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0019 SHUBAEL GORHAM ROAD
, ,..; � 4-.;. i� •�� tar ! c. _y d, �x.., :�f�.�;.'� � `'�' �r 4 - � 1 AAr�t j� s �:'{r i`C� �,yCr�. ,,F. .- r '.i.•'ire � R3�7:, -R. �;� i ��' #f 11''t!1�"", fs' - � n J ��`L Y ti3 r r 4 i �� 1 ,s P E �� �� � � i � � k S d����E�"� t, V � F � � �' (((/// 7 7 � l��s(((////// fI c �� � z � —. ._ , , TH`r�.e Permit No- ----- TOWN OF BARNSTABLE 20812 -- - --------------------- Building Inspector G 1Aal7TAU Cash _W4.00 o raT-'� OCCUPANCY PERMIT Bond ----_---_-------_-_---_------ "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 Alan Small Address Centerville lot #133 19 Shubael Gortfam Road Wiring Inspector Inspection date f� �L..- G• •- {- fps. �. �. Plumbing Inspector � Inspection date Gas Inspector Inspection date Engineering Department - 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. ................... . ............ ........... .......•..........................,............................................................................... Building Inspector S sessor's map and lot number .............. SEPTIC SYSTEM MUST Bt oFYMEro L _ INSTALLEDL�COMPLIANCE �Q v Sewage Permit nu er ........................................................ r d ,► WITH ARTICLE:-II STATE'. SANITARY CCDE AND TOW = MA"sTLBLE, House number ............ ........................................... _i . ,7 NAIL REGULATIONS. °o i639. a MAX ti TOWN OF . BARNSTAB"UrE BUILDING" I'NSPECTORN = APPLICATIONFOR PERMIT TO .......................................................................::.........................................:.......:.. TYPEOF CONSTRUCTION �-.� `=. ................................................................................,.................................................... .......................19`. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for,p permit according to the following information: Location ...4T:(...' .lr ... ..... . .... ........................................................:.................................... f ProposedUse ... ...................................................................................................................................... ZoningDistrict ........................................................................FireDistrict .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Name of Builder •..n !,....,t' ...............Address Nameof Architect ......"..............................................................Address .................................................................................... Number of Rooms :...........................................................Foundation ......L!:4 �........................................................... Exterior ...... ...:�r: "'.:.................................................Roofing ............................ ..................................................... Floors .......a!'-t'i4........................................... ....................Interior ....... !", ..................................................................... Heating .......``.....®":/..........................................................Plumbing ......................... ....:::......................................... Fireplace pp............!r�`.�':::�..............................................Approximate Cost ...........�.���..��':``.......................�. Definitive Plan Approved by Planning Board -----------_------------------19________, Area ..✓.. ....................... Diagram of Lot and Building with Dimensions Fee ...................: ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Al o v i i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - Name ...... ''r , . " - ' Small, Alan ` ^ ` . . 