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Town of Barnstable -*Permit# - - b
6 monthsf vm issue date
Regulatory Services Ecee�rrn rM05,15
�►���a��
` Richard V.Scali,Director
Building Division OCT 18 2016
Tom Perry,CBO,Budding Commissioner T f 1 A STABLE L
---200 Main Street;Hyannis,MA 02601 1-1-
www.town.bannstablema us_-- -- -- ------ -----.---___ -
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERAuT APPLICATION - RESIDENTIAL ONLY
Not VaNwAoWRedX-PresshVrim
Map/parcel Number Y� 4 'S
Property Address / / (0 ®"o-t o", �k'D v
[�Residential Value of Work 00 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
Contractor's Name ��£', ��)C2 t P,0 Telephone Number 6-1 D--�`Z&
Home Improvement Contractor License#(if applicable)A*)':Z� Em1;i<0XVP,A,0 (Zewo Q.C9, crm+.
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I an a sole proprietor
❑ I am the Homeowner
E!.I have Worker's Compensation Insurance
Insurance Company Name (V\ / y
Workman's Comp.Policy# 6"Vo - 014o t q 3 o),O�(.*A
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
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Wmdows/doors/sliders.U-Value . (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
"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 Contractors License&Construction Supervisors License is
'red.
SIGNATURE:
Q:IWPFI M70 ding ' 1ormslE7PRESS.doc
Revised 040215
{
- im.k 1 1}1 La A.I.M Mutual Insurance Company
VI `ua Massachusetts Employers Insurance Company
New Hampshire Employers Insurance Company
INSURANCE COMPANIES Associated Employers Insurance Company.
NOTICE OF REINSTATEMENT OR WITHDRAWAL OF CANCELLATION
Conrad Remodeling
Jeff Conrad 09/22/2016
535 Phinney's Lane
Centerville, MA 02632
Effective Date of Cancellation: 9/21/2016
Insured`. Jeff Conrad
Policy Number: WCC-500-5016143-2016A
Policy Term: 6/24/2016 to 6124/2017.
The Notice of Cancellation which we issued on the above date is hereby withdrawn. The policy listed
above remains in full force.
If you have any questions.regarding this procedure, please call Patricia Deviller at(781)270-8716.
Sincerely,
Robert R. Cella
Vice President-Operations
Placing Office: 500-115-2
54 Third Avenue • P.O. Box 4070 • Burlington, MA 01803-0970 •Tel: 781.221.1600/ 800.876.2765 • Fax: 781.270.5599
BRIDGEWATER• BURLINGTON •CONCORD, NH • HOLYOKE* MARLBOROUGH
sponsored by Associated Industries of Massachusetts
� . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
(,�
Map "1 Parcel DS ��ao�- Application #
Health Division 'Date Issued l
Conservation Division Application Fee .SD
Planning Dept. Permit Fee
Date Definitive. Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address 11L 0Aka<'i cAJT- 90
Village Jilin f}-LW m ID
Owner ( A Address Cl(e CW411CY1V _ Rh, ,q¢2
Telephone ;O R —37S0gi a-
Permit Request 0i*In A/6y ��PA�2 //V�' IJ0-GvN tg 2Qa A-- f
gE�6Q iL n ?=A4CTL u AL Ldl:f
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation S G 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 _0 !S Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: Q&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
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑existing U new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ Ory ge_
Attached garage: ❑existing U new size _Shed: ❑ existing ❑ new size _ Other:
c� o
�.., _n
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ n
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use ^� n
rn
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name �� �� j Telephone Number ��' �� 1
Address !a �LAPP Q k License # (f5 eke7 5-
Yz z epcld P&C 0a2C,�'S Home Improvement Contractor# -re �2 el 0-1�S
(,r9E. ��,2yy�so eif
Worker's Compensation #A 6 9 9gem a 3
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE l®
FOR OFFICIAL USE ONLY
APPLICATION#
" DATE ISSUED
MAP/PARCEL NO.
i,
`F ADDRESS VILLAGE
{ OWNER
DATE OF INSPECTION:
'FOUNDATION,;'
F FRAME
INSULATION:
FIREPLACE
` ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
1 =
GAS: 3 : . °ROUGH r t FINAL
} FINAL BUILDING '{:; ., _. k•
,E
f :_::DATE CLOSED OUT f; -
ASSOCIATION PLAN NO.
ro
Town of Barnstable
Regulatory Services
' SA�TI6TABLE, t '
p � Thomas F. Geiler,Director
1639 ��
°rEDt► Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using ABuilder
I, ���' /JE�ZS��'✓ , as Owner of the subj ect.property
hereby authorize SIEVE C¢ppEL 1-14 CC! to act on my behalf,
is all matters relative to work authorized by this building permit application for.
I I(0 6AkM6AvT Ge Cq&DI- Q 14 i-D AA,
(Address of Job)
Signature of Owner Date
Print Name
If Property-Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:OWNERPERM1SS1oN
� Town of Barnstable
F 1 t
0 osy
"0 ' 'Regulatory Services
Thomas F. Geileri Director
a,tirrxsriste, �
rtwss
Building Division
Tom Perry,Building Commissioner
200 Mairi.Street,._Hyannis, MA.02601
Yt,ww.town.barnstabl e.ma.us
Office: 508-962-403 8 Fax: 508-790-6230
HOAIF—OWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number strmt village
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
7be current exemption for"homeowners"was exten ed to in owner-oc u ied dwellin s of six units or less and
to allow homeowners to engage an individual for hir who does not posses a license,provided that the owner acts as
superviso
DEFINMO OF HOMEOWI`
Persons) who owns a parcel of land on which he/she r sides or intends o reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detached s etures ace Sory to such use and/or farm structures. A
person who constrycts more than one home in a two-ye period s not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a f ace ble to the Building Official, that helshe shall be
res onsible for all such work erformed under the buildin e (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for c MP
Hance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
The undersigned "homeowner" certifies that.he/she understan the Town of Barnstable Building Department
minimum inspection procedures and requirements an64at hr-/s e will coruply with said procedures and
rerzririrements.
