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Home My WebLink About0048 SEABROOK ROAD i rt Assessor's map and lot 'number .. :-.-. `1... -. Od Sewage Permit number 17 4s...:� . .......................... ... FTHEtO�o TOWN" OF BAR-NSTABLE `i Z BABH9TADL , i 131.117LDIHG ' INSPECTO z639 R �p . c: r, APPLICATION FORS PERMIT TO .?. . 4G/ c ...,�� /.T i a......................................................:................... . . ... . .. .. s �9 TYPE OF CONSTRUCTION :.!'. ..... w ..........r dll.....Z5............19. TO THE INSPECTOR OF BUILDINGS: ;.•? - i The undersigned hereby applies for a permit according to the following information: Location ......*. ......�A•614 av a4y,ja1 S Proposed Use ........ .u''2i << (¢� C.7-1-) ff/1`-q...Aa!t d... .......................................................................... ZoningDistrict ........................./�...............................................Fire District .............................................................................. Name of Owner .1 ......!..!..�.... ').'L�� '��'......Address 4 ( ' j .. . :.......�E`�-��... ... Name of Builder .5,.... t .1/ 1� ... ! .4 i7 ........Address ...�......`!1. , wiQ. .................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......... /.................. 73./.�.p•�. ..... .............................Foundation ....... .................... :........................... wuvl ^ �. Exterior ....................................................................................Roofing .........i"3:sab4.i....l...... ...h;Ai........................ Floorsw(�.04...............................................................Interior .....S. .! T .. '.p .......................................... Heating .401....CrL1��!L�........... .......Plumbing ........0 J:..................... ........... a ..................... Fireplace ................ ........................................:...:.....Approximate Cost ...............5a�•.......................................... Definitive Plan Approved by Planning Board ________________________________19________. Area !. `f ....................... Diagram of. Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF. HEALTH N r) P r,"Wd I hereby agree to conform to all the Rules and Regulations ofXTownBarnstable regarding the above construction. Name ..-. ....... .......... Sheafferg John A. No .19752..... Permit for ......!W 9;Wn............ ........... ............................................................................... Location ..........48..S.eab3mQk..R0,...................... .... .. ...... ....................................................... Owner ............................ Type of Construction .....Wo.o.d..Frame............... . ................................................................................ Plot ................. .......... Lot .3.07........200........... Permit Granted ........... .. iQY....15..........19 77 Date of Inspection ....................................19 Date.- Completed .......................................19 PERMIT REFUSED ................................................................ ig ............................................................................... ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ........................................................... .................... ............................................................................... "+ Assessor's map and lot number ....... f.... .:':...................L�`U xF Sewage Permit number ..'�' S T '' ♦'°" ` l� .. ......................................... ' P�OFTHET��o TOWN OF BARNSTABLE Z BAW &MLE; i "b BUILDING INSPECTOR Gp�OMpY�. �• � �E } APPLICATION,FOR PERMIT TO ......if�•J'I&D f-1 7l7> T r'r k-- ... ....................................................................................................... !�o u 0R r9 r1 TYPE OF CONSTRUCTION ..................................................................................................................................... r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......:.........................................: ':.................................................................... ..... :.......... Proposed Use ..............!:`.:.r r . ..::F i .................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ............ '.I......6 ..'......7 t f�fi� ( �:+ ......Address ................................................l'' ... ..... ... ....................... Name of Builder ............f.....:......... fL: ........Address ...1.1�.....C.�, ,: rr�,r1 c'� �J I'1 Nameof Architect ..................................................................Address .................................................................................... Number of Rooms f a..................................................Foundation ....................E:....................................................... • f Exterior ' ...Roofing :!..........`- r...................................