HomeMy WebLinkAbout2160 MAIN STREET Z1(p0 i774i17 (.1`k. ✓
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map (9 3 7 Parcel 06 Application #cQO/c)OCo 7 37
Health Division Date Issued t t
Conservation Division Application Fee
Planning Dept. Permit Fee 1.
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation / Hyannis �p /
Iv
Project Street Address 21 C7 U V IAI4 .
Village ri 6 , Mil- 7 b
Owner Lgai C`{, airvildtv Address Zl16 Vkaii4 (A awl 51j J "
Telephone V7iZ— la/3
Permit Request G WA(6//dVI, ` � ``% �zG';1. 'J K r2Uvr S air -� ,j lin t vI r�Gf! R
G.4-6ce� f� /i. V 4 bin € 4; 1760 3b O f -/ 1040--faced 4i 6 kt C{rav/
Taaj (rlv It k-Ia tifee boxedfVøW&IV L /' CrAtdbficee_
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation ;TOO, n Construction Type (Vl' M
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family OK Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Ni way: i (es I:No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other _ —
Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)
v
Number of Baths: Full: existing new Half: existing new
rn
ttt
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
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
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 ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ��/eif G o /.�SL��/�'�J�� Telephone Number Li Z? 77 Z
Address License # /� / -
Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE ()ell- 'J4 2-0/
- FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT .)
ASSOCIATION PLAN NO. _�:.+;; t.
ref)
OWNER AUTHORIZATION FORM
1 L u 0; P .c kti(Owner's Name)
Name) •
owner of the property located at
I6C) S11._
(Property Address)
141-54 Xa-b.-5-1, e I g etC.F1
(Property Address)
hereby authorize C0Q-€ Coc) — i SO IC. ,(100
(Subconjractor)
an authorized subcontractor for✓✓ RISE Engineering, to act on my behalf to obtain a building
permit and to perform work on my property.
Owner's Signature
Date
rSEE5VED
P 0 2"i'L
6
C k`A PE CO 6O N OF BARNSTABLE
INSULATI0p917 DEC 26 AM 10: 33
ITV
Nom
NUR ours SEAMLESS SPRAY IOAAI 7umeNipp10
SAM OY[i[RS AMU/Allan CSIIINOS
1-800-696-66111 V ) N
Town of Barnstable
Regulatory Services
Building Division ?GZ—Z7��Z
200 Main St ff
Hyannis, MA 02601
Date: //h/ ?—
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
.2i 6 0 4441,) 6.-/i/eit aff.e)sk..6/4e._.
Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted
Ceilings ( ) ( ) ( ) ( ) ( )
Slopes ( ) ( ) ( ) ( ) ( )
Floors ( ) ( ) ( ) (01) ( )
Wallls�,•P'es.
• 31C W (k) ( ) ( 14' ) (;') ( )
att (
Sincerely
He y E C sidy J , President
Cape Cod nsulation, Inc.
R -
HE Ibis, • Town of Barnstable *Permit ab I Z bl 713
Expires 6 man& om d
' s Regulatory Services Pee
Rppp
+' R�A1Vi.TART.R t.
� '-
Q., Thomas F. Geiler,Director
P /4"/
Building Division
TQ ®F • Tom Perry, CBO, Building Commissioner
wvINSTA pp,
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office:.508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number o e 7- 6 D 8
Property Address 6 U c,�/.44-7 Jam/
sidential Value of Work 0Uv Minimum fee of$35.00 for work under$6000.00
� 2 / ��
Owner's Name&Address "(J`Clf'IQdG� 1/ , jQ/'f?'le./9t���
/ 1, ;-.) p X414,
Contractor's Name Telephone Number g I 66. /8,5
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
•
❑Workman's Compensation Insurance
Check one:
❑�I a sole proprietor
a I am the Homeowner
❑ I have Worker's Compensation Durance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
R Re-roof(stripping old shingles) All construction debris will betaken to 0c)f0 4/ 7/
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders. U-Value (maximum.4-4)#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 opy of the Home Improve ii :nt Contractors License& Construction Supervisors License is
aired.
