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51-0117-7
SEPTIC SYSTEM MUST BE
INSTALLED IN COMPLIANCE
S � o C 7/ . SATNH ARTICLE.11 STATE
ARTICLE
CODE AND TOWN
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rO�� TOWN "VX
1 N�STA.ELE
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"6 BUILDINGam INSPECTOR
O•EPY Or
APPLICATION FOR PERMIT TO .. 4; , .........7. L�Lr .:....:. A..
TYPE OF CONSTRUCTION ........ . ..........T..
.............`.. ��..............19...
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby appli a permit according to the following information:
Location .. .,aLl �`� ....�,,�.. .��`1... f'I/..G` ........�� .............. . ?r�2lN ?.....................................
ProposedUse ........... . . . a .. ...........�� ................................................................................ . ..............
Zoning District .....// 1�4�G'( ........................Fire District
Of
Name of Owner 0(l�L. ......Address ..f .r....... .........
Name of Builder / � ��• ' �-°::.�., .Address ........ ....... . ..
Name of Architect li ...... -4...................Address 6-V......� ..... .. ........ ... ..
Number of Rooms ...........41.......................................................Foundation `✓L G.( ,,.-. .. .,
Exierior .... ...Roofing ........ �.
�.. ...... ... ...... ......... ...............
Floors . .... Interior ....//d�.' '/�iC����:!ti...T....................................
,
Beating .......................... . ...............................Plumbingk§a.....ax..... .. ...... .. �..
Fireplace ................................................................................-Approximate Cost ......��a...,��.�................�........:.............
Definitive Plan Approved by Planning Board ---------- _ _
Diagram of Lot and Building with Dimensions
SUBJECT TO APPROVAL OF BOARD OF HEAL H
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name e�,,1.. •:•••• .. ���ta�� .....
LaFleur*Development
116267
1140 ................. Permit for ....... ........
single family dwellin
.......................................... ................&.................
Location .......Jard&e Lam
.
.................................................
............................ ....................................
Owner............LaF.e.2mm..Development.............
...... . ...... ........... . .......
Type of Construction ...............;Crarae...............
................................................................................
Plot ............................ Lot ................. ...........
Permit Granted ..........Jun.e...4.................19 73
Date of Inspection .........................7.........19
Date Completed ......z.............. 3.......19
PERMIT REFUSED
................................................................ 19
...............................................................................
....................................... ....................................
................................................................................
...............................................................................
Approved ............................................... 19
...............................................................................
............ .......... ..................................................
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' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 1�19'7 Parcel Z r Permit# 7 Z 2 6
Health Division � Z"Oc'floo a Issued 2w c
Conservation Division f 2 03 Application Fee
Tax Collector .%/d;3 Permit Fee- 30. B
Treasurer • -- ._ •�_—�
if� 'I ���` off; OYSTEM MUST SE
Planning Dept. t".-:7 AL LED IN COMPLIANCI~
IMF;TITLE S
Date Definitive Plan Approved by Planning Board >u;d �^� Ev'�T�L CODE ANV
Historic-OKH Preservation/Hyannis TOYM REGUUTIONS
Project Street Address 2-7 ill/cg
Village 1s
s l Cafe>�y
Owner Q_2io-CP A (��ifey�{/��e—,/ 64urxr_�� Address �'/�n�
Telephone 4" 7 7 t — 3 6 Y I
Permit Request /3wlc,D 4 'G✓at- x � ',�C� Eiv i—
Square feet: 1 st floor: existing proposed T 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation - Construction Type
OT
Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation.
Dwelling Type: Single Family 9" Two Family O Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes 0 No On Old King's Highway: ❑Yes 4No
Basement Type: ❑Full O Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new k Half: existing new
Number of Bedrooms: existing new l
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:Cl existing ❑new size Barn:0 existing ❑new size
Attached garage:®existing ❑new size Shed:U existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded
Commercial ❑Yes 4No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone Number ��` 776'" S�'G
Address License# CS 0,�3;?-2-3
/2f*Ay 5 Tvx/s IGGs � D 4 ? Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOj° a�°�i9rE �y?viJ if/✓1i
SIGNATURE DATE /� 0� '
} FOR OFFICIAL USE ONLY
1
PERMIT NO.
