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- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map_- Parcel " ' 4 _ !Application#
Health Division
Conservation Division Permit# L? S�
Tax Collector !': /��' ('�,G w.c� Issued 4- 6
Treasurer Application Fee
Planning Dept. Permit Fee r
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address z-o �� / 1--�
aCVc�n S
Village _ ZG /} �� ��
Owner � D / Address ✓-J 1 4�lf�
Telephone
X Permit Request
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuati n- _ Construction Type
1
Lot Size ge'Se Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family �§--- Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes O-No On Old King's Highway:4vals No
Basement Type: 4 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: �L aas ❑Oil 9 Electric ❑Other
Central Air: ❑Yes )Q-No Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes XNo
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage'-existing ❑new size Shed:)Iexisting ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes *No If yes, site plan review#
Current-Use -- Proposed Use - - - -- -
BUILDER INFORMATION
Name Telephone Number _50 X Z'
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PR JECT WILL BETAKEN TO
SIGNATU` TE
; t
FOR OFFICIAL USE ONLY
' , a
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
w
ADDRESS VILLAGE
1 .
OWNER
DATE OF INSPECTION: \
9
FOUNDATION
FRAME
INSULATION
r
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING j
DATE CLOSED OUT
ASSOCIATION PLAN NO.
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
wvmtown barnstable ma.us
Fax: 508-790-6230
Tice: 508-862-403 8
HOMEOWNER LICENSE EXEMPTION
Please Print
} DATE
' JOB IA T10N street yu►age
number ;
"HOMEOWNER": /v home pbone#
name
CURRENT 1vIAIlING ADDRESS �A
i
ty/tom "state zip code
The current exemption for"homeowners"was extended to include owner--occuvied dwellings of six units or less and
to allow homeowners,to engage an individual for hire who does not possess a license,provided that the owner acts as
c� ert'isor' 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 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
re onstble for all such work verformed under the buildine vermit. (Section 109.1.1)
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 she understands the Town of Barnstable Building Department
ectioa procedur' and re is and�hat he/she will comply with said procedures and
1e ts.
Signature of H tr
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
'din Code..Section
ection 12.7.0 Construction Control.
State Butl 8 HOMEOWNER'S EXEMPTION
The Code Stasis that: "Any homeowner pmbming work for which a building permit is required shalt be exempt from the provisions
• gages a person(s)far hire to do such
of this section(Section 109.1.1-Incensing of construction Supervisors);provid
ed that if the bomeowner an
work,thaf such Homeowner shall act as supervisor:'
wry horaeowaers who use thus exemption are unaware that they are assuming the responsitrilities of a supervisor(see s,Appendix Q.
Rules a Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awaren ss often nr al o ba with a licensed
when the homeowner lures unlicensed persons. in this case,our Bocannot proceed against person
Supervisor. The bomemmer 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 bdshe understands the responsibilities of a Supervisor. On the last Page of this issue is a form currently used by
sveral towns, you may care t amend and adopt such a foradcertification for use in your corranunity.
A•fe.,�nc•hmmeeXGIITflt
�r
it sessor's Office.(1st floor) Map Z'� Parcel d� Permit#
- 0) Date Issued // _®a Ss
- - ) Fees
Engineering Dept. (3rd floor) House#
g) �
MASS.
19
lED MA'S a
TOWN OF BARNSTABLE
Building Permit Application
Pro Address o d O ':ru k•U r ,2rl
Village
Owner (21 6y) f rj Address '3 00 0"'1
Telephone
Permit Request `
S
First Floor square feet l G CEO Sep 4-7-
Second Floor square feet
Estimated Project Cost $ f,5 d)
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type
Commercial Residential
Dwelling Type: Single Family Two Family Multi-Family
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name Er7fts-E J, Telephone Number S 0$ Y.;18 a�)�Fa
Address j��}tz�Gyt co? License#
r
C64 - m8, 0.�_)6s 5— Home Improvement Contractor#
Worker's Compensation# /Ix / 511;k �L 01K
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 &a, 2!!
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
1
j f
FOR OFFICIAL USE ONLY
PERM N
t
DATE SUED ,
•
S
MAP/6 A R. E N L O. 14c .
t ,
6
t
i
• VILLAGE s —
ADDR SS
OWN
I
DATEF SPECTION:
FOUNDATION
FRAME
INSULATION I I y
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL E
FINAL BUILDING
DATE CLOSED OUT `lh �
i
I 4 I I I
ASSOCIATION PLAN NO.
+ . °= The Town of Barnstable
K#A& ,S Department of Health Safety and Environmental Services
t� Building Division
367 Main strut,Hyannis MA 02601
Office: 508 790�ZZ7 Ralph�
Building Commissiont
F= 508 775-3344
For office use only
Permit no.
Date // a
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"Teconstruction,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 cc Wn exceptions, along with other
requirements-
Type of Work' Z Est COST 1 2�
2���-�^-
Address of Work:
Owner.Name:
Date of Permit Application:_
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under SI,000
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that: CONTRACTORS
OWNERS PULLING THEIR OWN PERMIT OR DEALING WTIH i7NREGISTIED
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.
Dar Contractor name Registration No.
OR '
-_mate Owner's name
Yl
�^'® / � .
': a A Im-A' . - S E war
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Qyo�THEtp�y TOWN OF BARNSTABLE
fps. • O� �
i BJBBSTABLE. i
,639.
�M BUILDING INSPECTOR
Opp FY a
�E J & i e. � -f-A xT w
APPLICATION FOR PERMIT TO .......Build SirQ1e Family..Dwe.11in ;
TYPE OF CONSTRUCTION Wood
.....Aug..18..........................19.68.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ......Lot...27A Indian Hill �istates, Barnstable, Mass.
Proposed Use ........ e. idenCe
.................................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of Owner ...Alexander Blair ..............Address ...Squaw I8Aand, Hyannis Port, Mass.
Name of Builder .Village Store Builders, I'Mc?ress ...njain Sheet, Yarmouth Port, Mass.
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms 7 oured concrete —7—
Foundation ... ?......................................................... .:.............
Exierior singl®. .................: ..................Roofing ......k?ap�.r..shingle. .........................................
Floors Oak................................................................Interior sh®etroek
................ ......................................./.............................................
Heating ec triC
....................................... Plumbing ........., ,...... gam!✓
...........el..... ....................................................
Fireplace brick..........................................................Approximate Cost 30 000
Difinitive Plan Approved by Planning Board -----Kai!--- 9_____________19
Diagram of Lot and Building with Dimensions S-p
�o
�v X
/7,Y Y "
1
-J
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name
-
Blair, Alexander ~=
'No ..... Permit for -----one...������-- '
—'�1�����.����;��onwa
�l�]�.
Location --������.----�������..����-=�
. �
m
^ L.
----.---,����r�c���—.+� �ro^��w^�`*��—. �
Owner ---. . -----_—.
Type ofConstruction ........... ....................
-----------------------:---
� ���8 '
Plot ---------. Lot --.��"=----. '
-
August
Iq 68
Permit Granted --..............'.....----lA
`
Date of Inspection ------------lA ,
Dote Completed ~ - lq����
. —��--..^�°�.-----
/
PERMIT REFUSED
__________-----------.. lg -------~-
.----~----.--.--------------.
',__.--..---------------...—' `
.--.--.,..~..--.~'---.--.--.--.—.—..
'----^—'---^—~---^---`—'-----''
'
Approved ~--------------- lg ^ �
�
'
---------------'-----'-----`
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-------`--..------------,..— .
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