IGNATURE: ���a/' / v -
/
\WPFILES\FORMS\building permit forms\EXPRESS.doc
�a� n-rn i i n
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4
Town of Barnstable
417 s � Regulatory Services
* snxrsresrs, Thomas F.Geiler,Director
b�o mid�•0� Bu •
ilding Division
•
Tom Perry, Commissioner oner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: `7 7, l
JOB LOCATION: oc l�_ d -/ 12 ,,fr1 id/564
number /n street / village
.HOMEOWNER": G�(JGmd, �C�lOY1Qhfl° 3 �� (4�/`1/8,5
name home phone# work phone#
CURRENT MAILING ADDRESS:3rS�v �O v-�,.. .
ciy/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied 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
supervisor.
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
responsible for all such work performed under the building permit. (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 he/she understands the Town of Barnstable Building Department
minimum inspection proce ures requirements and that he/she will comply with said procedures and
require nts.
Si ature 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
•
•
4
4 1:,-*1„.,HETown of Barnstable
11 Regulatory Services —
�g Thomas F.Geiler,Director
•
�a6;q. 40
o ' Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
i
Office: 508-862-4038 — -._ -- ---F. 508 790-6230
t
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, ,as 0•• r of the subject property
hereby authorize to act on my behalf,
in all matters relative to work au: orized by this buil.'„. permit
•
(Address of b)
**Pool fences and alarms e the responsi i ' 'ty of the applicant. Pools
are not to be filled before `ence is installed an. .ools are not to be
utilized until all final ' pections are performed d accepted.
•
/
Signature of Owner Signature of Applicant
Print Name Print Name -
Date .
Q:FORMS:O W NERPERMISSIONPOOLS
Ib71CY
,(4,02.s;r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 0 �� Parcel Application #2O1 ocxQ3-cv
Health Division Date Issued Z l (6
Conservation Division Application Fee 14, 7
Planning Dept. Permit Fee 6S
Date Definitive Plan Approved by Planning Board G I
Historic - OKH _ Preservation / Hyannis i
Project Street Address 2160 Main STreet
Village Barnstable
Owner Suzanne Howes Address same
Telephone 508-362-3185
Permit Request air sealing, insulate floored, kneewall and open attic spaces, insulate sills,
crawlspace ceiling, and the crawl apart. perimeter walls.
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 3755.00 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ 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 `9
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ``-0 Yes ❑ No
s,a
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size Barn: existing- ❑ ew size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name RISE Engineering Telephone Number 401-7R4-3700
Address 1341 Elmwood Ave, Cranston, RI 02910 License# 100459
Home Improvement Contractor# 120979
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE ) l A D
Erik Nerstheimer for RISE Eng.
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP_/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
' FOUNDATION. -
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
ii GAS: - -ROUGH FtLcv FINAL
O,tFINAL BUILDINGIL .+ `:
: .DATE CLOSED OUT •
ASSOCIATION PLAN NO. '' /
f .-
f ,
, ,
•
+� 7,7 - RISE ENGINEERING Federal ID#05-0405629
t RI Contractor Registration No 8186
A division of Thielsch Engineering MA Contractor Registration No 120979
CT Contractor Registration No 620129
1341 Elmwood Avenue,Cranston,RI 02910
� *�•' _...,,m (401)784-3700 FAX(401)784-3710 CONTRACT
It
Page 2
THIS CONTRACT IS ENTERED INTO BETWEEN RISE
ENGINEERING AND THE CUSTOMER FOR WORK AS
ENGINEERING DESCRIBED BELOW_
CUSTOMER PHONE .. DATE Client It
Suzanne Howes (508)362-3185 09/16/2010 110788
SERVICE STREET BILLING STREET
2160 Main Street 2160 Main St
SERVICE CITY,STATE,ZIP BIWNG CITY,STATE,ZIP
West Barnstable,MA 02668 W Barnstable,MA 02668
JOB DESCRIPTION
$61.20
RISE Engineering will provide labor and materials to install 256 square feet of R-10 rigid fiberglass insulation board to the crawlspace
perimeter wall,and R-19 Kraft faced fiberglass to the band joist and house sill under the living`room.
