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HomeMy WebLinkAbout0032 ATHLONE WAY Cape Save Inc. 7-1) Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fag: 508-398-0399 DATE Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 32 Athlone Way'(#201401071) has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. - Sincerely, William McCluskey r OISIA10 17 it ,L1 pWd i iiws`; ' j 310VISUVO Ad NMOb, R TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 r Parcel Applicationz�iq/ v / Health Division Date Issued Conservation Division Application Fee S O 01 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address `� �' ay Village S Owner Address Telephone S d Permit Request4_ ✓O 2/ tV1 e Rai d C ffildosr 0 /-C I q Ce ffk—Q tz fi W Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation4(NOO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family J,,"' Two Family ❑ Multi-Family(# units) co Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin"g� Highwayn 0`Li ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other �a 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 ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Namew ��` ��� �`�'��-A44c, Telephone Number Sr� Address 1. Nu4i4%� Ave License # /l 0 Home Improvement Contractor# Email Worker's Compensation d Q/c ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �c) SIGNATURE - DATE /� .a ti 1 FOR OFFICIAL USE ONLY APPLICATION# t DATE ISSUED MAP/PARCEL NO. .� g. a �t l ADDRESS VILLAGE a- OWNER DATE OF INSPECTION: FOUNDATION 4 FRAME INSULATION ? FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL `r GAS: ROUGH FINAL t FINAL BUILDING F DATE CLOSED OUT ASSOCIATION PLAN NO. r Building Permit Authorization I, Perry/Nancy Caine , as owner hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Office:508-398-0398 to take all necessary steps to obtain a building permit to perform work at my property located at 32 Athlone Way Hyannis, MA 02601 Signed IL jki Date 1 ix The Commonwealth of Massachusetts - _ Department of Industrial Accidents Office of Investigations ~; 1 Congress Street, Suite 100 Boston, MA'.02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/pl m bers Please Print Legibly Applicant Information Name (Business/Organization individual): Cape Save,Inc. Address: 7D Huntington Avenue City/State/Zip: South Yarmouth, MA 02664 Phone#: 508-398-0398 Are you an employer?Check the appropriate bog: Type of project(required): 1. ✓❑ I am a employer with 17 4• ❑ I am a general contractor and I 6 0 New construction have hired'the sub-contra ctors employees(full and/or part-time).* �, Remodeling listed on the attached sheet. ❑ 2.❑ I am a sole proprietor or partner- These sub contractors have g. ❑ Demolition ship and have no employees working for me in any capacity. employees and have workers 9 ❑Building addition comp.insurance.+ [No workers' comp. insurance 10.❑ Electrical repairs or additions required.] 5• ❑ We are a corporation and its 3.❑ I required.] a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL 12.❑Roof repairs myself. [No workers comp. c. 152, 1(4),and we have no insurance required.] § 13. ✓❑ Other insulation employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing t workers'compensation policy information. heir wo 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Technology Insurance Company Policy#or Self-ins.Lic.#: T1NC 3353968 Expiration Date: 04/09/2014 j,�,,� �� City/State/Zip: Job Site Address: "r Attach a copy of the workers' compensation poli 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 e Investigations of the DIA for insurance coverage verification. I do hereby ceiW under thepains and enalties o erjurytl at the information provided*bisand correct. i =Date -- St ature: Phone#: 508-398-0398 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#: ACp F LIABILITY INSURANCE ��. CERTIFICATE O 10� / THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the'policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. `OW CT PRODUCER NAME: Colleen Crowley Risk Strategies Company PHO o E (781.)986-4400 FAC o:(781)963-4420 161&15 Pacella Park Drive Suite 240 INSURERS AFFORDING COVERAGE NAIC# Randolph Ida 02368 INSURERA:3elective Ins. or America INSURED INSURERB:Safety Insurance Company 3618 Gape Save, Inc INSURER C:Technology Insurance an 