208I2 one story 1No ' Permit ^ ^�..—.—.. .-----.-----~ . � single family dwelling .r.�---.—_—_.-------.----.-----. . + Location ........1g..Stuuboal..Gozbain..8oad........ . ` Centerville .---.----------.---.--------.. � �l�u Small Owner --"------------.--.r---. ' � ` Type of Construction -----..frame_____. � . . -----.-------------- -..;.---.. . -. , ^ Plot --------n.� Lot �----.�[L33--' ' ' ' � . . . . 0ovemb�r l3 G ' Permit <�nonto6 ..--.. ? ' �w ~ `��^~ ��- Date of Inspection ---.. --...—.---lA . ' . . �� 19 .. � . ` ' PERMIT REFUSED � ' � ___--_—,.-------------' lV � � . - ..................................................... x / :..-----�rr=`^,..�nx��^m��=~--- ` ....---_—..^—.—....—.--.--..—.—~..—.. � ----.—..--.------...—~—.--...—., ^ - � Approved —..----------..'--- lQ � . ' . . --_—..�—�.-_-----......,---....—. ` . . ^ ` ' —..—'^-----------...--.--~....... � i Assessor's map and lot number ............. ................. ............ CFTNEtO Sewage Permit number ........................................................ 0 /�/{� Z BAUSTADLE. i House number • f 9 MAO& �p,o�2639. ♦� �O YPY a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION .......`... .............................................:............................................................................ q ...............................................19........ i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... r^ .!....:'�r./. .......:....: :..... '..... ...............................................:........:... ProposedUse ..................... .....'................................................................................................................................................ ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ..............f........ `... ..................................Address ...........`...`..`....R...::........ ................................................ Nameof Builder ..... .........................1.. ...............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... r Numberof Rooms ...................................I..............................Foundation .............................................................................. Exierior �'....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior ............:...............::....:................................................. Heating ..................................................................................Plumbing ........:......................................................................... Fireplace ..................................................................................Approximate Cost .............................::..................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ...............:.......................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ` c� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................ ..... .................................. ............... Small, Alan A=171-132 . 20812 i .. Permit for ..,.ane storY.......... o single family dwelling ........................ Location ........1g..Szubap-.1.--Gorham••Road........ Centerville ............................................................................... Owner .........Alan...Small .............................................. ` Type of Construction ..........fX.aW.e..................... ................................................................................ Plot ............................ Lot ........#133............... Permit Granted . November l3 19 78 Date of Inspection . ...................19 Date Completed ............ ....................19 PERMIT REFUSED ............ ...... ....... .. 19 /. . . ...... ............................................................................... .................................................. ......................... — Approved ................................................ 19 ............................................................................... f ............................................................................... l TOWN OF BARNSTABLE }BUILDING PERMIT rARCEL ID 171 132 GEOBASE ID 9977 .ADDRESS 19 SHUBAEL GORHAM ROAD PHONE CENTERVILLE ZIP - LOT 133 BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT CO PERMIT 43302 DESCRIPTION ADD 142 SQ. FT TO EXISTING GARAGE PERMIT TYPE BADDI TITLE BUILDING PERMIT ADDITION CONTRACTORS:_ BROWN DONALD B. Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 BOND THE CONSTRUCTION COSTS. $E,300.00 434 RESID ADD/ALT/CONV 1 PRIVATE P I STABLE, MASS. FD INI� BUILD BY DATE ISSUED 12/29/1999 EXPIRATION DATE ,JNVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- cNTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR GRADES AS WELLAS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROMTHE DEPARTMENTOF PUBLIC WORKS.THE ISSUANCE OFTHIS _AMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 RrNg 02- 0--Ui e�s t l� I-2 L (JS- - 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. -4-cK�-'e- a vy\ �(A 1 ------------- ---------- Ol -� 04/20/04 76074 76077 76079 76080 76081 76089 76090 76097 76098 04/16/04 76039 76040 76055 76058 76059 04/15/04 76023 76024 76026 76027 76028 04/14/04 75997 76010 04/13/04 75975 75977 75978 75984 75991 04/12/04 75937 75943 75944 RUN DATE 07/16/04 TIME 08:43:36 hod°• ii`� /�389 US/UbrU4 76394 76397 76398 05/04/04 76372 76377 76378 k yt 76383 05/03/04 76314 76315 76316 76320 76329 76330 76331 76335 76359 76361 76363 04/30/04 76308 76309 76310 76311 04/29/04 76275 76290 76295 76296 76301 04/28/04 76252 76254 RUN DATE 07/16/04 TIME 08:43:36 a lzevri� ��l � sQ?� ,c �aR� �r 2ooi Luc ...�yyy.�//� � ,'.2ad1 Lam{ 1`LO _ b � t � •�, ,. , ,,; ,;,�, r,':,� > ;, t i W - 11 tC '3 t '3��7 �e.P.tj 1 :'.7 l �", l I ''`r t" .f �', .. ,:�-�, F•' t y + 1 r<F,' EWV SE�nc TG'A�.iKAl- 7 USA- tOVC1 l7QL 1 fS r� 4 itJ ! `rt a T •r :� •— r 1'� �{ 1 1` .✓ '�i t+ S jii it Cf v flY' tJ;��""' 7 �ISPDSAL" PIT uSE i o©O )rlrt SWGUALL AIZE.A =;tso S.P. ���� SF °.2.5 • i 1:75 G.PD , . 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V , .. 1 • IA�1 ♦ � If r s f. r �I •, Imo` 11 f, f >VC 11.+ ° �' Qr' 'phi• T1-4 m IW ..�+AL I. `I�I'� ♦+ t �i' f r •.� ?. i..r , '}r ,Nl/i iS -fit Seph /{ 1 •v i. f.'+ Y- to 11 �, ' t' �r J t 1� s - A�9 99 ♦ Y9 -�.r a 7"S _ ` (NV' , .� ` � 3 'T�►NK � r - $ r, t�t�ci 5 t d ��'+ t�4 yii � 1�� ' htt+ ' � GQd.. ��'�j.' 0�� i f.,,�� �.j' { 1,J .. a e' ; •�� �+,_ �..1 �IJl�'',.�}S' �f� J. it}_y tl�{ tiF ,'. .,.1��� I_.z.,• JLI LpE.Q(,k•�',.,, .', -1 > `-1swa..9.? f ` j. yy �'I1�✓i`, f.t - PIT ,' .r •r f '� X a } + r ' t ••1 9 ` ;' Q• t f.-6 rk{ -.I, 1F r : w �'i` ra w�TN J i fin,, is �, 6 A ` S _,� ` t - 9 *• I� lT 1 - Kf1� 9"y tt rl I r ,. t n,. �: t 1 A w r �. r; > rt 1 r • r s y r i t f r 1 a:f� tZ WASHED, I { I' �GZ tP"'��� p d� t •'1 ' 1 Lr r L4 0 �i�°,�1..� r 1 ) J (` U/ATErty . l '�=• T!✓ ::1r1 IAT•' TNT ; C'��+.IDATIo►J Staowf,.l �r �l..A1.1 ` ` R��I`RE�:1GE {'r g r - ' , _ 'r?'N�IZ Ei bG� 'GC�v1rdPL�{5 WIT{-� T�••IE.//��S I II�1_11•••�� J. + , t � J } � ,Jt+ A1JL7 SE`t'��K �EgvIQE�tit�uTS IV� .THIti {.p"(" OwU ®F l�V_ 7TA$CG fDA'I'6 .X r REG1.5'DtR6D ; 1.AI.ID., SuZv&Yac��. ` THIS VLAW IS Uo'r 'E54.5ev ' l)1..p AU r' O57Efs:V1�LCi o AMASS/ IWS{iZC1MEt:IT gUizvM , t r ti►bT 81 'UcsC63 Y OF��,ET� 511Cw1a� APPL CA r. i"Tr,i 5+�:ItX T"• 1 - T ` 1 ' �.. ' � � ��I'+,^Y.,....