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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map= Parcel Permit#
Health Divisio . hi .2�. ��'�2 Date Issued
Conservation Division A O Application Fee
Tax Collector jOOa — 0 Ic — N�.— 7 b a Permit Fee J'®i dc,
Treasurer (� (� _� ® SEPTIC SyS a Eid,filul-VT C
INSTALLED TALLE
D INCO�tPLIAF`��Planning Dept. WITH TITLE 5
16
Date Definitive Plan Approved by Planning Board � � EAL CODE A NL
Historic-OKH Preservation/HyannisV RGULATIOIyS
Project Street Address _5 6 4 N N V U fy
Village T-C- R LL e-
Owner CEO P, 10 t-- S L.t s i4 yu � Address �v 13 U N N r LA r1 C-34
RV
Telephone_ �d 8" .3 6 2- ENW�--
Permit Request r LX a 4
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Square feet: 1st floor: existing proposed 2nd floor: existing proposed Tota)new rn
Zoning District Flood Plain Groundwater Overlay
Project Valuation l 0 0, V-0 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ki Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No
Basement Type: )d Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing / new Half: existing e�) new - O
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new S� First Floor Room Count 5
Heat Type and Fuel: AGas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes XNo Fireplaces: Existing New Existing wood/coal stove: Cl Yes ).No
Detached garage:❑existing ❑new size Pool:❑existing O new size Barn:O existing ❑new size
Attached garage:❑existing ❑new size Shed:54 existing ❑new size Other:
,J on ❑ p Eloning Board of Appeals Authorization Appeal# Recorded
Commercial ❑Yes ❑ No If yes,site plan review#
current Use Proposed Use
BUILDER INFORMATION
Name C#at? L G s T9-6 b Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE I !1912 DATE � 31 02'
FOR OFFICIAL USE ONLY a
PERMYT NO.
DATE,ISSUED
Y• • I
MAP/PARCEL NO.
ADDRESS VILLAGE ,
OWNER
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DATE OF INSPECTION: .
FOUNDATION 11
V
FRAME k'
INSULATION .
f' FIREPLACE
ELECTRICAL: ROUGH FINAL
x •
PLUMBING: ROUGH: ; FINAL
GAS: ROUGH_; _ Q t�. FINAL
FINAL BUILDING 0 tl—
a DATECLOSED OUT
ASSOCIATION PLAN NO.
C/ -
3
Town of Barnstable
yP��P 1HE
Regulatory Services
• Thomas F.Geiler,Director
aaxxsrasre,
y Mass• �*
1639. Building Division
'°TEn MAC°' Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: 5-0 �� (4 C E NTEW y I L"1 ��
�onumber street 2 village
c
"HOMEOWNER!':l A,412Le5 `- J �l S 14N4 T�V 0 � 7 09'' L:L—�J''S dN
name home phone# work phone#
CURRENT MAILING ADDRESS: 5_0 (3 g N N Y R U 0
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
allow hom
eowners to engage an individual for hire who does not possess a license,provided that the owner acts as
to a
su eervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
res onsible for all such work performed under the building permit. (Section l09.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
ignature of Homeowner `
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger,will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
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Job Name: �� S-�- Wood: f Profile Style&V-I/ i I N
Order No: bhfihLr,016 Finish: ❑ Overlay Wall: f 5fl t
Designed By: Hdwe. Doors: ❑ Recessed Lip ,�C3
Wertch Cabinet Mfg, Hdwe. Drawers: S'— z- ❑ Apollo Hinge: Q �21'UE
0(13)k ®0= R ® IL0H0 s ®_T BE &ACLU E STANDARD LEGEND
NOTE:not all symbols will appear on a map
L-17 q'� GOLF COURSE FAIRWAY
2
2 r EDGE OF DECIDUOUS TREES `
72 ^----- ^ EDGE OF BRUSH
t ORCHARD OR NURSERY
v-T-v-v EDGE OF CONIFEROUS TREES
MARSH AREA
--•-— EDGE OF WATER
DIRT ROAD
AMPrp'P DRIVEWAY
'V1n 3 E----PARKINGIAT
' �— PAVED ROAD
3 - - - DRAINAGE DITCH
� ----- PATH/TRAIL^
PARCEL LINE
w1to E— — —MAP#
21 E PARCEL NUMBER
*IBM—HOUSE NUMBER
2 FOOT CONTOUR LINE
—Lg-- 10 FOOT CONTOUR LINE
Elevation based on NGVD29
4.9 SPOT ELEVATION
STONE WALL
MAP 2 -X—X- FENCE
w w RETAINING WALL
4-1 1-1 RAIL ROAD TRACK
STONE JETTY
SWIMMING POOL
MAP234 1 PORCH/DECK
0 BUILDING/STRUCTURE
` \ 41 6 DOCK/PIER
,# 569 HYDRANT
0 VALVE o MANHOLE
----- P23 �
0 POST CP- FLAGPOLE
T O W N O F B A R N S T A B L E e E 0 ® R A P N I C I N F O R M A T I O N S Y S T E M S U N I T A SIGN ® MRM DRAIN
r PONIED KU IN FEET *NOTE ft map is an ordmganent of a **NOTE..The Arad Ones are only grephic repremautiars DATA SOURCES:Plarrim tFks(man-made features)were interpreted Gan I"S earful photogrephs by The lames
1°=IW scale map and may NOT meet of property boundaries.Im are ad Iroe locations,and W.Small CoTny.Topogroy and vegetation were interpreted fran IM aerial pb ftmphs by GEOD 0 UTILITY POLE n TOWER
