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Town of Barnstable *Permit#� 3�_
X-PRESS PERMIT Expires 6 monthsfrom issue date
MAY 2 5 2006 Regulatory Services Fee 4 Z S (Din
Thomas F.Geiler,Director
TOWN OF BARNSTABLE Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERNHT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Zap/parcel Number (3)6 9 il 2 3
rbperty Address D TA C.J J C y- _b o Cc P-V l LL 4, PA A C)ab3a
esidential Value of Work 5 96 0j Minimum fee of$25.00 for work under$6000.00
)wner's Name&Address Fe"Tz,�,
;oR ractor's Name Telephone Number
come Improvement Contractor License#(if applicable)
:onstruction Supervisor's License#(if applicable)
]Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
am the Homeowner
❑ I have Worker's Compensation Insurance
nsurance Company Name �b6' �`1' L co
Vorkman's Camp.Policy#
:opy of Insurance Compliance Certificate must be on file.
'ermit Request(check box) s
Re-roof(stripping old shingles) All construction debris will be taken toi
❑Re-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 t sign Property Owner Letter of Permission.
Ho vement Co tract s 'tense is required.
SIGNATURE:
Q:Forms:expmtrg
Revise071405
Town of Barnstable
Regulatory Services
ST Six
9 XA�, $ Thomas F.Geiler,Director
Building Division.
j°TEpMy,`l► �
Tom Perry, Building Commissioner
200 Main Street, Fiyaunis,MA b2601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section.
If Using A Builder
as.Owner.of the subject property
x hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Address of Job)
2 S of
S' nature of Owner ate
Print Name
QTORM&owxERPERMISSinrt
Assessor's 'map` and .lot 'number .... ... ....,.....:.. `" ; '
0,14
/�c=vvwe
Sewage Permit number ............!�.a:... .Eu!�isGr�NSTq�� SYST�/�
sq Tjy gRFO / C BUST
y�F'THE r0�y _ TOWN ' OF, B A R N S T yt�' //°M'°zi lv
eF
6
M39. . .BUFLDING INSPECTOR "
i6 \�0
:F APPLICATION FOR PERMIT TO. .. ..i ..l:.� ......:--?.:.!.K� (f�l!1..�N ......1 d................................................
TYPE OF CONSTRUCTION ........... ... N U ..........................................
.�..................19...7f�
TO THE INSPECTOR OF BUILDINGS:
The, undersigned hereby applies Jfor a per�a.r
it according to the following information:
�0........SA C./.]. ..... ...............................................................................Location ........... ... ......................................
ProposedUse ........... .!. 'l.!N. ............oAL..............f�..,,.X..3..........................................................................
ZoningDistrict ...................Fire District ..............................................................................
Name of Owner ....�/.d/U.E ....6!'!�AJ Q.(�S ....Address. S�i�C�.........................................................
��ss
\,Name of Builder
I\ 14. ... �N/n/ `( l" Address ....... . . CA r S. )Pd
:1................... ........... ......................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ...............................:..................................Foundation .......... .........................................
Exierior ...Roofing ..............
Floors ......................................................................................Interior ..............................................:.....................................
Heating ..................................................................................Plumbing ................../. ............................................................
0 6)4 r OO
Fireplace ..................................................................................Approximate Cost ........................................................................
Definitive Plan Approved by Planning Board ________________________________19________. Area .............a. .......
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF B ARD OF HEALTH-®
Uel
"� Q
6�
No
� �5 P
c>20 r �00
i
C�°�5
190
t
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the Qbove
construction. (� ,` D
Name ..!!..^i J /2 a�iUC...(Jc'T�.
Mancovsky, Sidney
18331 swi in pool
No ................. Permr or ................ ...... ............
..............I......... ..................... .................
', 90 Sachem Drive
Location .................................................................
. ..Vi-no.. .............
Centerville ,_r
...............................................................................