��lrT-1�.J��'�Y ��.,J.f i 4 y(( r ____ '�,•..'�"7""'"•„1 . � --1 ---.••�.;...r.r,_..I_ 'e r ..'Tr !Y'A?,�i'/'yi" r._�...1.. ,_�r�„ •�.�� 'a,. .5. t,r -Arr TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Parcel Permit# 43,. Division Date Issued nservation Division Z Fee 4, j- 00 '' Tax Collector, . ` SEPTIC SYSTEM MUST BE Treasurer /�' 3 INSTALLED IN COMPLIANCE WITH TITLE 5•, Planning Dept. ENVIRONMENTAL CODE AND f../ TOWN REGULATION , Date Definitive Plan Approved by Planning Board � Historic-OKH IVO Preservation/Hyannis Project Street Address r Village AAII V /Z� Owner Address Telephone Q11171f 89 t Permit Request Ao x , S Square feet: 1 st floor: existing proposed a (,► 2nd floor: existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type d . e Lot Size ►3q Aa , Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Two.Family ❑ Multi-Family(#units) Age of Existing Structure "LI Historic House: ❑Yes •Q No On Old King's Highway: ❑Yes !9 No Basement Type: �Q Full XCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new X Half: existing y new Number of Bedrooms: existing_ new ry Total Room Count(not including baths):existing 7 new First Floor Room Count / Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other Central Air: j Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes iNo 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 A No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name 6Telephone Number 140 Address License# Home Improvement Contractor# Q Worker's Compensation# A/ 4 ALL CONSTRU TION DEBRI RESULTIN FROM THI PROJE WILL BE TAKEN TO A 444- i SIGNATURE DATE FOR OFFICIAL USE ONLY R ` PERMIT NO. - DATE ISSUED; MAP/PARCEL NO. ADDRESS *' VILLAGE -� OWNER # ; DATE OF INSPECTION '_ t FOUNDATION q / e I , FRAME V (5 L� t INSULATION FIREPLACE ELECTRICAL: ROUGH C. FINAL PLUMBING: ROUGH. ' ni f" FINAL GAS: ROB FINAL � m � }� FINAL BUILDING o - o _ tv DATE CLOSED OUT ASSOCIATION PLAN NO. P`oFTHETp�� The Town of Barnstable n O1' ft. SS.SS. E. Department of Health Safety and Environmental Services MA P 4Q ib39.opTED Mp�a' Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location 9 _ �G V:� C. Permit Number 3-7Z Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: MOST-ST- C IUL V- VAT a VA ti 1A+V rc to ; Please call: 508q-88662-4038 for re-inspection. Inspected by �. Date ,2 Ve.4v eves Vew zXP,,e 4qf-S C;!G~ 2xb �'. Tres D��q,LI� f3• B1�DVU� �2 Ski cr.. -c lg,�-�ll LCs / t!/3 c,L, C LiPfi�f�; 7D — / Z)(4?7'S:�� r -rll� WR SJ R I_ 1 _ l ✓ f r _ - Ves-vehr - � r rP7 St 20 . Qom d,-r/o lovwlt IDR- 1 i i ki.es zxi ,e, s ��y zx C.- r�� _ D v�q a ,B, Bev_W-/V .-_- f 51li ® _ M1 Cla y v Olt --- j 1 M - 4 --- -ram - - ---- -- --_ i ILL- -- _. - -- __ - / O /Njf F��(i76�4e21 �•� �/��x- tee, .� y� y3a9 �// .�7 0393 TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 171 132 GEOBASE ID 9977 ADDRESS 19 SHUBAEL GORHAM ROAD PHONE CENTERVILLE ZIP - LOT . 133 BLOCK LOT SIZE _ DBA DEVELOPMENT DISTRICT CO PERMIT 43302 DESCRIPTION ADD 142 SQ. FT TO EXISTING GARAGE PERMIT TYPE BADDI TITLE BUILDING PERMIT ADDITION CONTRACTORS: BROWN DONALD B. Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: $25.00 ` BOND � $.00 CONSTRUCTION COSTS $E,�00.00 434 RESID ADD/ALT/CONY 1 PRIVATE .P MASS. 639. INIr►� BUILD BY DATE ISSUED 12/29/1999 EXPIRATION DATE ,JNVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- cNTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS _RMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST CARD SO IT IS VISIBLE FROM STREET. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. p 1 1 � �• . • • : sell I i 1 : •1 . 1 • 1 • •1•w •• i 1.. y1 / ••1 •/ • • rwI•1• • I • • �.• w•1 •1 • • r • : .1st 1st • • • •r .1 r••• •rw 1• •• "1 •11• 11• '1 ••I • � 1••�. 