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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map M Parcel V T TOWN OF BARN STABLE Application
S
Health'Division Date Issued S h l6 AM
�'S
Conservation Division Application Fee
Planning Dept. .Permit Fee R95 -
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address
Village CC� c• „��I�
Owner �• 1.,,� Address s.n�
Telephone
Permit Request \0,Jt4V" J.._ }_�� ccl��1%
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 Gl/ 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 Mike McCarthy Construction Telephone Number
P® Box 52
Address West Dennis, MA 02670 License #
Cell (508) 280-6964
('S ,-58633 HIC-169393 Home Improvement Contractor#
Email Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE .
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
bP
rir
FRAME
-F INSULATION
s
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
z
GAS: ROUGH FINAL
FINAL BUILDING
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DATE CLOSED OUT
T
ASSOCIATION PLAN NO.
Town of Barnstable
Reg latory Services
ASS •Riffiw-d''V,scab,Director
.. �� 'Building hzsion
Tom Perry,Building Commissioner
24o Maio Street;I yannis,A�L'A 026M
�v�r'�v:totvn.taarnst�iiena.us
Office: 50.8-862-4038 Far.: 509-794-6bO
Property. Gamer Must
Coxwlctc,wid Sjgx phis Scc-ion
If Usin, o B lde
A f G J-" ,Z, .. as C?amer,of tlae subject p�,r�pexty
he xebp authorize ' SJ C> ' .: co acc on my behalf,
in all matters irehatim to xmrkauthoi 3*:this.bading permit:afiplicauon for.,
63
x"Pooffences and alarms are the rrespons bislny:af`the'applicatit. Pbdlt
are not!.to be'Oed orutil zed-before fence is iBsta ec auc ate f.i:iial
pectin are pufcirmed.and accepted.
V.
Signa o rter °Signature of.Aopbcant
AA H K UZ
i '� not Name Paint'Nanie
AD
Date.
Q,FORMS:01W J.LPMUSSIONFOOI..S
l sLoy
Town of Barnstable *Permit# �Os? •
pRM �rim, a date
&MUMAMM _ Regulatory Services Fee ,
Thomas F.Geiler,Director NOV O 8 2
Building Division ABLE
Tom Perry, Building Commissioner TOWN OF BARNST
200 Main Street, Hyannis,MA 02601
Office: 508-8624038
Faxi 508-790-6230
EXPRESS PEPWr APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X Press Imprint
lap/parcel Number 001 r
roperty Address Owl i 1x) Y I/ co�%IAt'j. A
Residential Value of Work I DIR Minimum fee of•$25.00 for work under$6000.00
►wner's Name&Address �1
N" Put— m MA
:ontractor's Name ` 6. f l`�,I Telephone Number�Q
tome Improvement Contiactor License#(if applicable),_ � �
;onstruction Supervisor's License#(if applicable) LS 0
Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor _
am the Homeowner ✓6,�' --
a � n /�
I have Worker's Compensation Insurance � awl
(�n d Board of of ,
zurance Company Name l;/ v C-$�L/ r HpM R�,E IIW "'I"ons and Stan.
a V'EM
Registral�o ENTCONTRACTC.
�orkman's Comp.Policy# �'" � Ex fi -,132282
zi
p�rat�®Tt 1 /21/2004
opy of Insurance Compliance Certificate must be on file. K.P.
� Q¢A;
REMO'DELIN� a
ermit Request(check box) KENNE7'H P' RRYt
19 GUILDFORD RD
❑ Re-roof(stripping old shingles) All construction debris will betaken to:.. Centerville,
1W _
A 0263'2
❑Re-roof(not stripping. Going over existing layers of roof) ,_ Administrator
Re-side ---
Replacement Windows. U Value ( ,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.
Home Improvement Contr rs License is req ' ed.
ignature
Torms:expmtrg
vAse063004
c
F,�+E Town of Barnstable
o �
do
Regulatory Services
' &ONSTABIS, ' Thomas F.Geller,Director
Building Division
QED MA'S p •
Tom Perry, Building Commissioner
200 Main Street, Iiyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I �604911 QJ ,as Owner of the subject property
hereby authorize. fAimaC,1�� 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
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