DATE ISSUED
Y MAP/PARCEL NO.
t
. v
ADDRESS VILLAGE
OWNER
s
DATE OF INSPECTION: .Co A T_0
FOUNDATION 0 !7 ®� da , y '�} '
FRAMES t N'i (� ro �� �f >�� d� sv fit/
r
INSULATION
y FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL'
GAS: ROUGH FINAL
FINAL BUILDING n/ lk 7 /
DATE CLOSED OUT `
r ,
` . ASSOCIATION PLAN NO. j
The Commonwealth of Massachusetts
Department of Industrial Accidents
' - - exce offoaesffoatloos
600 Washington Street
Boston,Mass. 02111
`} Workers' Com ensation Insurance Affidavit
name Rd 1b�T
ocation �0 �
l /���aO'S
city �� tIN taws !°�/`ta'3 , phone# 508-7Tb-S�6 7
❑ I am a homeowner performing all work myself.
I am a sole netor and have no one workingm- ca acitp
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❑ I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who
have
the �followin4,workers' co ensation polices: v , . .? _.•• ,
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Faihse to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criadnal penalHa of a fine np to S1,500.00 and/or
one yea",Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against md. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I da hereby certify under the pains and penalties o perj hat the information provided above is true and correct
Signature / Date
Print name a G 13 Eft f'Ul�Kt��� )E Phone# ���- 7 7b- 5��'7
4 official use only do not write in this area to be completed by city or town oiBclal
city or town: perndtllicense# ❑Building Department
❑Licensing Board
❑checkif immediate response is required ❑Selectmen's Office
❑1lealth Departruent
contactperson: phone#; - ❑Other
O viud 9195 PJ/a
r . �
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer;or the receiver or
trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
{, Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and
supplying company name *
and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
or town that the application for the permit or,license is .
date the affidavit. The affidavit should be retained to the city PP
regarding the"law"or if you
being requested, not the Department of Industrial Accidents. Should you have any questions
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permitllicense number which will be used as a reference number. The affidavits may be retarfiR io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions•
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
amce of fnvesilgauans
600 Washington Street
' Boston, Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375 .
a .
�oF�+Etoy, Town of Barnstable
Regulatory Services
snxr�sTaet.E Thomas F.Geiler,Director
y Husa $
�Ar616 9. ,0 Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
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.
L l)
�ns� c7Toal '0yQAfr 417T CK Estimated Cost
• Type of Work: t� 1, '� I
Address of Work: �7 ��N l c� L/9�tlL N yi9/b A-�15 01601
Owner's Name: & R ��
Date of Application:_ /dq 3
I hereby certify that:
Registration is not required for the following reason(s):
E]Work excluded by law
[]Job Under$1,000
[]Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
l `
Da a Contractor Name Registration No.
OR
Date Owner's Name
°FSHE Tp� Town of Barnstable
ti
Regulatory Services
BMWSMAM TM3LE,$ Thomas F.Geller,Director
4iArec �a�` Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner,Must
Complete and Sign This Section
If Using A Builder
b-q it-i-t4 1*6R- , as Owner of the ro subject
l P per'
hereby authorize /`��,3L�/L7 �e�'>'ECtf/✓/� to act on my behalf,.
in all matters relative to work authorized by this building permit application for:
27 \J�NZee Z*lvrt 4A, D2-60I . .
(Address of Job)
Signature of CK4er Date
Print Name
Q:F0PMS:0VRgWERMISSI0N
a I
ilk: . ��TT pp
h i BOARD OF BUILDING REGULATIONS
k7icense: INSTRUCTION SUPERVISOR
Numbers:\ 063223
" € 0Q04 Tr.no: 1555
Nil
ROBERT
i PO BOX 305/166 H6
MARSTONS MILLS, f;48 Administrator
( ' J
Town of Barnstable
• Department of Health Safe and Environmental Services
p h',
■ARNSTABLE,
Conservation Division
200 Main Street,Hyannis MA 02601
Office: 508-862-4093 Robert W.Gatewood
FAX: 508-778-2412 Conservation Administrator
MINOR ACTIVITY REGISTRATION
6"4et 7WrJ5_'I#_I Acro�x ayw 7-h'�nf-le
Property Owner Telephone number
Mailing address
Project location �� Map/Parcel
Project description
The following minor activities will be reviewed,under Art.27,by Conservation staff instead of the
Conservation Commission,'as long as they are constructed at least 60' from a wetland resource area or top
of a coastal bank.