1 • r • t • • ' 1 •II • r•r•r1 •1 I •r111• •I •/1/ .II M' • • • w• • • Y• '1 ' • I9• • • r rr •1 • • •I•• • I►� / • • ' II• 11 r I 1 • •1• 1• « 11 ••1 •I •• •1 •• J .1• ••atom a too •• 1• « re to • 1• •• •• H i►1• :t•1• • t•••.� •II/ •• 1/« r• 11 .II •1 � • 1• • .1 r /'. 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I am an em 1 rwi providing company name: :..... . case. ..... .....:;. .:... ........ . ...:::. .........:.. ane� a olicv# ...................... insurance co. ❑ I am a sole proprietor,generai contractor, or homeowner(circle one)and have hired the contractors listed below who � 1 1 have ' ensation olices: ::::::.:.:.:..:;:.:;.:<.>;:.;::.;:.;:.;:.;:.;::;:;.;::.:;;.»:<.:;<.;:.;:.>>::<:::;<::«::;::>:><;:: ::<;«;>.>.<.; ollowin workers comp P .............. . . .::::.:,::::::..:::.::;:; .:::: :.:.::.;:.. .::. :.:;::>:::.,.:.:..:..:::::. ::::._.:::.:. the f g : ::::::.. ::::..:::::.:::::<.;;::.:::::::.,...:::::::::::::..,.:.::::: : . com anv n ::; ; M. address- . ::.::....... :::•:.:::::.: :. ::::::s::; ........::.;:;::;:::•:::;::::•:::;:::.............. .... ...... .. .... .. .... .......... ......::.......:.. ....:.::.:::::•::;.::.:::.:::::::::.::::::.::::::.:::::::.::.:::::.. ..................... ..................:::::::::::::::::::::::::::::::::::::::::.::::.::::::::.::::::.:::. tme ...:.::.. ::::::.:::.:::::::.:.........................................................................:.h :..::...:...... :......... ci :::::::.::.::,................. ... :..::. ..:....:......... ........ ..:.r.. .................................:......... .....:•::.::•>: r::;::::::;:>::::;:;i::is i::%:: :a::isF;S;r:<t:%3:r;>:•.::.::;•a:•::•x:•r:::•:::i................. ::»::::;c:s;:t.•;:.'::2:'<::::..;;..:.::.::.:::...>.;';:.>:;:::.::::>::.r:..::;.»:::.>..:::::.::::::;.>::>:>::>:.>:.;>:.. insurance,cm' ,..:..;:.;;;:-::<.;;::.::::,.::..:::.:::::....... ...... „r///%//%/%% c anv name:• . .. ........... address: ` > .... i ............ eti ............ .::.:..........::::.::.......... .:.;:...:...;:.......................................:: .•::::::.:::::.::.:.:;:;.:»::»>::::::•:. lieu ........... :.........................................::::::.:........................................:::.:::::::::::::. u FaOnre to secare coverage as repaired mmder Section 25A of MGL 152 can lead to the ymposition of criminal penalties of a Sae nP to 51,500.00 and/or one yam,imprisonm��wen as civ8 penalties in the form of a STOP WORK ORDER snd a Sne of 5100.00 a day against me. I mmderatsad that a wpy o[thb statement may be forwarded to the Office of Investigations o[the DIA for rnverage verincatioa I do hereby certi under the p ' and penalties of perjury that the information provided above is tru.and come Date — Signature �1.r Print name I thole# official we only do not write in this area to be completed by city or town ofncial permMcense# ❑Building Department city or town: ❑Licensing Board h Hired ❑Selectmen's Office ❑checkif immediate response re4 ❑Health Department contact person: phone#; o�er-- ' (MVISed 9/95 PIA) ' Tablo.fSZ2b(egad) Preeripth a PadcaM for das and TwaFamily Etnidmtlai Banding Sated with Fmd Forts MAXIMUM atom Gazing ca. Offirl wall Floor Bsaemmt S H=d*C00lia9 %) UwWu Rrvato� Swam'- &vW=J Wall ftci== splo== Ema=we p� Tlrval� 1Gval� Elm M1 to 6s00 Hestia;Dec=DaW Q 12Y. 1 0.40 1 3E 13 19 10 6 Nocosai R IrA GM 30 19 19 10 6 NO�� S I2= 0.30 31 13 19 f0 6 SS AFUE T 15% 0.36 3E 13 23 WA WA Normai U 13% 0A6 3E 19 19 10 6 Noaasi &44 JD 13 � .idn a-.. !S AFUE w Is% I0.3Z1 30 19 19 to • 6 tf AFUE JC I Ir/. I om 33 13 25 WA WA Namud T Ir/. 