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth MA 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL13102268490 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION'OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICYEFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MMlDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL.GENERAL LIABILITY PREMISES a occurrence $ 100,000 A CLAIMS-MADE Q OCCUR 1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PRO X LOC $ AUTOMOBILE LIABILITY Ea accident W LJECT BIND LIMIT1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED 208200 1/6/2013 1/6/2014 BODILY INJURY(Per accident) $ AUTOS NONODVMIED PROPERTY DAMAGE $ X HIREDAUTOS M AUTOS - Per accident $ I X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAR CLAIMS41ADE AGGREGATE $ 1,000,000 DED I I RETENTION$ -01 1994480 0/16/2013 0/16/2014 $ C WORKERS COMPENSATION Officers Included for, X WRSTATU- OTRH- AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN overage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBEREXCLUDE[ Q NIA 3353968 /9/2013 /9/2014 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Weatherization Specialists GL: Blnkt AI, Blnkt PNC, Blnkt WOS, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow & Ice Removal/OCIP/Wrap Ups CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE chael Christian/CLC ACORD 25(2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005).01 The ACORD name and logo are registered marks of ACORD 4 Nlax Cc' Coin it wctisln Sidi"i'.t.r Spccinli:- - _ca-- CSSL 402776 \ 37 NAUSBT ROAD West Yarmouth HA 02673 - 06128120151 :' =t OfFce of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 -Home Improvement.Contractor Registration Registration: 171380 a Type: Corporation 'Expiration: 3114/2014 Tr#f =184" CAPE SAVE INC. WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 y Update Address and return card.Mark reason for change. Address —8 Renewal =`; Employment Lost Card DP&-C.^,1'0 50h1,0VOL4410121E -- — � fie"C?G9:(lJiG71£LBLLLC;1 c%'..•fiasiicfur.seC Office of Consumer Affairs ec 132siness Regulationj,icense or registration valid for iudividul use only -_HOME IMPROVEMENT CORITRACTOIZ before the expiration date. Hfound return to: -; Registration: '::171380 Type: _ Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 - E:piration 3li4l2014 Corporation Boston,MA 02116 C EJSAVE INC WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE g- "\ SOUTH YARMOUTH.mA 026ti4 Undersecretary, Not valid evit o signal The Town of Barnstable Department of Health Safety and Environmental Services �°r ; ►,' 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 e or building be done by registered contractors, with structures which are adjacent to such residenc certain exceptions, along with other requirements. F;-V"f ,y 13, 3 UD Type of Work: a rhos,UM41510iNlnEst. Cost %Nl I SIDI'MC, REPS• ��� T GCE/LEFTS ir�G of cN�mn� only + ,�Lu�n. 7�ivn e6�erx�e Address of Work: 11A /I � y /Ails Owner's Name lJ MCL/ (:�Jj'I A65S Date of Permit Application: l l of u I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. 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 PROGMkM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. ef!P OR Date Owners Name f e omen o — Department of Industrial Accidents ., ?� � , �� , Olflea ofltmstlgstlOos r'- 600 Washington Street Boston,Mass. 02111 —' Workers' Com ensation Insurance Affidavit name: location: H' city 1 }�A�l l S phone 4 775 0,396 ❑ I am a homeowner performing all work myself. ❑ I am a sole etor and have no one worker in anv acity q rye �iiiiii/ii�iii/i�,�iaii��ii,�.aima��i�aiai,�iiiiiiiiiiiiiiiiiiia�o�,����� I am an employer providing workers' compensati n for my employees working on this job. anv a e.cam n m <` res ... ..: a c::>::>:.;: !'nsurarrce cv. ' . b�Jelz (06P� trilc�# - ❑ I am a sole proprietor,general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: compan v name. ... ... .......... :. address: .... ...:... . .............. .... ......... M 'L .. ....:. .... ..:. ....:::.�.:�.. ........ .........: .. ..... .......:i?iiii:,;:.. v'.i•:wi: ii•<i:•ii:'iX�iiii:vii:i::•i"<$;{:.}"i}ii`ii::i::ii?i:.....i:-ii'}::;> :'�:;:;:;:v�i:;i`:svi:i:y!;i:!ii:!J;!:i`i::5ii::i;::;:;'.;is:;:i;}:Liv;}?::{•::??�$j}:i:+�iY.i::::::i::.i: .... is is iiii:•iii.•::::::'i"viiiiiii:