* Pathways 4' in width
* Fencing that does not create a barrier to wildlife movement,6"above grade
* Conversion of lawns-to decks,sheds,or patios that are accessory to single family homes,as long as:
-house existed prior to August 7,1996
-alteration within the buffer zone is less then 250 sq.feet.
-sedimentation and erosion controls are used during construction
* Stonewalls(this does not include st ewalls for retaining wall purposes,grading and/or fill)
/; /�Xx ` 1.- od' ea
Signature Date
1ZAZO.3
Reviewe y Date
gecrl=an)
minoract.doc
s M^y N ®-r B ccu PLAYE STANDARD LEGEND
NOTE:not all symbols will appear on a map
GOLF COURSE FAIRWAY
EDGE OF DECIDUOUS TREES
EDGE OF BRUSH
ORCHARD OR NURSERY
�..;.....1' EDGE OF CONIFEROUS TREES
MARSH AREA
—- — EDGE OF WATER
DIRT ROAD
DRIVEWAY
MAP I��— PAVED RO D
PAVED ROAD
MAP 30 I ————— DRAINAGE DITCH
27 PATH/TRAIL
PARCEL LINE
rw 21 MAP#
021 PARCEL NUMBER
5 # #367 — HOUSE NUMBER
7 — 2 FOOT CONTOUR LINE
91 f io 10 FOOT CONTOUR LINE
Elevation based on NGVD29
4.9 SPOT ELEVATION
STONE WALL
—X—X— FENCE
----................ . \.. 41o............._...
RETAINING WALL
T-- RAIL ROAD TRACK
STONE JETTY
07
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PORCH/DECK
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DOCK/PIER
HYDRANT
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i
o POST O� FLAG POLE
T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M 5 U N 1 T a SIGN ® STORM DRAIN
r� -
M PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of o EN )parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James ❑ TOWER
I"=100'scale map and may NOT meetundories.They are not true locations,and W-Sewall Company.''.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD UTILITY POIE0 15 30 National Map Accuracy Standards at this ant actual relationships to physical objects Corporation.Plonimetrics,topography,and vegetation were mapped to meet National Map Accuracy StandardsUGHT POLE O EIECfRIC BOX
I INCH=30 FEET* enlarged scale. at a scale of 1"=100'. Parcel lines were digitized ham FY2004 Town of Barnstable Assessor's tax maps. .
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AssessoI. r's offioe.(1st floor): THE
4ssessor's map and lot number ......��.�+....��c��... , �"�-® h��' �� �.Q••�f �ITe�f
.. o
Board of Health ;(3rd floor): c� -=`° i k� MPL1A ' "
Sewage Permit number :.... 'aa'. �D. ..`. ®� 5 Z BABISTSDLi
Engineering Department (3rd'floor): , p F���� ®® �o� 1639
House number :.................. � .7 cU �i, 9E�'���� '°�to v a�
� A -
APPL16ATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00''P.M.�only+ TOWN. RE����i®�� ya '
- TOWN;l ;OF BARNSTABLE
BUILDING, INSPECTOR
APPLICATION 'FOR PERMIT,TO �1 1.�� ...: i .....CaF...�?C1 1.�lla�z....1�F , f........ t .
TYPE OF CONSTRUCTION TIs� �l l/'{..r/��x(�/ � �'L��.. a)5 � 1.IV�Gt .............................
. ....................... --....19.C.?.:.I
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location :...... .. �..�.... . . .. .......................................................................:................................
Proposed Use .............::. .............. .................................
........................ ... .....
Zoning District �`..... .....a.......................:..........Fire Distract .................. Cl ..................................
Name of Owner F•��Q).....bAVT_H.(.�J.0.............Address ...�4 ... :.. . .� ,.. .�.f-1 .,N�s............
Name of Builder 1 ss �. .. 7���-� .:G4. .( i.�
• t
Name of Architect .........
..........Address
Number of Rooms ......�.........•..................................:..........Foundation ................................................
Exterior ........1G �`..1.1 ..................................................Roofing ........t1.K.(.5TOV.(0..
