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0731 PITCHER'S WAY
'731 "�7°'��-che rs c� - � - � ---- --- ----- -- - - - ' - - -- - r�". /o-�e, - �y Town of Barnstable ', W Regulatory Services Richard V. Scali,Director c P r� * ' * Building Division '0 eA "�`"B Mnss r a �f1639. a Tom Perry,Building Commissioner k 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ea Office: 508-862-4038 Fax: 5000-6230 PERMIT# P�0 HbWO� FEE: $35.UU SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less Location of shed(address) iVillage Y r D�I �J Y1U1 t Q,�' M QVI �1(rbjjbg -9 to Property o er's name Telephone number Size of Shed ap/PaUl# aalA Ji4gnture Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:040914 l �� C�A233GG1= C�R1�JL���Z. Ua«�( Ft ow tib 3 33b G.p.V. ��-tC T�►,11C = =330,. ISG % • 4�rj 6 PD, : ""'�-..� � _ - g� Usk k o0o C A t_. I�_SPoSAL PtT uSE iOCao G&L- AZIBA C� Sty. � .� - ��d �•r•Vr i N P$oq S TOTAL 'DESIGN 4ZS G.P.D. ToTA L. T��t 1..�( FLAW t 33D 6�P.D , 40 P�iZGDldT10cJ :R�"t'� ��I�+.j� m l W*O¢ LfiYy I , I + I t r ip of , RICHARD BAXTERc.t. f 1 ! g o r !0,118 ; I`14 - t I l I r • i I r 70* Fyv 4 i goo 0 t 1 i ' i WV MF U 0� ¢rpP� Dist I V. 4 �. sic ? a u TAW14 (� ` 1000 GAL. low To y � I ...;. . I. A P17 Ii i r WAS+IBD ' j a rw C-SQT�FIEL] tt�GAT1oa� e, ; .Z l g I GG12TIt=�f TI4A-r TNC �OL)kY7(�� IOt.� 5�10�u1J E ' I R�PcRE1:lLE 4 iF. G Mo" c�PL,-1 t-1 S W 1Tk T :=: fjID�.1.1►-►Es i r i 1 I I -rc3wLj . or— L�w�g . � u,2i rI.l is t2CGlS'[L-R�U 1..A�.lp i .5U2V�tioiS BA r 05TEzv%L- .G ; 'o `�"t-�I a j7 c._A I-J IS 1-1 oT ti3AS CV 0 6•1: AN ' � , , art A SS. ; �lyrQ J AA C:W jUlk:%/r--( ;� TtaC. 0f C--' -1, .�j1�0LiLD _ 11 F�P L.1 cr Q.l�..l •r ,_,q,Ll C.ViKt►JI= '1_D'(' Town of Barnstable *Permit#0�0 G 3 Expires 6 months from issue date Regulatory Services Fee,�,,.3� JUARMABIA 1639,6 Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �f f Not Valid without Red X Press Imprint Map/parcel Number Property Address 7 i+C', UZS UQ CI U CI UPI yNIm S, Residential Value of Work ,3 E0 O Minimum fee o 35.00 or work under$6000.00 Owner's Name&Address r(S ;7nQ,\' a t',( 13t �c��S L � 1 7pinrlls, (�1� �2ieof Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: PERMI' ❑ I am a sole proprietor I am the Homeowner :'- I have Worker's Compensation Insurance Insurance Company Name TOWN OF BAPNS 1 ABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) i ❑ 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 #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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 copy of the Home Improvement Contractors License&Construction Supervisors License is required. n CIV SIGNAT �YcL,r,�GLTj C:\Users\decollik\Ap ata\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\DDV87AAZ\EXPRESS.doc Revised 072110 f �•7 1 7te Cou ntortweakh of Massachusetts - -. Department of Indrtstraal Accidents Off we of Investigations 600.Washington Street — Boston,M4 02111 fvtvrt:ntass.gor•Idia Workers' Compensation Insurance Affidavit: Builders/Contractors/Elect{riciansfPlumbers Applicant Information Please Print Legib acne(Bttseuesslorganization/tndi�ittual): V Y1 I�Q�C� �I Address: 1 W ity/State/Zip_ �JZ�rL ( Phone# ( —Cl 1 Are you an employer?Cbkck the appropriate box: T project. general contractor and I Type of P ject(required): 1.El I am a employes-with 4 ❑ Y am a g 6. ❑New construction employees(full andtor part-time)* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7_ [-]Rem I wdeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers" g_ ❑Building addition [No workers'comp.insurance comp.insurance-1 ] 5.❑ We are a corporation and its 10.❑Electrical repairs or additions Pred 1 Y am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑hoof repairs insurance required.]1 c.-152,§1(4),and wehave no employees.[No workers' HE{Other comp.insurance required.] *Any applicant that checks has N mast also fill our the section below showing their workers'compensation policy informatia 1 Homeowners who submit this affidavit mdxz=g they are doing all walk aad thm hire outside contractors ams-t submit a new' al5&M indicating such tCautractots that check this box must attached an additional sheet showing the name of the sub-commmrs and state whether at nut those entities bsve employees. If the sub-contractors ha:a employees,they most provide their workers'comp.policy numbe2 I ant an estptot er that is proiidutg tFvrken'compensation insurance for tnv eatpioyeex Below is the policy and job site information. Insurance.Company Name: I Policy#or Self-ins.Lic_#: Expiration Date- Job Site Address: City/State/Zip- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c_ 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and{or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be fDrwarded to the Office of Investigations of the DU for insurance coverage verification_ do h c fy under t e pat nd penahies of pedury that the ittloratalion pros ded abmro is true and correct: Silumnastur : Date: ( Phone#: 0 9 Offs al use oniv. Do not write in this area,to be completed be ci07,or town of, daL f j City or Town: Permit/License F Issuing Authority(circle.one): 1.Board of Health 2.Building Department 3.CitylFown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: j 6 I r• Town of Barnstable Regulatory Services i s B^ M"& Thomas F.Geiler,Director 39. 