Sidney Mancovsky
Owner ....................................................
Type of Construction ..................... .....................
................................................................................
Plot ..... Lot ...........I.....................
0—
April 22 76
Permit Granted ........................................?19
Date of Inspection ......./....... ................... 9,
.........Date. Completed 19
z
PERMIT REFUSED U)
.......................... ............................... ..... 19
............................................................................... zo
......................... .................... .............. 5..... ............... . ..,. r
10
..... ............................................
rV
...........................................................................
4n
L
Approved'- 19
......................... .....................................................
............... ...... ...............................................
IL
t 2 0? -7s
yofTNEro�4 TOWN OF BARNSTABLE
BARNSTABLE,1639- i
a CFO NO '
BUILDING INSPECTOR
M 6
APPLICATION FOR PERMIT TO .. . ................. ............. ..... . ......... ...... .................. ........... ...................
TYPE OF CONSTRUCTION ... .... ........ ... ... . .. . .............. .........................................
...Ar'fau.... �..................197
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit accordi\n�g' to the following information:
Location .0.j. .......... ........ t, .�rY Y�.Imo.......................
Proposed Use 11`...... .
ZoningDistrict � l Fire District1 � — �
....... ............................... ..................
4*
Name of Owner. �`4 .>.. ��:U. `m .Address .J.�a.�� k.�i� �-vT- �-`?I�Y� oiLL
Name of Builder1.tC.. U � ,(�1.�p-��`d1Address
Nameof Architect ..................................................................Address ..........................................................,......................,..
it
Number of Rooms ...... ................................ i
1 .........................Foundation .AD.........�a.wt�.1�-�....... ..C?tt�?�j�, s�...
Exterior .... .. Y r`` .�1(f°�Lc�
��.�i�..6..............................................................Roofing .. ....�7. .............................................................
Floors ............1.........................................................................Interior ��.T.IN' L:L-...................
....... ....................
Heating c .a.......14.1........1��.?! . ..............Plumbing ... 1���� ..:...... ... 1 .
Fireplace ..... ....................................................................Approximate Cost ....GO., .C:?. ...........................
Definitive Plan Approved by Planning Board ------------___-__-----------19--------. G`j
Diagram of Lot and Building with Dimensions
a
SUBJECT TO APPROVAL OF BOARD OF HEALTH
liT
Lei, 0 m
o
W New z
(D o .m: o
Cr
u. o
L .i.. p o (j), .
0V) < Z w
m"O �� � m ; w �
ao � Z oZ
q } d wH �V
I-- d Z ¢ 06 h
� Q
I herebyagree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
9 9 9 9
construction.
Name ..
Nancovsky Sidney R.
S,
14963 Permit f one -story
............. e or ....................................
G single family dwelling
ng
........... ..........................................
Location ��Fm Drive
..........................................
Centerville
...............................................................................
Owner Sidney R. Mancovsky
Type of Construction ............frame..............................
................................................................................
Plot .....................:%..... Lot ................................
Permit Granted .....April 20 19 72
Date of Inspection
".0....... .....4......
Date Completed ... ....19
PERMIT REFUSED
................................................................ 19
...............................................................................
...............................................................................
................................................................................
................................................................................
Approved ................................................. 19
...............................................................................
...............................................................................
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PLOT RLA N OF LAND
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FOR �
,� ('`� S'C'A,1��3 C�;'T . O��" "4=�� {'.'�t,.g E•i�rt''r�S --..�`F�l. t�ti'';`f 1, �'�� ^��� ��,�" ` _ - ,
0Q, T-9\S i7-1vDRAWN
ACC BY SCALE : 4 W 7
1-l4�211.. CCo kq_12
CHECKED BY DATE :
CHARLE S N. SAVERY INC .
f
'REGISTERED
CIVIL;ENGINEERS a LAND SURVEYORS
H,YAN NI S, a SOUTH' YARMOUTH
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