1 0.42 31 19 25 WA WA Normai Z 13% 0.42 32 13 19 10 6 90 AFz1E M 180% 0.50 30 19 19 10 6 90 AFUME 17 1. ADDRESS OF PROPERTY. pro/��eijlllle- 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): Rdr/111710 7p 6704�e e771Y NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q.fbmu- 90303a ®F THE Tp� �AB The Town of Barnstable BARNMAS& �m Department of Health Safety and Environmental Services 059. '°rEc 't°i Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. 1,11-7;k Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. A Type of Work: Cs Estimated Cost A Address of Work: r Owner's Name: Date of Application: — I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date w r s me lt l A� OW q:forms:Affidav 90ARD OF BUILDING RMVU►TIONS U l ¢ense: CONSTRUCTION SUPERVISOR Numbe'' 026820 &� /1935r '_� 2000 h no: 7187 7. ad To: 00 DONALD B BROWN ', 21 MARY DUNK,RD, g HYANNIS, MA 02801 _.__ _ Administrator p Y OME:�,tNgRO ENENC�NjgACTO t � 'Regtstrlorr= �nIBXd�' 'J;L A ,y. QONAL '� BROgg, RD �� r , Engineering Dept. (3rd floor) Map Parcel 13 Permit# House# Date Issued -7— J �IY�pr too PI L—a Cj -3�t _ Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Q)'1 T ',5;Tea -cFee 0 —,321 SLU PTIC SYSTzo� Fs,gi pg _ Conservation Office(4th floor)(8:30-9:30/1:00-2:00) g1 e i �BALLED_ INI CGRARUIVa,C TITLES 19 EN �,.` AL��®��a�D "BANIVSTABLE-�'a ULATE �e 4ti• ✓R. - r �' 1. �. , � V NLINAS6.f2 •� '��` TOWN OF BARNSTABLE Building Permit Application Project Street Address 19 ha®d e/ gajeA AM r a, Village �e�`r�e v l/lam Owner c� ��l �, ®��/� Address � - � Telephone c Y 2-Vt l Permit Request 0 Ila First Floor f� LZ square feet Second Floor o4like square feet Construction Type e Estimated Project Cost $ 000 Zoning District 19C Flood Plain ® Water Protection t9 Lot Size •3 7 /4 e+ Grandfathered ❑Yes ❑No AA Dwelling Type: Single Family �` Two Family ❑ Multi-Family(#units) Age of Existing Structure Aa Historic House ❑Yes No On Old King's Highway ❑Yes ONO Basement Type: sw Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) IVo.#e- Basement Unfinished Area(sq.ft) k Z104- Number of Baths: Full: Existing _ New 0 Half: Existing New 0 No. of Bedrooms: Existing 2 New 0 Total Room Count(not including baths): Existing 1b New �_First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑Electric �❑Other Central Air A Yes ❑No Fireplaces: Existing Yam/ New Existing wood/coal stove ❑Yes 4 No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) )l Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# Current Use �� -s, p�L Proposed Use Builder Information Name Telephone Number �9 � ��9 Address 4 License# t 6 IL1 a 7 �v Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) • ��.,"'s --tom-_��, `_. � _ + -Z .. .... � S• ', ` _ ,•.1.` ± Tom. 7 � .. � .� .- �: � `. .'.� � S - yi• . r. n �'p The Town of Barnstable ���' Department of Health Safety and Environmental Services 9- Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no.— Date— AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,alon with other requirements. y Type of Work• D Est.Cost Address of Work: Owner's Name Date of Permit Application: — I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied =Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME WROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please prMnt- 1. .. . DATE JOB LOCATION a j G . "Number Street address Section of town "HOMEOWNER6zz " . e • Name Home phone Work phone.