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0079 VALLEY BROOK ROAD
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INSPECTOR s SV� �� APPLICATION FOR PERMIT TO ... .0 .. .. ......... ......... ..... . . ............................. ............. TYPE OF CONSTRUCTION ..... . ) � .. . ..u !! . . .. ......... ...... . .............:............. y .....: �-�..`.. .... ..... ..19X. ..r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... .......CA ....................... .......................................................... ProposedUse ........... .........� GA. :.. .. ............ ..... .............................................. Zoning District .... .....................Fire`District . ���Q.fl.......................................................... Name of Owner .: e � ... .. ....... � ......................................................... Name of Builder" .t1riQ. ....... ....... 11� .i. ..........Address ......... ...... ..`.. ? t '?....` :................. .... Nameof Architect :.......................................... ......... .........Address ......... ......... ......... .................... ........................... Number of Rooms ................ <1........................ ..... .........Foundation C,1�tJL _ ....... 4 t, ... ............. Exierior ... ........... ...... .............1. .. t u' Roofing .......................... �;l ..................................... Floors ........ ........ � ... . .... ...............................Interior ................. - t ................................................... Heating ...Plumbing Z: 1''> � '................. .......1.. ,.. ...... .............. .. ....�... ...... Fireplace ...........'.Xv.J.�^........................................................Approximate Cost .................. .. � .�:�,0c�.........^ Definitive Plan Approved by Planning Board _____________— _______19_______. Area 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 of Barnstable regarding the above construction. Name . .. ,fi t .! ......................... J SMITH, JAMES KZ -188-4 6-/ 63 No .................4358 permit for „One Story .......................... Sin9rle Family Dw lling ,r .............................. Location Lot #1'6 79 Valleybrook. Rd ...................... ` .%.................................. Centerville ...................................... ....................................... Owner James K Smith/ Type of Constructi0 Frame............... . .. ....................... ' Plot .................... .. . . ..Lot ......................... Permit Granted .A.ept.... ', , 8 2 .................19 Date of Inspection ,........ .... .....................19 Date Completed .:........ .................� ......19 (93 or's map and lot=number ...�!`'✓ THE t� Sewage Permit number` �.: House number .... .... . A ... s� r t639- TORN ' OF BAIL 1v5 CCzwFs - l; �. is 19 BUILDIG eI;HSPECTPOR APPLICATION FOk PERMIT TO '. C C.�N�s.�?�r�. :.....r:�'�.4�`��r� ..................:......... :::.. F TYPE,.OF CONSTRUCTION' ...0l.d4).% 1, ,�'t M .................................................... .........�./..... ` c ...........................19.�1.. " TO THE INSPECTOR OF BUILDINGS 'The uridersi ned" hereb lies 6 erm t Aaccordm``i to the following information: 3 g _ y q pp y iG. g 9 Location \ ......��,:... Gt\� `� �.... �....... Ellij�\\ .—............ V ' T . t . Proposedfi,Use ...11.`. '...,... .�..4..� ................. .:-. ............ Zoning District ;1. ....................Fire District ..... �� ...... ............................................. _. Name of Owner �.��l"� Address C� ;C.......... .. .. Name of Builder,' ................a 11 �` ...Address ..:............ r` _ ... .... .................................................. "i.... Name of Architect ..1... ... ......... ......... ..^ ..::.:..i ,. .......Addr#ss ........... .. ... . ;. :........ ' Number of Rooms I ... .�d?.. ! Foundatid r Y. �... 1 �C ............. Exterior l ; Roo rig .4.. .........." .... Floors .......`\.� (?!`^ Leo.................................................` ior ... i Q �`—........... } Heating ........ Yl G.. ................... P1OMbing r � .............. ......Approximate Cost .... ..I.Fireplace ...........� .................... .. r_St0...O.........................� :............... Definitive Plan Approved. by Planning Board _ __________.__-___-_______19_______. , -DitigraiY►"of`Lot and_Building with Dimensions_ ............ i ,ti • Sri•.. w �-- " i SUSJ.ECGT TO APRROVAL OF B ARDr F. HEALTH I ' -iQ7 i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the.Rules and Regulations of the Town of Barnstable regarding the above construction. Name . 