�a i ................................................................................. ........... . .......................... r'A 1 FloorsInterior .....::......................:........::.............................................................. ................................................................... Heating . r ..................................................Plumbing Fireplace ...........................................................Approximate. Cost Definitive Plan Approved by Planning Board --------------------------------19--------. Area ... y ............................. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH A 0 ♦ ^y r +t ' a J I hereby agree to conform to all the Rules and Regulations of the Town of,Barnstable regarding the above construction. Name°... f.'................... ........................................... $Wfif, John A. r7 -a `0� Sheaffer No AV5�Z.... Permit for ......Addltiotx.......... .................................................................. ....... .... Location ....O.Ae.abra.0k.Rd................... .. ...... ................Hyannis........................ ...?... ............... ............. ....; Owner ............. John..I.-SheaffAr...1 Type of ConstrucZi �n --.W.Qod..F-rame................ ................I.................... ....................................... Plot ............................ ll o ....Z......2QQ........ Permit Granted ..................N�ov,...15.......19 77 Date of Inspection ................ ..................19 Date Compi t d ......................................19 PERMIT REFUSED ...............................\............................ 19 ......... ... .. . .. .. ...... . ....... .. .. .................. /000 ................................................z............................... .................................................. ........................... Approved ............................................................. 19 ............................................................................... ............................................................................... �� i� Town f Barnstable 14 fop o stab a *Permit# `C� 4 2006 Expires 6 month om issue date SEP Regulatory Services Fee -rOWNpF BARNSTABLE �- Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 (r www.town.bamstable.ma.us V Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint [ap/parcel Number �� C�06 roperty Address 48 SZPrP&Qr_ R D tKo N iS, AA 0Z-60I j Residential Value of Work �300 Minimum fee of$25.00 for work under$6000.00 1wner's Name&Address jo k N L!,K"etz-- AS 5gA-6► oV__ 2) hA+vNtc> UL440CiI 'ontractor's Name Telephone Num'oer (W) 17/ -6241 [ome Improvement Contractor License#(if applicable) 137-O I ;ertstiac- rn's License#{ app3ieablec j�0- 6 Go ]Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance isurance Company Name Vorkman's Comp.Policy# 'opy of Insurance Compliance Certificate must be on file. ermit Request(check box) [ Re-roof(stripping old shingles) All construction debris will be taken to 13rP "STA✓t., LAfv'D FILL ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: perry Owner must sign Property Owner Letter of Permission. copy of the Home Imp a ent Contractors License is required. IGNATURE: !:Fom,s:expmtrg .evise061306 r� f k`t t�uiUdip Cgilat cC 2691 ! r �t; } 11�07 ter; r MI c TE t Nil-6 rid 1Ql•!p �- g 1'lu Nit, r ` i � ' The Commonwealth of'Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 y www.mass.gov/dia Workers' Compensation Insurance Affidavit: builders/Contractors/Elects icians/Plumbers r Applicant Informmtation Please Print Legibly Name (Business/Organization/Individual): SCOT, kt. QUI Mtt Address: 2A1 S1V W P,Uu,(,K kh LA, 4 City/State/Zip: - A)TC-t k_ t IN oZb 3 Z Phone#: Are you an employer? Check the-appropriate box: 'Type of project(required):- 1,❑ I am a employer with 4. ❑ I am a general contractor and I 6 employees(full and/or part-time).* have hired the sub-contractors ❑New construction 2.9I am a sole proprietor or partner- listed on the attached sheet:'t 7• ❑ Remodeling ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insuran0e. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repasts or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 122 Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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 forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby of perjury that the information provided above is true and correczt certi under the pains and p naltaes Si ature: Date: Phone#: (5-VO ?7/-624 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Y °FINE r Town of Barnstable °^ Regulatory Services vBA MASSS. Thomas F.Geiler,Director .eIED MA'S p`e 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 A Builder I, JW+ A -50-46A FEerL , as Owner of the subject property hereby authorize SCo"fT !t, QUI c-reft- to act on my behalf, in all matters relative to work authorized by this building permit application for: A8 SFAi3200V--Rb µ y",VIS, MA 02,601 (Address of Job) S& ature of Owner Date .70 F�nl � SCN Print Name Name Q:FORMS:O W NERP ERM IS S ION