HomeMy WebLinkAbout1160 PHINNEY'S LANE (13) Engineering Dept.(3rd floor) Map Parcel b �jr ermit#L I�
House# 1/ Date Issued
Board of Health'(3rd floor)(8:15 -9:30/1:00-4:30NA
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Conservation Office(4th floor)(8:30-9:30/1:00-2:00) �� 1
Planning Dept.(1st floor/School Admin. Bldg.) SE
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i '4 Plan Approved by Planning Board 19
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TOWN OF BARNSTABLE
Building Permit Application
Project Street Address C� ,
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Village elf
Owner (' ,,_ � '.,%i�L�C_�1.�i ��-�e� Address1160 �
Telephone
Permit Request i2
rs f
-First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
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
No. 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
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
r Current Use Proposed Use
Builder Information /
Name Telephone Number
Address License# a z�_6 3 VO
Home Improvement Contractor#
JZ�3 Worker's Compensation# z Z C<02 3
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
SIGNATURE DATE �f f�
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY 4`
PERMIT NO. :
DATE ISSUED -
a
MAP/PARCEL NO. -
ADDRESS- VILLAGE
OWNER
DATE OF INSPECTION: y {
FOUNDATION
FRAME
t
INSULATION
FIREPLACE -
ELECTRICAL: ROUGH FINAL
PLUMBING: 'ROUGH FINAL 1 ,
GAS: ROUGH t FINAL
' FINAL BUILDING,„__ '
DATE CLOSED OUT'
ASSOCIATION PLAN NO. 1 +
r
1.
75.
STANDARD LEGEN
77 D
note:not all symbols will appear on a map
\-/ .0 0(
GOLF COURSE FAIRWAY
7
DECIDUOUS TREES
167#1
q� EDGE OF BRUSH
-70 3 fw ORCHARD OR NURSERY
V ......
CONIFEROUS TREES
MARSH AREA
2
70A
75.5 EDGE OF WATER
..........
DIRT ROAD
A.,
:7,9.3 DRIVEWAYS
PARKING LOT
1.20 A( PAVED ROAD
69.0
DITCHES
\�8
• PATH TRAIL
�#VI&5
7
PROPERTY LINES
LOT ACREAGE
Z
------- ---- HOUSE NUMBER
70 21',te�PAR(El.NUMBER
1 A
7 5�,�3
2 FOOT CONTOUR LINE
6 1
10 FOOT CONTOUR LINE
73
X" SPOT ELEVATION
75.2 69.1 6( STONE WALL
.4 FENCE
x RETAINING WALL
4
RAIL ROAD TRACKS
-74 5
TELEPHONE POLE
7 4.9\\ L',
v
STONE JETTY
0.00 W 6 7.
.0 Q
SWIMMING POOL
.. ............
......... 0, PORCH DECK
........ ......... 0- BUILDINGS/STRUCTURES.
76. Z
DOCK/PIER/JETTY
ASSESSOR'S MAP BOUNDARY
•
.... ..............
............... ..........
lj
0.30 AC
'7, 3.1
86 - 9
" SITE MAP
...
jAc
T.O.O.GEOGRAPHI(INFORMkTIONSYStEMSUNIT
0.30 AC #17 0.32 AC
9 2 ....... ...
SCALE:in feet
0.30 AC 110- 4
86 - 10
X.-
a.67-3 1 Q3 #15
#213\
50 100
71 1
/0.41\A
#34
N
0.29 AC
..........
\/_8
.L3
91 - 1
....... 0.28 A( 0 29 AC 86 121
3
#44
#33 3
7 A( 110—
S ART ONLY GRAPHIC REPRESINTATIORS OF
.9 THEY ART NOT TRUE LOCATIONS h 8
#12
. .......... , --, ' X k, ,I
VEGETATION,TOPOGRAPHY AND PLANIMETRIC DATA INTERPRETED
6.30 A(
89 AERIAL OVERFLIGHTS,PHOTOGRAPHYAT 1-800'
-0 36 MAPPED AT 1-100'.PARCEL DATA DIGITIZED FROM 1'-100`
A( FROM 9'
ENGINEERING ASSESSORS MAPS 1989
86 ..............
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The Ctlttnnott iveafth of!Massachusetts
Departmeit1 of Industrial Accidents
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Olficeol/noestfgatfons
600 Washington Street
4i +� Bostotr. A1ass. 02111
Workers' Compensation Insurance Affidavit
Annitcant mtrmation• b :aa
location:
City phone#
1 am a homeowner performing all work myself.
(rl I amp aas sole
+�proprietor and have no one working in any capacity ^
t...�..tir--.i. •..Y�w:aY+._ "' _•iT '.X.:-^�B'E!"++7AK�P'R?" y1FT,K yT� .._:.:gin �...:_.: • .- ' ��'�Y+''�^.'•n +e•v,4�
1 am an employer providing workers' compensation for my employees working on this job.
mil),im•name, —
address: —
city: phone#•
I• II #
ncur, ce o. . .
,. • ..., .....,, ,�_.. .fir,......:v:n w..-..�:p.�v..«-. !.e+�.-w*r+wrs+w.:.r+. .K!7A,�� _ -
I am a sole proprietor, bw- tracto or homeowner(circle one)and have hired the contractors listed below who have
the following wor•ers compensation polic
comliany name•/
address• )l9)6Q2�
#•
insurance c #
L .:-y.:' ... ... tn:,n':: - •..7.ta�.�-:-�-,... '-r-Z- f ..T.�rr.•�s:Yr'��r: �"'`�if�':�^;`�1.�` r►ni.±1�"'��y.•xD�•.r +�s.�i •3YZ�,7.�r-r+.-..•:�o..,,,�- -•�C-•..•-..—•.L
^.�.�.,...-_.u�.. .aa:a• — — v.�- +...,rL..uii..�iC�':.+.a.ia:z:.ui
tom anv name•
addr ss-
city phone#•
insurance co policy#
:Attach additional sheet if tiecessar "y:.,.��' ;�`^��`��`f= �,,�= -,�f*-;"�•' '�"`�' ',�.tt��- •ter`
Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a
cop)-of this statement may be forwarded to the oMcc of investigations of the DIA for coverage verification.
I do herebt•certify tinder the pains and nafties of perjuq that the information provided above is true and correct.
Skmature Z
Print name Phone#
official use only do not write in this area to be completed by city or town official
city or loan permit/license# r'tBuilding Department
[]Licensing Board
O check if immediate response is required �Sdectmen's Office
I Health Department
contact person: phone#• rJOthcr
i
^ten.--i•-;.,-.-•-•..-rsra.+ .'; ......is..-.+dF"�'�"z+�.7�4�ec!^'►+r! ..�•�..r..-•v. -r;:. •--�*-'^R"�^':y.
Im'ued 3,93 P1AI
CF THE ln.
. � The Town of Barnstable
• �exsrasi,E, -
9� ' �0�' Department of Health Safety and Environmental Services
59. 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.
_-o O�t,r Olew_ k 9pt I'T�
Type of Work: ip,T; 5)c io ..2a Est.Cost
Address of Work: D
Owner's Name J2 '�"��2�� �-�w�� ate.-? _
Date of Permit Application: %D /R,
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 age -of the owner:
Lf 4 / � 2(.2
6at6 Contractor Name Registration No.
OR
Date Owner's Name
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