phone47 Are you an employer? Check the appropriate bow i J�� T.. `of ect r d- 4- ❑ I am a general contractor and I Y ° egnare - 1.El I am a employer with6_ ❑ �nn New s.auc#ioa employees{full andlorpart time * listed havehrr the sulr�autEactoEs. VonI am a sole proprietor or partner the attached sheet ❑Rent odeling strip and haze no employees These sub-contractors have g- ❑Denwl'tion w for in an capacity. emplayts anal have workers' orking Y 1 9_ ❑Building addition comp-insurance_ o urorkers' comp_insurance �l3 f reT�ired-j 5-. We are a corporation and its 14_[]Electrical repairs or additions 3-❑ I am a horneo Amer doing all workoffisa��= h exercised their 1 J_❑Plumbing repairs or;3:6d LkM myself o workers, right.of exmption per MGL 12_. hoof � �P- ❑ repasrs insurance required_]1 c_152,§1(4),and we have,no empl y'ees-[Na workers' 1 -❑Other comp<m=-ante requlretl_J *Amy sppUcant dhat checks box'1 must also i411 ovi the sectian below showing dhek taa&en'condensation policy in ffirmx zsr_ i Homeowners Who submit this affidavit inrr cst ng they ase doing zdi osic anal them ling outside couttactors um-st submit a new afdxs st ru ic:�sra- *Contractors tUst check this box must attached an additions)sheet shxms—the name off the sate-ems and state uhetLer ornat these atiFies nave empluyges_ If the mla-contmctom have empIoyees,the}must pwaf&their workers'comp.policy ntanber_ .Tate art employer That is prm idittg itrorkers'coniimrmilion irmirar€ce for my.emplgyesu Detots is thepoli4?and job site information_ f Insurance C<'ompanyName: t' Policy 9 or Self ins_Uc-4: 1 Expiration Date: i --- Job Site Address: o� `� 1;l'� `�� ' Cib"St wzip: c Attach a copy of the tsorkers'compensation polky dediration page(showing the policy number and elation date). Failure to secure coverage as mqi i�,mdes Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a fine up to$1,500Q00 andlor one-year impns .as well as cnrii penalties in the form of a STOP WORK ORDER and a Ene of up.to$250-00 a.day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Im,ewtigations of Vae DIA for inset-anciY coverage verification_ I do hereb}r certi under th Reans and penatt ofp ury that the ire formation prat2dc�d abrrsre�ja 6zca}anrf correct Sienatuie.: .Bate- "� + 1 r Phone 9: (3ffrc,at use only. Do not twits in tFus arre,to be complet6d by cbfv or town offi'c&L City or Town: Pm..:nitUcense# Issuing Authority(drde one): 1.Board of Health 2.Binding Ilepartmeut I Citvffawn Clerk 4.Electrical Inspector 5.Plumbing Iu-,zp--.ctor 6.O4her Contact Person: Phone 9: 6 Information and stfuctions Massachusetts General Laws chapter 152 requires all employers t provide workers'compensation for their employees. Pursuantto this statute, an ernployee is defined as"...every perso in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,associati corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the egal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or o er legal entity,employing employees. However the owner of a dwelling house having not more than three aparfm and who resides therein, or the occupant of the dwelling house of another o employs persons to do maiaten ce,construction or repair work on such dweIling house or on the grounds or building a urtenaut thereto shall not beca e of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also state at"every state or Io licensing agency shall withhold the issuance or renewal of a license or permit to opera a business or to coi struct buildings in the coramonFvealth for aiay applicant who has not produced accepta e evidence of com liance with the insurance.coverage required." Additionally, MGL chapter 152, §25C(7)sta s"Neither the co onwealth nor any of its political subdivisions shall enter into any contract for the performance of blic work until acceptable evidence of compliance , I'L the insurance requirements of this chapter have been present o the coatradimg authority-" Applicants a Please fill out the workers' compensation affidavit co Ietely, y checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses and ph e number(s)along with their c:eri-uca c-(s)of insurance. Limited Liability Companies(LLC)or Limit "LiabAty Partnerships(L LP)witlrno en:; loyees other than the members or partners,are not required to carry workers' co ens t'on insurance_ If an LLC or LLP does have employees, a policy is required_ Be advised that this affidavi be submitted to the Depa nent of industrial Accidents for confirmation of ias urance.coverage. Also be su e o sign and date the af5d2N:t. 11e of davit should be retumed to the city or town that the application for the permit license is being requested not the Department of Industrial Accidents. Should you have any questions regarding i3s law or if you are required to obt:im a workers' compensation policy,please call the Department at the number 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. Th Dep ent has provided a space at- 'Jac bottom of the affidavit for you to fill out in the event the Office of Investig 'ons has o contact you regarding the applicant. Please be sure to fill in the permit/license number which will be us as a refer cc number. In ad:di doa,an.applicant that must submit multiple permitllicense applications in any given ye. ,need o submit one afj-davit indicating current policy information (if necessary)and under"Job Site Address"the licant sho write"all locations in {city or town)."A copy of the affidavit that has been officially stamped or m ed by the ci or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or censes. A ne affidavit mist be filled out each year.Where a home owner or citizen is obtaining a license or permit n t related to an business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT r ed to comple this af�da�-it_ The Office of Investigations would Ilse to thank you in advance for yo cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. 