$691.20
RISE Engineering will apply all applicable,eligible incentives to this contract. You willbe billed only the Net amount. Currently,for air
leakage sealing measures,the Cape Light Compact offers a 100%incentive,outside of the$2,000 per calander year limit.
-$1,056.00
RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible
measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year.
-$2,000.00
WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
***Six Hundred Ninety-Nine&30/100 Dollars $699.30
UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL.BE CHARGED MONTHLY ON ANY
UNPAID BALANCE AFTER 90 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION.
DO NOT SIGN THIS CONTRACT.IF THERE ARE ANY B K SPACES
4/ 2)/triA-- Ct!6 is 01v
AUTHOR SIGNATURE-RISE ENGI NG STOMER ACCEPTANCE
NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE 9- .2 a- /6
3® ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE
SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK
DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE
',..
TOWN OF ARNSTA L
RISE ZOO `4AY #0 AM II: I ;
Division of Thielsch Engineering,Inc.
1341 Elmwood Avenue
ENGINEERING Cranston,Rhode Island 02910
DIVASIO
May 1, 2013
Thomas Perry, CBO
Town of Barnstable
Building Division \it)
200 Main Street
Hyannis, MA 02601
Re: Insulation permits
Dear Mr. Perry,
This affidavit is to certify that all insulation work completed for 2160 Main St./Rte 6A has been
inspected by a Building Performance Institute (BPI) certified Professional.
All work performed meets or exceeds Federal and State requirement.
Sincerely, "
`Erik Nerstheimer
Supervisor of Installations,
BPI certified Building Analyst Professional and Envelope Professional,
RISE Engineering, a division of Thielsch Engineering, Inc.
1341 Elmwood Avenue
Cranston, RI 02910
401-784-3700 •800-422-5365 •Fax 401-784-3710
ofTMe r
. 044.
°„ The Town of 1: arnstable
•9 �' Department of Health Safety and Environmental Services
�i,,,tea`` Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Cross en
Fax: 508-790-6230 Building Commiss:
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,along with other�t)l requirements.
Type of Work: ,4D!//7M2 Est.Cost „/,c eroZ)
Address of Work: /&10 17931/1)57 W I JSTA S_ da
Owner's Name s'(. E / d
eS
Date of Permit Application: 6 0/17/97
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:
(%/27 �7 /oc36'6ER
Date V Contractor Name Registration No.
Engineering Dept.(3rd floor) Map a 7 Parcel iXIC.8 AC Permit#- ZC3 J 2-0
Ail House#• Q- (. 6 O-el- Date Issue 1 t 6 ` "() 7
Board of Health(3r'oor)(8:15 -9:30/1:00-4:30)f 7a, /5Yg, . Fee 77•
0 Conservation Office(4th floor)(8:30-9:30/1:00-2:00) I[/�J�3' � ��
66 SEPTIC S - MUST BE
Planning Dept.(1st floor/School Admin. Bldg.) �. '? PUANCE
ip re�1>c ru► hi
Definitive Plan Ap• • -. ° _Planning Board 19 1 �, - o i LYI 6
El VIRO' i" °F'A '
�,; . ODE AND
1- S, TOWN OF BARNSTABLE TOW `I : .r •TIONS
I `J"' Building Permit Application
Project Stree • •°ress ,. 16D /y1AM) � '; 8 Aa to Slop- )o
4
Villag:'' 8AW S TA geK MA . 08
Owner Vng.S S Of_, RCA IDS Address 5/be
Telephone ?.j - 31 ec F
.Permit Request t 0)7057400r /5,4X a '. A-pp/77s ilJ N&Th S/ Qj'C
•c(CT7it1 t� l--l �u ..1-�►TTi..1.(7g - ai
First Floor One square feet Second Floor square feet
Construction Type 57K— --
Estimated Project Cost $ (plc/ADD
Zoning District ,, Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure 5j'O • Historic House ❑Yes ❑No On Old King's Highway E Yes ❑No
Basement Type: ❑Full ®'Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing A New Half: Existing New
No. of Bedrooms: Existing g• New
Total Room Count(not including ba s): Existing S New f First Floor Room Count 4-
Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other
Central Air ❑Yes I (No Fireplaces: Existing New Existing wood/coal stove Li Yes I�lo
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
6'None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization Li Appeal# Recorded❑
Commercial Li Yes ❑No If yes, site plan review#
Current Use Proposed Use
�/,,� Builder Information
Name 3MA -4X)/ 7
Telephone Number 3f Va:
Address 7n .. /v2 -LA • License# 634-n61�-
t ,F)-04
1-/i/A774 L, i 4. l},dj('. Home Improvement Contractor# l b S 64
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
04RAiT c (o471)P ri'u-
SIGNATUREy2�'�'" DATE " ,} p2 ?'7
BUILDING PERM DENIED F THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY -
PERMIT NO. 2___ . .