Floors ...... j. .j.L! .................................::::.................Interior � �[�.......
yam- •
1 I / ...............Plumbing 1 �ti eaoo. .Heating .. .�. .r........................................... ..........
i -
Fireplace ...... .. . ............................................................'.....Approximate Cost .....(5Ma............. .........
04
Definitive Plan Approved by'�Planning Board ------------------------------19-------- • Area ........�... ..........
Diagram of Lot and Building with-Dimensions Fee `..............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
. � Sic � •
3(v
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform` to all the Rules and Regulations--of the Town of Barnstable regarding the above
construction. ti
I
Name ..... .. .............. ........ ..................:........................
Construction Supervisor's-License ,( Z4141)...........
' GAUTHIER, GERALD
' 10897.,
No ......... . Permit for ....................................
Single Family dwelling
ti � Z7�Janice Lane, -Lot*..#.5....
Location .............
+ HXannis
Ownerf Gerald. Gauthier..... Y........:.
F
�" aj f,, . I` a ,�-. • r
Type of Construction „•,Frame �t ,,•
g... .K ......................................................... ` r y : •< ,
Plot... ..... .... Lot y ........ .........
Permit Granted June 2.3......... 1.19 8 7
.nspe 1
Date of Ic tio n'.... ........ . .....'..19
Date Completed .... .... 19'
l 4
IL y
,,,", /j ,
Assessor's otfioe (1st floor): i
• ., ✓ � CF TM E TO
Assessor's map and lot number .....t.. ! ...... . ......
Board of Health (3rd floor):
,Sewage Permit number ..... � . S 33AXIST&DU •
Engineering Department (3rd floor): tb 9,
House number 3 `e
...................................... ' 'Fa YPY a'
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00•2:00 P.M. only
TOWN OF .BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO �.lS.f..... .�i? .I�(i ..,....t .. �C! ��.h.... �'� � ...............•,
TYPE OF CONSTRUCTION ...�� ����YI1..,1�-�ANJ .. X(��rit�J�
/.. . ........................(.%�.- -....... �
TO THE INSPECTOR OF BUILDINGS:
The undersigne-d7 hereby applies for a permit according to the following information:
Location .... ...!..... i(f=... , NN ...,?..........................................................................J..
_... ..........................
Proposed Use al t�1(o� � 1C,`t... 1,^,1�1���........................................ ..........................................................
...................................
�j
....... .........................................Fire District �,
Zoning District ....................... �.................. ........................................
Name of Owner r �� . tr\� TL-! � 2-� C �� 44 :+' J(�ll
.. . .... .................Address .............................�... .......... `�... ...........
C. .�f .n..i -M11U'Alddress .� ..t��Y ��`� G�C� < �=n ri- r2,�1rC.C.
Name of Builder -... c............• . ........... .........
Nameof Architect .. /. ....................................................Address .......................................................I............................
Number of Rooms ......P1,......................................................Foundation n................................................
Exterior ........ ..................................................Roofing ........ :7C./ ']-ILILC..................................
n!/..,^ Lam. '. C ./'Tr.. �c�r.... r.n..n1..............
Floors ......�-�...�.�...........Y!......................................................Interior .....
r-+
Heating ... #:.o ......Plumbing 1 ')! ' � CC
Fireplace ...... � ...................................................................Approximate Cost .....�. �
................::
Definitive Plan Approved by Planning Board --------------------------------19-------- • Area .................... . ...............���
Diagram of Lot and Building with Dimensions Fee ........
............. ..........6-0..................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
�xlsTi Nto +-
3(a
24
3Cv
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above F
construction.
Name -
Construction Supervisor's License .n?�-�. `t-+�.1...........
GAUTHIER, GERALD.
A=307-275
No .3.08,97... Permit for .B14i1d...Dormer,.,
..Ingle,.,fam ly,,dwe,ll ng,..,,,,,,,,
Location .....7....4?A A i,g.e....14?X1e.....LA.t;...
�.5�.
..................H.y.? ...........................................
Owner .....Gerald..Gauthier
........................................
Type of Construction ..F.KAMe...........................
...............................................................................
Plot ............................ Lot ................................
Permit Granted ....June 2.3 , 19 87
L Date of Inspection .........:..........................19
Date Completed .......................'.............19