Signature of Homeowner
Approval of Building Official.
Note: Three-family dwellingscontaining 35,000 cubic feet larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EJIE?Y= N
.The Code states that: "Any omeowna performing work for which a buildin pcmvt is required shall be exempt from the provisions
of this scctign.(Scetion 1D9.1.1 -Li sing of construction Supervisors);provided that if e homcov,mcr engages a person(s)for him to do such
work,that such HOMCDwnQ shall t m supcvisor." i
N#ny homcowncr-s o use this rxernption arc unaware that they arc assuming the responsibilities of a supervisor(sec Apprndix Q,
Ru)cs&Regulations for Liccnsvrg Construction Supervisors,Scetion 2.15) This lack of awarcness bftrn results in serious problems,particularly
when the homcowncr hirrs unlicensed persons. In this ease,our Board cannot proceed againsi'the unlicensed person as it would with a)iernse:d
Supervisor. The homeowner acting as Supervisor is ultimate)y 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 thathdshe 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 fora 1ccTbfieation for use in your cori-urrunity.
Q:fomrs:homccxcmpt
TOWN OF BARNSTABLE Permit No. __ -_---------_
Building Inspector
Cash ------------------—
• 'w9 l
»,& OCCUPANCY PERMIT Bond --___-___---------_' ���(
Issued to Address
lot #2o2—_ :I l.fi 0Pkr)Mr_ ',Road— t,'mrnaouid
Wiring Inspector Inspection date
Plumbing Inspector Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
Board of health Inspection date
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.
Building Inspector
fs p number ........ y�. `.. .:. ... °
sor s ma and lot
���OfTHEr��o
....... .......- ?,f .....fi e
S Permit number � .... .. 0 �IZCf� d
House number �� t ; g t;sL►p".:ldi`:. 9 Baa►gines LE'�
...... ..... .................................................. pp��y, ,o�
4ALLE4,� VIN !�#.�E� ��'FOMPYa�00
a A 9 'U LE
TOWN OF BARNSTAE- AL ,�''��
� u �� >
BUILDING INSPECTOR
r
APPLICATION FOR PERMIT TO .. .e?"'.:. 3.. ...... :... :. ........................:.....................
TYPE OF CONSTRUCTION ............ cr oa�...... 7C `L.........................................................................
J
s : .�.......�................19g:Y
TO THE INSPECTOR OF BUILDINGS:
The undersigned/hereby applies for a permit according to th`e. follllowi/n �i/nformation:
Location ... . ..*. ..��.pz... .c.�`"'.` !......Aed..... �rK.!!�!!'^� t... / .........
ProposedUse ......... .1. .......................................................................................................................... ......
Zoning District ..... ........�. ... ...............................................Fire District .............. t ! . C.......................................
w
Nameof Owner ... ...... .. .. ...... 9 � ............. Address .......................,................. ....;..............................
QyName of Builder ,...... ...... . ......................Address .�.. ?........ ...... ................. ....
Name of Architect ...... ,1.��.!Y ! ...5( � ..............Address .........: :
G( Q.�. ........ ,.". ........................
Number of Rooms ........... ...................................................Foundation ............... `. <.........a
..............................
Exierior ...... . .. . .....................................................Roofing ................. .................. .............................................
Floors .....�r. ....................................................................Interior ....... l... , .. .. `.:'`"�0...................
......... Plumbing 11 /�
Heating C ..�f .. !�?�... �'�. g. P�..r ........................................
Fireplace ............�.` .....................................................Approximate Cost .
Definitive Plan Approved by Planning Board ________________________________19________. Area :l... .................
Diagram of Lot and Building with .Dimensions Fee a' ;�
SUBJECT TO APPROVAL OF BOARD OF HEALTH
(/ 3'3 3
1 1.2
9C— (r ct.�a?e.
t
I
lop
.�A
6 °
hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ...... ... ......
r
`�..., CARY, DONALD & MARGE
r ,
68 One Story
' y ,
Permit for '
Sin le FAmi.l Dwellin -
..............J...................... ........................g............... _
r;
Location ..Lot #202 116 Oakmont. . . . ...Road
... .. .... .. .... .. ....
Owner ....Donald & Marge. CarY.:.........
Type of,Construction ...Zridle.........................
Plot Lot '
/• " December 22,1 �� 82
Permif�Granted ........................... !.....19 , r^�
Date of:Inspection .....C.........r.�.......` fi 19
Date. Completed .........s�.. . 77.5t 3.. ' 1.9' �4
`4 r r
PERMIT REFUSED REFUSED' n ! l ti. �[..
;c 19
may{ �,�, � � y ,_...�-.•"
. -............ ............ n:.........../ .+� C t
c ......... .... .. . . ..... ............................
Approved ................................................ 19 f
...............................................................................
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