- PRESENT MAILING ADDRESS Adr =?' City town Sae Zip co The current exemption for "homeowners" was extended to include owner-occue dwellings of six units or less and to allow such homeowners to engage an : dividual for hire who does not possess a license, provided that the owner acts as supervisor' DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one to six family dwellii attached or detached structures accessory to such use and/or farm structui A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner"- shall submit to the Building Off on a form acCeptable to the Building Official, that he/she shall be respor for all such work performed under the building permit. (Section 109.1.1) The undersigned • "homeowner" assumes ,responsi.bility for compliance with the Building Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requireme: and that he/she will comp with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be reuirE to comply with State Building Code Section 127. 01 Construction Control. q HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for wh�*dh_ ,ta build permit is required shall be exempt from the provisions of this section • provided tha Se .,in of Construction Supervisors) rovid ct' Licensing S )(Section 109. 1.1 Zi P Home Owner engages a persons) for hire to do such work, that such Some shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are ass= the u ervisor see d' Rules and Re late responsibilities of, a �s p ,( Appendix Q, gu . for .licensing Construction* Supervisors, Section .2.15) . This lack of aw often results in serious problems, particularly when the Home Owner hir unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed 'Supervisor. The Home"Owner --as supervisor is ultimately_ responsible. �. ... To ensure that the Home Owner is fully aware of his/her responsi.bilitie communities require, as part of the permit application, that the Home O- certify that he/she understands the responsibilities of a supervisor. last page of this issue is a form currently used by several towns. You care to amend and adopt such a form/certification for use in your commu: A - �` The Commonwealth of Massachusetts Department of Industrial Accidents 11 bi Office ofinvestiyations ;iW 6011 f•�ashin., Street - --; Bosron, A1a.u. 02111 Workers' Compensation Insurance Affidavit m UJ loc•ttion L: �f3ff �d f,�ffdl�l �� a city aeN � l(�LL-� . am a homeowner performing all work myself.K1C31 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#• insurance co. _ policy# 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name- address: city: phone#• insurance co Policy# ,.. _. !.e:F7r«' .71�0+. ^-^f"'!;•:'-+T.e'.e!.Nf:-t _T �T'tT"bVr~^..�-ST�r,,*•vr+...6C,:�• a ■r•n+:•,'i' .fie�....,..--•s• !'-..�._...-_._c_.. ._.._._ .�J•aa• - ..rr. .:�a.�arr■ 'RAT".._ _.tz .� ti.. .-Jm::.'•^.""` rs2_-_L company name: address: city: phone#- insur•nce co policy# Attach additional sheet if tiiiessarx�:r- Y,�_-`j 3f y: "��'!" y y�.�. ...�.�y a .�v _*15r •+ :�.•�^•- _. ._-_ .._ ...-r ir. `�r-`¢`.,�� -e t£� .�• .. - '�sbit�:tL,�tt<Jw:c;•-.sia'. Failure to secur».e coverage as required under Section 25A of n1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 andiur one years'imprisonment as well as civil penalties in the form of a STOP N1.ORK ORDER and a fine of S100.00 a day against me. 1 understand that a cop).of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do ereht certify under lire pains att ena/t'es ojperjun that the information provided above is true and correct. " Signature Date Print name A-t- R` Rtl AA Phone# 775 r _.official use only do not write in this area to be completed by city or town official city or tp�vn; permit/license# riBuilding Department ❑Licensing hoard ❑check if immediate response is required ❑ Selectmen's Office ❑Ilcalth Department contact person: phone#: rjOthcr Ire%ised 1;95 P1A1 information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted irom the "law", an entpl(rnee is defined as every person in the service of another under an_v 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 emplover, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling, horse having not more than three apartments and who resides therein, or the occupant oFtl e dwelling house of another wito employs persons to do maintenance , construction or repair work on such dwelling house or on the .:rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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, 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. _..