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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Applica ion # Health Division Date Issued � Lt Z Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p D 1Z41g'iz Historic - OKH _ Preservation / Hyannis Project Street Address f3ytkiif U Village 5 LF— Owner Address Telephone mod$ ' Z " 0 03 Permit Request ahm_ 1 l7D12 or -udJ1 ' 6 " t L_�& .A Jwx a54,p ' �� Z -� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain /Gr__oundwater Overlay Project Valuation 000. Orb Construction Type 1W/4�6� R___ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family `d 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 C? ^� ';g Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood%coal stove:]Ye ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑e fisting ❑.n9w -size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes a- o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) :fie � �� e 6t ' t«//i Telephone Number Address �, .� /i/� License Home Improvement Contractor# Worker's Compensation( ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Dl�7 2L-,Z,1Z SIGNATURE DATE �� �r�' 7 i FOR OFFICIAL USE ONLY fx - APPLICATION# r, DATE ISSUED MAP/PARCEL NO. E ADDRESS VILLAGE _ OWNER t DATE OF INSPECTION: FOUNDATION FRAME INSULATION ;I FIREPLACE ELECTRICAL: ROUGH FINAL :.. PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - ' FINAL BUILDING - t DATE CLOSED OUT Y I - h ASSOCIATION PLAN NO. ' r A OWNER AUTHORIZATION FORM I, ne Je—2--ctt-d , (Owner's Name) owner of the property located at q r` (Property Address) (Property Address) b authorize CDJ �-here y uthontot QO \j , (Subcontra ) an authorized subcontractor for RISE Engineering,to act on mybehalf to obtain a building permit and to perform work on my property. er's Signal We Date A A CAPE 86iff 1, NS U LAj(jgcNt p 2: 3' R-e-P]El N n IIySp OI SSA MSSSS Spp AT tOAAI SySP[NOSp sans uurnys iesulabD»oQem�uS�s 1-800-69�f���RN Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, A 02601 Date: --,)/7//3 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements, Property Owner Property Address Village , Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( ) (x ) ( y2) O (X ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( �C) ( ZL ) Walls ( ) ( ) ( ) ( ) ( ) Sincerely l�- He yWsidysident Cape c.