0.l1.. .... ..... MA�............ ........ � _ bi Y trSMITH; JAME z 24358 One Stogy -- Permit'for ...... . ........ ... ......... _k .'..Single 'Family Dwelling w, Location Lot...#16, 79 Val l"eybrook R Centerville ...................................................... ...... 4. James K. Smith I., J.�• .r ,. Owner .............. ...... .. ........ ....... .. .. ; J. 1 ^ Frame 1 Type of Construction n. ............................ ..... *.� Plot.....! ....... Lot... ... 4 Sept 9, 82 _ y Permit Granted .... 19 Date of Inspection . ..... .....19 Date Completed . .....19 .4 ►►.JGLC-- FAMILY - gE�RocM �W:o GAIXBAGE 6auNDs.2' 6G; 'i p{a1L�( Flow {►o x: a3oG.Po o L u5E ;-1 ooc . o15Po5AL P1-r' uSic , {voo (SAL. .' S►Dw�/At.L A►tGA• a 13o S.ti �• ri5o s.F x 2.5 t .3?5 G,Po _� � ..._ �ti�. • BOTTOM AREA: . 10 5►F•_ _. . .O �.� -to .10 So S.F• X 1.O R �j•o G.�o . .j� �- '� m 'TaTA L. DES►t;N * ,¢2�j C�.P D � 4 'ToTA%- DA 1 LS( F'LOV4,= 330 PQ / � jam• P82Co{.ATI0r,I MATS- 8 Ill1N 2MIM 012-1.65S ` ' . ! ,{ _ Jp Aw N ( JONES N BAXTER N 2S o i. No 25100.G No.24048 \ `' T p INV. DIST. IIN. GAL. 3'� $ S�FY}Oli.� g0X SCPT1G �• Z IObO ,. LNG 3T..6 .TAN► 4�a_/ LEAGLI , PIT: INV. . WITOJ . M �• WASNeD �. 6•tvNEr ` b. - "'1 t� - G E QT 1�f G p P 1.oT P►-A 1•! , PROFI'LG l.oG4�►�N n j SCALE Sc__ Uo V/4TSe. P>•-A t.� REF�2EN G� . I :.{ "CEQ.•T{FY 'THAT ?NE F,vwt>AYio14 5140WN {.I,rRsoN GOMPL%?!S VATN 114E S•1 oEL1N C LOT. (� Aum -6WreAGK 9-rm0uI9-C-AS 'MI of •tNE TawiJ-or- �A ZA17TAv3t 3 AND 16 NOT _ 35 L0C&.TE 1: .W I -, I :T .� F.LO•o D:;P A,N F L;e a�. �ovrzt sd. 8AXTE2! . 6t.EG I SZ E26D L AW D S u MY rcNiDL'S B N W=; Old A N - .v.ou 0 3TEiZ.V I LLEs • MP S• IN5T2v:MEWr S,v2VGYi ;-rHE ���-yW-15` si l,� I. v�,s:•:t�:tc :Q.CTr:.c�1�1�-1� l c?'T�LIIIE�� QPPLIGANT , • Iv1ers -'. 1 v>mI s4 . TOWN OF BARNSTABLE 24358 Permit No- -------------- -------------------- ��� Building Inspector cash SAM OCCUPANCY PERMIT Bond ______-___- Issued to James K. Smith Address Barnstable lot,3#16 79 VAlleVbr(;k- -Ro-ld. f'pnt-ar+*l 13 Q Wiring Inspector Inspection date � Plumbing Inspector �� - �! Inspection date Gas Inspectors { Q.r ^. Inspection date �� R *-"'Engineering Departmentr, - :, Inspection date !/Board of Health rf �'G �� Inspection date1 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ��I Building Inspector oFz r Town of Barnstable *Permit# ,y� 0 Expires 6 months from issue date aT Regulatory Services Fee *3�� w * aaarrsr EIM v� MASS'1639. Thomas F.Geiler,Director ��&Isho ♦� pTED h�Ar A Building Division ®PRESS PERMIT' Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 a U G 4 2010 www.town.barnstable.nta.us Office: 508-862-4038 TOWN OF94PS�gS��9�2�0 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint' Map/parcel Number 1$$ Property Address 1/�}���ft t'1 a r� ✓ ey/a)-- C C—rJ Z Residential Value of Work $mod Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address -S Contractor's Name Ylw (-Y z-e � Telephone Number 1!T-2;q R Z Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) �eo ❑Workman's Compensation Insurance Check ne: 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) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris,will,be taken to 2"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 Contr ctors License& Construction Supervisors License is e ire SIGNATURE: QAWPFILESTORMS\building permit forms\EXPRESS.doc Revised 072110 �f,� �onY,,, Cueao � aa License or registration valid for individul use only Office o Consumer airs mess ego a ion j HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to. . i Registration: r142516 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Expiration: 4t7/2Al2 Individual Boston,MA 02116 . i Ri rd E.LeBaeuf ; iAi Richard LeBoeufr \ t 20 Bacon Road "� -�t-� Cs'ae - t Hyannis, MA 02601 Undersecretary I Not valid without signature i y .. t -' MIUSSachusctts- Dcpai-tmcnt of Public SafctN Board of Building Regulations and Standards Construction Supervisor License License: CS 18096 RICHARD E LEBOEUF i 20 BACON RD HYANNIS, MA 02601 Expiration: 6/23/2012 Cummi sinner Tr#: 27920 f r s > - - The Conirrrorr.wealtlrofMassachusetts — - Department oflnrl!rrsrrirztcrireitrs: Office of Investigations 600 Washington Street , y Boston,M4 02111 Workers' Compensation Insurance Affidavit: Builders'Contr:ictoe-s/E-lecfr ciansfPlumbers Apphcant Information Please Print Le gib Name(B,usinessfQrg=atioul ndividual)_ Ad&e.&s-. 49,4-) 6A�0�e , City/StateJ2p: Phone+4,_ Are You an employer:'Check the apprope-iate boa: TYPe of project(regvired):. 1.0 I am a emp lover ur th 4. ❑ I am a general contractor and I 6. ❑New constniction loyees(f 111 and/or part-time)-* have:lured t1'e sub-contractors 2.Erpilalmq a sole proprietor Mar partner listed on the attached sheet.. 