—r- ..-_—.._..77777 .77.7, cam- ± - ^-- ,,...-•eT - ---—- .. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits 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. -.. -» -`:. 3^w ri*'7:., 7'.:yr City or Towns Please be sure that tite 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 permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. -,_,.rt.c_s'.._�,..,:...__.._._._.ro....,.-... ...�...n,.m•....., �.•.�...,..3-=-Sa-•-w--�--•�..........�.•.,.,rt�i�..,.:.,4'vl�•....,.. .r.-„-.: q..-.. .r.,..µ=..f1..,-•'i�:�.f2T,:•—r.'-sv.p...y.,p•...ws-s.,..�.,.• 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 fax #: (617) 727-7749 phone 4: (617) 727-4900 ext. 406, 409 or 375 � �lce V/omrmaeu.P,a`/,�C o�✓f�aaacaco/uaelta_I. . . . _ _ . Restricted 7o:.00;HPARTMEN" Oi r�PUBLIC SAFETY 5 7 5 G 5 CONSTRUCTION SUPERVISOR 1110ENSE @0 None Nust'e*:~� - Eypires: 1G - 1 & 2 ?ami':y !ia©es Restricted To; 00 Failure to possess a current edition of the Massachusetts State Bu_:ld;ng Code ate` DONALD 3 BROWN is Cause for revocation of this _:cans?" 21 4AR4 DUNN RDIPO BOX 456 HANES, M 126@1 NONE IMPROVEMENT CONTRACTOR. ' Re0strati01 118740 Typo INDIVIDUAL ExPiration 04/18/97 DONALD B BROMN DONALD B. BROMN r t;1 NARY DUNN RD/P 0 BOX 456 _ ADMINISTRATOR NYAMMIS MA 02601 s -- - - -- -- -- - — -- - — --- - - --- -- ------------- --- / env - - •-D' I , _ - �A Ve —QC; -- + 1 � is ;i�_ - --. C�BSS New-ceir r _.. . . z-is R( IS - /D/�i��_ A/ _ All- RZhW eR I -- -- -- - - -- -- - __ 11< IT ! f ! _q LOCUS V � V �P LOCUS MAP PLAN REF: 306/2.2 RES. ZONE: "RC" ASSTSSORS MAP 171 PARCEL 133 Z / FLOOD ZONE: "C" l 0 / P / / LOT 133 LOT 134 AREA = 16,830f S.F. / / / SEPTIC PLOT PLAN OF LAND / SYSTEM i / ° LOCATED IN : ;ka ;; CEN TER VI L_ LE MA . ,p PREPARED FOR: 1$: V`REEOCATED�� D O N A E D Sc JEAN BROWN \ DECK 6� """"iiiiiiiiiii EXISTING,,,,,,,,,,, / LOT 132 12•g DECK \ HOUSE �, o #19 „ C.B. 6 JUNE 26, 1996 PROPOSED ADDITION► 1a. \ o \ 6 GRAPHIC SCALE Cz v `t� �� � � 20 0 10 20 40 so A � IN FEET ) OF 1,fgs�9C' R� 1 inch = 20 ft. Z� PAUL yG� GO A. ME+RITHEW �. No. 32098 �° - YANKEE SURVEY CONSULTANTS UNIT 1, 40 INDUSTRY ROAD S P. D. BOX 205 I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE MARSTONS MILLS, MASS. 02648 IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL TEL: 428—0055 FAX 420—5553 STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN THE .COMMONWEALTH OF MASSACHUSETTS. q AUL A. MERITHEA, P.L S. DATE J#50978 GM i i a Gate\ g 3 �P LOCUS / O LOCUS MAP PLAN REF. 306/22 / RES. ZONE: "RC" / ASSESSORS MAP 171 PARCEL 133 Z FLOOD ZONE: "C" / V P / Q / LOT 133 LOT 134 AREA = 16,830t S.F. / Q GP / �s / SEPTIC 9`9' / SYSTEM PLOT PLAN OF LAND / O o � LOCATED IN : CEN TER VI LLE MA . PREPARED FOR: / o/ /� �� ,,,,,,,,,,,,,, � C.B. 1$i RELOCATED\> D O N A D 8c JEAN BROWN �1 , \ DECK / EXIS i,iiiiiiiii 12• 9 MOUSE / LOT 132 rn DECK #19 - C.B. JUNE 26, 1996 PROPOSED ADDITIONS 0 '6, 1a 6 o.\ NO P o GRAPHIC SCALE N� Q z o 10 zo 40 so IN FEET ) -�N Of 1 inch = 20 ft. PALI G OIST YANKEE SURVEY CONSULTANTS UNIT 1, 4 0 INDUSTRY ROAD SN . I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE P. D BOX 265MARSTONS MILLS, MASS: 0,2648 IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN TEL. 428—0055 FAX 420—5553 THE C�MMONNFALTH OF MASSACHUSETM PA UL A. MERITHEA, P.L.S. DA J#50978 GM