" 0 20 =40 National Map Amumq Stadards at this do not represent actual mWw ddp to physical oNeds Coryoration.P(on1wh s,t phy,and vagetation were mappd to meet National Map Ammq Standards
e I IN(H=40 mu* enlarged sale. on the map. at a sak 1°=1�.Parcel' was dig&W frown FY2W Tawo of Barnstable Assessafs taK mops. ¢ UGNT POLE O RMC BOIL
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The Town of Barnstable
Department of Health Safety and Environmental Services
1 Building Division
367 Main Street,Hyannis MA 02601
Office: 509-862-4039 Ralph Grossen
Fax: 509-790-6230 Building Commission
SHED REGISTRATION
56 0L( A/Ar Y �iq N ��NTr✓�2 V� L L c .-� a-� �-L.
Location of shed(address)
A-,1 e S -t-- S U-s I-I\J d 3 G 2— 3 S�-
Property owner's name Telephone number
L-®TT I
�o x r I-- ��44V 1300 1< i - 2- pa!i,�
Size of Shed Mapiparcei
S
3.. 0 3
11
Signature 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-shcdm
Assessor's map and lot number .. ...
Sewage Permit number
/�/l'Gh'e�•+cs �� ice-
THE.T TOa��N OF BARNSTABLE
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i MARISTODLE, i
M6 9 BU-ILDING INSPECTOR
��YPY h•
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APPLICATION FOR PERMIT TO ..... . ...... ' . .. ..........................................
/�I
TYPE OF CONSTRUCTION ��!/64 � +✓W....:... ......�'.............................
..... /.. �.......,913/
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applie for a permit accorld'inng o the following information:
��..Z�
w.....
Location/ .. rR
......
.tL
Proposed Use
..... ... .............. .. ................... .............................................................
ZoningDistrict .....................................................................Fire District ....... .................................................................
Name of Owner . ..... .....Address ........ .... ....... ......
Name of Builder .. -.... C% ` Cl...................Address / Gly �. �... .. �.
Name of Architect ..................... ..........Address ......................... .. ...... ... .. ...... ....................
Numberof Rooms ... ........................L,.!;...............................Foundation .................... ....................................:.................
,� G�-* *,
RoofingExterior .................................... .... ................... ........ ......... . P
Floors ....................................
AV4Interior ................... �........ .. .............
Heating ......... ..... ......Plumbing ..................................................................................
Fireplace ..................................................................................Approximate Cost ..................../�• d®.
......................
Definitive Plan Approved by Planning Board ________________________________19________. Area .:.....d... ... .... ...16r M.. ,
Diagram of Lot and Building with Dimensions
Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .........I�r•�°,l'...... ......
Bickford, Eugene
t No ............ repair fire
17882.... Permit for ... ..................................
damage
...............................................................................
Location ..4F&..Bunny..Run...............................
... ...... ........... .......
.....................C....................................................6
Owner
Eugene Bickford
L
..................................................................
Type of Construction .........f r.a.me.......................... . .... . I
................................................................................
Plot ............................ Lot ................................
August 14 75
Permit Granted ........................................19
Date of Inspection ....................................19
Date Completed ....................19
PERMIT REFUSED
................................................................ 19
...............................................................................
j
...............................................................................
...............................................................................
...............................................................................
Approved ................................................. 19
...............................................................................
...............................................................................
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