7..❑Remodeling, ship and have no employees These sub-contractors have:. 8 ❑ (Demolition".. workingforme in an c i employees sand have workers' Ypac" tY 9. ❑Building,addition [No workers' comp"insurance comp-insixance_X required.] 5. ❑ floe area corporation and its 10.❑Electrical repairs or additions offic'm have exercised their 11. Pltrnibin re au:s'ar additions 3.❑ I am a homeoixneer doing all work' ❑ g " p rnyw1f. [No workers'camp. right of exemption per MGL 12.❑Roof repairs- insimmee required.]T c. 152, §1(4),and we have no employees-rNG workers' 13.0 Other comp.insurance requu-erl.] •Any apphcm thai checks box#1 tnust also fill of the secfion below showing their wort ers'compensation palicl i�fori�t"son t Homeowners who submit this affidsvjit indicating they are doing aft work and then hire aastsids contractors 'must submit a new affidavit indicating such" (Contractors that check this box tnnest attached an addiriarM sheet showing the name of the sub-corrtsmctors and stare whether or not those entities have employees. Ifthe subcontractors have employees,they must.ptm-ide their Workers'comp.policy number.; � y lam art einpioyer thai is prmridirtg workers'corrrperiswfi&rt insurance.for ag eynployP?es. Beloit,is the patio'and job shV iRforma:i01 - Insurance Company Namre. Policy A or Self-ins,Lic.#: f Expiration Date:: Job Site Address: CityfStateizip: Attach a copy of the workers'compensation policy declaration page(shoving the,policy number and expiration date). Failure to secure coy erage.as'required under Section 2.5A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one-year imprisonment,as well as ci%ail penalties in the form of a STOP WORK ORDER and a.fne of.up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the I)LA,for insurance coverage verif cat on_ I do hereby vest" rt d t in r !ties of ` .r attJte info t nsrttioat prayzdcia€aaine is to and carrert - Si tore: Bate. Az Phone 9: atrial use orl}'. 17ri not write in t)tis in err,to lae.carnpzetad by ctt#'.or toravrt offi ciai City or Towii: Permit/11cense#. I Lssuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cty/I'ovvn Clerk 3.Electrical Inspector S.Plumbing Inspector 6.EOthei Contact Person: Phone#: 6 t ry - OFIHE . . BARNSTABLE, - 'SS.1639. -Town of Barnstable `�� s rA Eon Wgulatory`✓Services R l Thomas F. Geiler, Director, Building Division Thomas Perry,CBO, E E.. uilding Commissio B ner' x, 200 Main Street; Hyannis,'MA 02601 .www.town Rbarnstable:ma.us ' Office: 508-862-403?8 " " Fax: '508=790 6230 .�� ' t . M1 n Property Owner Must Cori plete.and,Sign This Section If Using A. Builder Y ` ... ._ .'. _ 4 qq 4• w .° .+ w . ., a I eS`k rt �(' h, , as Owner of'the subject piope>ty, F_ hereb authorize 1 c Q® y . ��(��^� �,,._�9 eU'F to act on my behalf, a in all matters relative'to work`authorized,by this' building`perinit application for , , e - �. ,r t• p._ 1 pry. ., - _ , Signature of Ownerfr .` r Date, , Print Name a ,` If Property Owner is applying"for permit, please complete°the Homeowners License Exemption Form on the r reverse side. Q:\WHILES\FORMS\building permif forms\EXPRESS.doc Revised 070110 The Town of Barnstable 9. �0� Department of Health Safety and Environmental Services '�Eo rev+A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION Location of shed(address) Property owner's name Telephone number Size of Shed ti z, all 7A I/ Sig a re Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) `THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg ' BARNSTABLE — CENTERVfLLE ALLYN JONES SMITH Land I t . ann....................................... ............. Belonging to...................................................... Deed in Book....................Pa�. sic...... 91979 749 59 BARNSTABLE DISTRICT Land Court Certificate No..........`..........in Book................Pags................In............................Regis try......... ........... ... LAND COURT PLAN 35548D WITH CERTIFICATE 48664 ` Recorded Plan....................................:................................................................................ Date of Plan..FEB... 2�...............................1982 • BARNSTABLE DISTRICT, IN 388 24 } in..........................Re Registry .No................ Filed Plan No.......................... 9 ry..........................................Book................... BOUNDARY EXAMINATION THE BANK FOR SAVINGS \ R I CHARD B. WE I TZEN, ESQUIRE �z Lom NO. JAMES J. & PATRICIA A. TARPEY 14 LAWSON & WAYNE F, `O� LOT 16 N ` N o w�aRy ; r N N is JUNE 14, 1983 73 k, JN 37897 mt . ; scale '" _4°.. O0000 VALLEY BROOK ROAD f I