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• TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
p99Map Parcel Permit# p
'Health Division � Date Issued
Conservation Division TIC 4'U
Fee
Tax Collecto Q' j� —YZ 0 r1 cl INSTALLED IN �Om��PL�ANCE
Treasurer ENVIRONMEN rTAL CnD AND
Planning Dept. Tom R* �� °�f�
Date Definitive Plan A roved by Planning Board by-
Historic-OK servation/Hyannis
Project Street Addre ss �3 / C� ��
Qn f l"_C�vl.off_��r
Village.
Owner (20 Address &,CaLLCe �0e
Telephone
Permit Request 29e14erZ, ® — Il e_ La. .4 ,�(A-c
Square feet: 1 st floor: existing " proposed 2nd floor:existing proposed Total new
Estimated Project Cost �� o Zoning District Flood Plain Groundwater Overlay
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 29 wS Historic House: ❑Yes KNo On 0ld King's Highway: , Yes ❑No
Basement Type: 9,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 ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes O No If yes,site plan review#
Current Use Proposed,Use
BUILDER INFORMATION
Name_ Telephone Number
Address IA a"-e Qc License# (-S
fJcc yLrrS�tt,(DI.� Y'L5 Home Improvement Contractor#
dZ.6 3 v Worker's Compensation# .
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO`
SIGNATURE jf4, DATE
FOR OFFICIAL USE,ONLY '
PERMIT NO. - z
DATE ISSUED
MAP/PARCEL-NO.
ADDRESS - . A VILLAGE
E OWNER .i
} DATE OF INSPECTION:
FOUNDATION
r FRAME
INSULATION
FIREPLACE <
ELECTRICAL: ROUGH t" FINAL
PLUMBING: ROUGH- ' FINAL; y
GAS: ROUGH'_ - FINAL
.. FINAL BUILDING
DATE CLOSED OUT }' '
ASSOCIATION PLAN NO.
�. The Town of Barnstable
KAM
019. Department
artment of Health Safe and Environmental Services
d, r9�ArFo ��`m Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
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.
Type of Work: 4- Estimated Cost "tc s o Iva
a
Address of Work:
Owner's Name: 4 4
Date of Application: 4
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
E]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
1 here ap fora perm' re, ent of the owner: i® �
Date Con ctor Name Registration No.
OR
Date Owner's Name
q:fbr ms:Affidav
Assess;s .map. and lot piymber .............. .... ......... .....ILI ......
SEP7•IC SYSTEM MUST BE
r' a � 1 NST LLED IN COMPLIANCE
!
.
w SewagePlpermit, number ........ ..................... .. ........... TICLE
WITH AR !! STATE ,
SANI TARP CODE AN
y�F?NE roes : TOWN O F B A R N��,�k �1'1 T L-E r�+Wvr�
�.J Z BASBSTADLE; i J - trj
1639- °�Ar RUI�LDING INSPECTOR
O '-1639• � ,y
{
�- APPLICATION' FOR PERMIT TO .. .� j ....................... ...........
TYPE OF CONSTRUCTION .....2�`S.I.tJI.E.NT.l11a..:7.51:1�t.�j..�C' .. CYII.I ..�. �OQ ,.ER0.J(Y2�. .
v
E� ...................... . . ....19..74..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
-oT.39. t1�,R1.!��:�....��nl.�. ��a.�N.��.R.(3`.�. IUTA, � . . ��rAT.�S.. .......
Location ,.. r... �............... .sA..Q11�.........r4[m..
Proposed Use .51 N�.� .. G41Y11.�. ..lU d .. Q(..... .................................................................
ZoningDistrict ........................ 7.................................Fire District .......... a° " ....................................................
c� 11 Des ?! �`Y1`�� c�c •�. ...........
Name of Owner �� .. .��?+�?.........�...,.+.. +......Address ......................... ............ ` ..,,.....rt..
Name of Builder b.Rip— .............Address 9 A CQPJI.N4r...
Name of Architect ......4. `� .::.. �Sxc.�� 6<.i1 YYN.Address ..... fir.:-.�....� .... ue �. .
................
�' I
Number'of Rooms .....(7..........................................................Foundation 1o....P..Qu�? ?.C4N ET.f' .....................,,.......
� H-CeDar- l T...Exterior Roofng , SPHft.LSE.(N 4C,S..................... . ..........
Interior ...
Floors ...P�Y.W.OAD....WIC—A.R'..PRn . ............................. �� .......D.Cry.ItJ I......,..........,.......................,.,....
Heating ...F.R.W...aY....GA.$..............................................Plumbing ..COPPiC'...12 + PUS .,f?i;.rlc,.......................
Fireplace ....L.:-..QRICJ4,........................................................Approximate CostA&ja
...........[........................................
Definitive Plan Approved by Planning Board ________________________________19________. Area ` 3 "'1707
Diagram of Lot and Building with Dimensions Fee .... .r. h..................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
Y
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... ... .. ...........
Crowder, Dale E. Jr,
18426
one story, '
N6 —. . — Permit for ....................................
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�� carr' Lane
Locotion4!--...--....�...----.—.~.—.,---'
' Barnstable ' �
.—.------.----------,..------.. .
'
Dale E. Crwwwdery Jr.
Owner ............................................
frmn�o
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Type �*ruchon ��- '
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Plot -----.��--- Lot —����-------.
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' Permit Granted June, -----]V `
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Date Como|o�e6 ,�1—�----]A
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PLOT PLAN
N OF Mg CERTIFIED ss9cy .,.
v� ROBERT G�
NEW CONSTRUCTION ONLY g . BRUCE L0T._3.%''_' 3-'7C04✓_/,q/Z^-_Fs 7-- r 4
' a ELDREDGE ti
TOP OF, FOUNDATION IS - FEET " IN
ABOVE LOW POINT OF ADJACENT �Fc ��o� 7-
ROAD �!SSURv O
ROAD �, �.� A1-'-� A157ABL E M 4. 5
SCALE: / = 30 DATE: 41IS126
t' Et DREDGE ENGINEERING_Co INC.I
CLIENT�°wc--� I CERTIFY THAT THE F__ U�/a�gT(ooV
SHOWN ON THIS PLAN IS LOCATED
4 REGISTERED REGISTERED JOB NO. F809 ON THE GROUND AS INDICATED AND
CIVIL LAND
ENGINEERS DR. BY:. �.O' CONFORMS TO THE ZONING LAWS
SURVEYORS OF SRRVS7,9,0Z,6 ,qss .
33 NORTH MAIN ST CH.'BY:
y/�
1 SOUTH YARMOUTH , MASS. SHEET /: OF
—� DA E REG. LAND SURVEYOR