1 he Conamonwpan of Massausetts Department cif liidustrial Acci. eats office of lavestintFans 6 40 Washingtan Sit Boston,MA 02111 Tel.A 617 727-4900 W 406 or 1-97-1 MASSAFE Revised 4-24-07 Fax A 617-727-7-749 www.iaas,5-go-ddia Town of Barnstable Regulatory Services b w THE roiyy Richard V.Scali,Director Building Division IAUiSTABLF� Tom Perry,Building Commissioner nrns& yob i639• �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us b Office: 508-862-4038. Fax: 508-790-6230 ROMEOWNER LICENSE EXEWTION DATE: \ Q �nn��-,,��!! JOB LOCATION: 3Qa5 �� ?OUV WQ 10 number r ' street village q ..HOMEOWNER':�-j `��CJm q '1'1��1,�;�I lL�_�l - name home phone# p,►'' work phone# CURRENT MAILING ADDRESS: city/town stare 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. DEFWITION OFHOMEOWNER 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- farmly 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) • r<` i 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, pro dures d r quirem)ents ana that htlshe will comply with said procedures and requirements. t gna,u 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. i 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 Iast 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:\WPFILES\FORMS\building permit formslEXPRESS.doc Revised 061313 � +ET � Town of Barnstable Regulatory Services 9BARNSTABMg` Richard V.Scali,Director i639' �� ATE1639. 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 roperty Owner M t Comp e and Sign T Section If LYAB er I, Owner of the subject property hereby authorize to act y behalf, in all matters relative to work authorized by this 'ding permit lication for. (Address of Job "Pool fences and alarms are the resp ibility of the applicant. Poo are not to be filled or utilized befor fence is installed and all final inspections are performed and acce ted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM S:OwNERPERMISSI0NP00IS Of tME Tp�_ 1UWLL Ui ]JQluv: Expires 6 Inonrbt%rom issue aac Fee :AfiLNffrAZLr—J .; Regulatory Services � & `ee*61 Thomas F.Geiler,Director plFO MAi J%v v Building Division �.eN Peter F.DIMatteo, Building Commissioner A, tj � 367 Main street, HYamis.MA 02601w l-O Q� Office: 508-862--:1)38 Cfi Fax: 508-790-621-0 EXPRESS PERMIT ;PPLICaTION - RESME11MAL 0AY Not Valid without Red X-Prm,[NPrurt flap:parcel`lumber 1 Property Address iResidential Value flf Work ��O D O Owner's Name 8:address Contractors Name �?l' L Telephone Number Home Improvement Contractor license (if applicable) S Cons on supervisor's License=(if applicable) + ' ,It Workman's Compensation Insurance Ik one: ata a sole proprietor rI am the Homeonner have Worker's Compensarion Insurance Insurance Company Name GCC� Workman's Comp.Polio• 3 Permit Requ t'check box) Re.roof(stripping old shingles)_ Re-roof(not sttippins. Going over existiag"Yens ofroof) �Re-side 44 yReplacement W indo%rs. U-Value ( ) [Q other(specifti) N *Where required: Issuance of this permit does not exempt cort:piiaaee with other town depantttent reguiations.i.e.Historic.Consen ation :=• ^ Signature Q:Fornu:eaamir'r:ra�+t%06U I , THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I m /,\ '�G�"- LI DATA Assessor's map and lot number ......j..lp�.'..�4�. .......... �Pypf TH E Sewage Permit number ........ f1.... l./................. � t /i1 �� Z BAHd9TADLL, i Hoyise number ..................../:.(J.. ...................... , rasa ape,t639. b 'Ea MAI d, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO S .. ..... . TYPE OF CONSTRUCTION ............ .. ........................... .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the llowing information: Location lQs-�- .Q ..... .. SC.,.T ...4�,ir>. �/.�?1 . .t .s�: t3 a'......... ..........d ProposedUse ............................................................................................................................................................................. Zoning District ........................................................................Fire District -'Jif....................... Name of Owner �at-q-k. La,,,e...................................Address t� � .1 ^:.:... .. . .5,... .. ....,�.1~.41�. .�1!Vir.�� ( t� Nameof Builder" ..............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .......... ...............................................Foundation ..................... ....................................................... Exterior .. Y.......... ..... !I. ...............Roofing ......... Floors -....................................................Interior ............. //.t.� ..... Heating ........ ... ..:.........:.......................................................Plumbing .... .. .. ... ......1.... .......................................... Fireplace ...........7:777=..........................................................Approximate Cost ........�ti..J.. ....... ........................ Definitive Plan Approved b Planning Board ____________:—___.