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: yk 1g I �l JOB LOCATION: number street t-,( � vi lage ) ..HOMEOWNER": syg-�ltC-`1_ a© � na4e— home phone# work phone# CURRENT MAILING 62-&o -• city/toivn 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 cedures and quire nts and �that Qhe/she will comply with said procedures and requirements. I. C� Sig1re of Hometivner Approval ofBuildin Official PP g 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. C:\Users\decollik\AppDataTocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 i PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 06/08/11 TIME: 08:59 --------- -------TOTALS------ _ ---- PERMIT $ PAID 35.00 AMT TENDERED: 35.00 AMT APPLIED: 35.00 CHANGE:- .00 APPLICATION NUMBER: 2U1103004 PAYMENT METH: CHECK PAYMENT REF: 812 ------KI -___-----' •. C Przopo5 Win' • �'-� ►.io GAr�A-tr 6: cWl4 rotJ 1L�4 1=L.ow - t1b 4 3 • 3�b G.P.D r �1:�'T—I G TL1t.1 K L 'S30 d Ir7 G % • L��7 6r.P L7� s � a , i t n r � r 1 I SMGWALL Q1'TA� �-� AI,SE tc2o S.P. — oo SmS 6.P.U, ,V a t' �a w Q.�' ♦`' { f t M' t ' YOTaL •�ESIGIJ = 425 G.P.D. '- r r (-{ ' ; ,<� � I. �.,� 5 ��; ° ' i TOTAL... { i r i 2GDl.bT101J RhTE tj �•�IQ 7.MIIJ o2 2 � :I C at R I i - •� i.. i :i r� t � ,{ � � � •r t i 'a � � � ,I t, IS-�� { ? k i [t F ' 't t •!_ +r � ti i ,ji.1� I � \.1�� OF ��t�i •try ; ) �, �� '��� r f A..� .t i 'r` � I = { ?O f i. '�' t t ! 9 �• 37 a I tI k 1 q t • f dd \ � � { GF ?• M,9�� + ' � k� �l /�, _+- nlAld � �'�+y� � ' t , T..'.� t Ii:.�._ � i y.� � ! �'�"(2+ 11 x ;.• e .'. .. �O'� , r 3 y cs RICHARDG r • �; � �iJt { � ' 3 �' + Y• � Ij� } r t t A.� M 3 1 4t••! � J ,( y1 `! jift A .:i .J ,, t i �.t � f � t �•� � .r-J DAXTER 1, '•�'� NN , t { i " e :� ....,.. 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I. efsor s map and lot number SEPTIC SYSTEM MUST BE IwS A g ED IN- COMPLIANCI Sewage Pe .....rmit number ...... WITH AIRTIuI E II �'rp T l...l....., � S�,I , -q. Y CODE AND MAUL TOWN OF�BARNSTABYL i BARNSTABLE, ' IL o pY.a�O� DUILDIAG I ASPECT j APPLICATION FOR PERMIT TO . .:�r l.G'C' C.. :............................. �1 h. ............................ TYPE OF,CONSTRUCTION .......i..Ram.e..r. ... ....................... ................ ..... .. .. ............................. 3� . . ......................9.2r TO THE INSPECTOR OF BUILDINGS: '! The undersigned hereby applies for a permit according to the following information: Location ....... ..............Y. ..Gl:.................................................................................................. ProposedUse ........................................................................................... ................................ ....... Zoning District ....�. .: {........Fire District ... :�n..n.IS... .............................................. 1-.I-e LU 1 ram' Name of Owner 4- .. ...............................Address ...................... It Name of Builder .. -- .. ................................Address ....V.....�! !QC.`-' '............. ..I. 4... Nameof Architect .. 1 r. C�7���.....................................Address .................................................................................... Numberof Rooms .... .....................................................Foundation .1........... ......1........................................ Exterior .....T......��.U.aj...Ftedln. .............................Roofing 14S.P�c . ......................... . � Floors ..FR,_q t'1 e .......................................Interior .....,71Ky. a.)a. Heating ...... /.. .................................:......................Plumbing ........................ Fireplace ..........NQN. ......................................................Approximate Cost ..... ......... ..... Definitive Plan Approved by Planning Board ________________________________19_______. Area ........ ................................... �o.so h Diagram of Lot and Building with Dimensions I Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH '9 I hereby agree to conform to all the Rules and Regulations of the Tow of B ns a re ing Bove construction. Name ` ~- �=d2Oeu�C.- � - ' . . ' . Weily' n R.-Trust . . - ~ cbuaI ...----.-.-.—..-.. ' . . . . Location ......I!itoliaco'Wav................. ............ ' -------�ya=za--.-----------.. Owner ..UemweaLyn.Real1y., ........... Type of Construction .........Xuod.Fcawe........... ............................. ........................................... Plot -----..---. Lot .-..��.4----.�- . Permit Granted^ March 1b . l9?� --..,,==..�---�---. Dote of |n .....................................lV } ~ ' Date A.. Com |etad �� - . _ . . . . ^ '6 + . PERMIT_REFUSED '. ------_ ........................................ lV ` - ---.-.--.'.^.-.---,--.----.---.,. --.--............... .............................. --.!---, r ...---~.-'�^ ........................................ -.--. '~ , ------.-..-......--.~..,-~----.. ` . . . . . . . Approved .................................................. lg -------------.---~-.-------. -----------------.---.---...�.. �^^�' | ^^��� Assessor's map and lot number`........... ' Sewage "Permit number ..... ....... .7/ . .. ................................. °` "ET°�° TOWN OF BARNSTABLE. i BAUSTODLE, i °moo �a�°° BUILDING INSPECT0,R,--� 'h s6 ♦ APPLICATION FOR PERMIT TO ....................f:.........L .............................f ; ..:....................... I TYPE OF CONSTRUCTION it r i ........... .3/�.......................19.. TO THE INSPECTOR OF BUILDINGS: * ��!(�" �1C? The undersigned hereby applies for a permit according to the following information: Location ....................................... ......! .................e:......... ............................................................. ................................... Proposed Use ...!.........;. Zoning District ......*..................... .�iia......Fire District ...q ,4,a i.!..................................................... Name of Owner .:"fir. .''�-- .............................................. 't$. Address ...."c`.:...--:....:-.. '.�.... .....�.. ....—........................ _ =-�---- Y-^�.. ��• Name of Builder .-:" .�............ '...............................Address I �S` IK. Nameof Architect .... .....'..x. '...............................................Address .................................................................................... Numberof Rooms Foundation...................��.'.''.''............................................ ........................ .................................................... Exterior .....?. ....:./�1:.�....?....f:. ............:............................Roofing ..........`............ .t........................................................ Floors ` ...........Interior I ..............::.............................................. ........................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..........!.�... :.r........................................................Approximate Cost ...................!. J.....`_ ..... ..... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ��� t . ......................................... Diagram of Lot and Building with Dimensions Fee 0 �- SUBJECT TO APPROVAL OF BOARD OF HEALTH - -'------ I hereby agree to conform to all the Rules and Regulations rthe Town of Barnstable regarding g the above construction. Name . � ........... ........................................................... Llewellyn Realty T. r A=271z,�� 21O46 No -----.. Permit fo,-����-a--..famil....�-...... ' . dwelling ' ---------..----.-----------.. � ��v . Loco�on --.�Yit����5..WAy---------.. ` ....................... ~..~~-~........................................ � � . Owner Ilawel��m � Type of Cpn,v,v,,/pn � � ` � � ` Permit *,qnroo � uor= or Inspection Date Completed � PERMIT REFUSED ` .` � � � � ( --~-- 19 � -----, .. ����-----. ! � -'----'�u«���----'-----------'' ' ~ � -.----.-.~.-.-~--.-...-~..-..---.. / / r ----------'----^`--^~-^~^^^--' /�. �. ' Approved ---------------- lg � � --------------_.---^-------. � ------------------------'^^'' � „�•;”. TOWN OF BARNSTABLE. Permit No. 21096 ______--- - Building Inspector sa"rnau cash OCCUPANCY PERMIT Bona "No building nor structure shall be erected, and no land, building or structure shall be used fora new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Llewellyn Realty Trust Address T lot #4 731 Pitcher's Way, Hy ahnis Wiring Inspector Inspection date <;7 Plumbing Easpeator � � x .1/1 . Inspection date Gas Inspector �, / � Inspection date Engineering Department 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. C f Building Inspector