. . ,
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DATE ISSUED
, .
1 , ,
MAP/PARCEL NO. . I
, . .
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ADDRESS . VILLAGE * ki
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OWNER . . S , .
. . .
_, • . , ,
DATE OF INSPECTION: ' ••,.
. , .
FOUNDATION -
FRAME / -c_ ...q0- F _ .
INSULATION ",g'- - ?9
.
FIREPLACE •-
....
ELECTRICAL: ROUGH FINAL ,
- ..,
PLUMBING:• ROUGH • '_ FINAL • >
GAS: in '" 0 U . FINAL ,
FINAL BUILDINS
co n ri
1 et 2
. ,
DATE CLOSED WO ai
:;
ASSOCIATION PI NOCI 0
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The. own of tarnstable I 2viLLiniCT-
. ek.O.ss -re-cr ia r /
Ercineering Dept. (3rd floor) Map 7 Parcel 7 / -di`.Ekrmit# 7 9._ ( �j
�
• House# �/6 dGe__ Date Issued /oq. — 9
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) • Fee / a S a Qv
Conservation Office (4th floor)(8:30- 9:30/1:00-2:00)
Planning Dept.(1st floor/School Admin. Bldg.) / ::1ME,q
/JY
Defin' ' ""e P n Approved by Planning Board 19 u ;
BARNSTABLE.
6 9 S
TOWN OF BARNSTABLE
Building Permit Application 0 I )4 —
Pr ' reet Address
Village/ /3 A/R NF/' 3(1Yf C t
Owner 5 c-; Z /119'er t " O W r 5 Address
Telephone - r 31
Permit Request R F Roo r /5dcitc fa t•J S £ f z Coo C G'
Cs,9
First Floor square feet Second Floor square feet
Construction Type 1.-U G n(1) Pit,0/14 £
Estimated Project Cost $ 'C� 00 ,
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family CV'
Two Family- ❑ Multi-Family(#units)
Age of Existing Structure So �/05)r41-listoric House ❑Yes &Go On Old King's Highway es ❑No
Basement Type: &full grKawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) M1G Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing / New Half: Existing New
No.of Bedrooms: Existing -3 New
Total Room Count(not including baths): Existing 6 New First Floor Room Count
Heat Type and Fuel: ❑Gas ff'6i1 ❑Electric ❑Other
Central Air ❑Yes &No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
1 ttached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes D No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name 1)1 C O( J r�
W i'�9 i'� CT
t t r Telephone Number 67 70 7
�
Address�� S��r �( go, License# Ci' /� ?
tl e C t' A a 2, CL,'j 2., Home Improvement Contractor# 0
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 /Gy?/''t' (Vet r
SIGNATURE < <� �- l DATE , .
BUILDING PERMIT ENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE •
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
9 p�
DATE CLOSED OUT i •
ASSOCIATION PLAN NO.
;r `
��Y
• ' .ads •
• The Town ®f Ita nstable
BARNSPABLE.
1 Department of Health Safety and Environmental Services
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,along with other requirements.
Type of Work:g ./; k-a i/( $Z Est.Cost /dc d
e � _
Address of Work: 2/ o /dlk /..5 tc,r S e-E0-/g C F. .04(,
Owner's Name SJ /9 F sP:- CZ //7 -S
Date of Permit Application: // `O i;)C
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 the agenthe owner:
�l— - Pc (c R /( lhi/Ns-N /O d 03
Date Contractor Name Registration No.
OR
Date Owner's Name
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