__________19_______. Area . .. ....... . ... pp Y 9 D� 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 o5TT..te ga ing the above construction. / Name✓.............................. ....... ................................... McLANE, SCOTT 4 4'Q BUILD DORMER No ... Permit for .................................... Single Family Dwelling ................................................................................ 1025 Old Stage Road Location ................................................................ Centerville ............................................................................... Owner ......Scott McLane /054 ............................................................ Frame . Type of Construction ................................. ........ ................................................................................ t-01 �Plot:-�•............................ Lot .................. ......... October ' 27, - 82 Permit Granted ...................................; 19 , Date of Inspection .....................................19:.* Date-Completed ....... ................ 719 5L 4e 147 /� assessors map and lot number ......1.Z!627.1160..... + SEPTIC SYSTEM MUST BE C, INSTALLED IN COMPLIANCE �, CO :"�� a2% 7 WITH 11 STATE Sewage�Perm�t number ......... ..................... ......................... H ARTI:'I E SANITARY CODE ARID TOWN s"Er°�° - TOWN- OF ABARN-STABLE o 3A,,STASLE. J9°ova aYa�� BUI'LI) IINGsI INSPECTOR CI`'j. rr APPLICATION FORT PERMIT TO ....al.. 45 .... ./........ ...... ....................................................... TYPEOF CONSTRUCTION .<r '.®�.. ....................................................... ......... .............................. ...... s ................................................19........ TO THE.INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information- Location ... '' ......�®� �� ............ ................tr'-�4�, !t.r .1.. ...... �..................... ..... ProposedUse .......!;f�.... �.........��............... ....................................................................................... ZoningDistrict �Q�+ .........1L a,......................... ........... ............Fire District ..G�1�s!'i..�....��?r. !`�wi` ..y............. Name of Owner ..... c! .kk.... .............. ....................Address . Nameof Builder ............... l�.r. . .......................................Address .........................1 ............................ Nameof Architect ......................a�-...................................Address .................................................................................... Number of Rooms ........yT .............................................:.....Foundation ...��.G� �'� '�. 2.. .............. Exterior ..�..... 1.- .�...... . .....:P........ .................Roofing ...... ,� :``. .......................................... Floors .....Oq4�. . .Interior ...... .. Heating ...............:...........Plumbing .......... �..... /.. ........................ Fireplace ................./�.G?......................................................Approximate Cost ............/"..�..�. � .............................. Definitive Plan Approved by Planning Board ________________________________19________. Area �� s Diagram of Lot and Building with Dimensions Fee �3'a� . ....................... ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Tow of Barnstable//a the above construction. Name .... ....... _ _---_" Douglas_ W. . . ' ^ ' » �u290 � l�� __. . .� . | ^ minola family � ------.--.--,^�-'. --.-. � ' � \ � ° l�� 8�s�� Road... �a� - , Loco!on ---._�_------.^--------. ' Centerville ' \ .--..'-----.-----------------.. . . ' Douglas W. I�ebml \ - � ( Ow --------~-.�----.------.. frame . . Type of Construction ..... --_--------.. . . ............................................................ . { . #105 . � ^ Plot ............................ Lot ................................ Permit Granted ^��x�� .lg �8 ' ---. .. -'—'-.. ' � Do^o of Inspection -- ' - . -. ----]q oote completed ` . . . - PERMIT REFUSED .-.-, ---..--... l9 ' � ...................... . ^ ` ` . ' .............. , _. . ,.�x�fi�� _... � --' / . ' -:�� *��:/4��/n-,, .-'-'--- ` '--'r---' ' ^-' � /\/q-, --�..�-..-..��-�.�--,--~---...~'...~'- ' i ' Approved lQ � ---------------- . . ' ---------------~...--�-.....--.. ` ^ -----------'--'-----`-~~-^^^'^ ' � . | . ~ � TOWN OF BARNSTABLE r02 y`,�•o Permit No. -- Building Inspector »aliT�l6 Cash --- ♦�Ow 'rOVA(�\ OCCUPANCY PERMIT Bond _____ X 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 .)ouglas W. LebP1 Address BOX 164. Marston8 M1.1 1 s 1 to #1 n5 1 tJ ulu luau, Centem, .E-_i.L / f Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department �! 7ia �,;✓i ..r 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. 19............ .................................................D............................................................ Building* Inspector t� 4 it bo I.fit U f 9DG 4 a d �r ld5 �9�t c5,o2� ' RICH A. M, CSQTIFtED pi..bT PL /->1—i to ATIO" �,E4•iT1~R»�/tt.�.t l G6LZT1 F Y T"A-r TNT. 1-lE{ZEo� GoNLPLIIS / WC) SET13AC-4 REQUt�E+t�i=i-1TS OF TNT �[ow REGiStC.jZGT> 'A "`�'!_#t� C7 LA t•.J t S L.l OT - '�yA.S E't' vw.� A.�1-- - ost�.�vc�,.1.� o A1tAsS• itrs-�cJ�tnEtJT SUC'de`f �-TNT oF�S�C'S SI-1GLJl.a APc�'t_t GA►�.tT �i�t k�tC�t3 Cr ►�U,r- R� usc-o TU t.oT Liti1CS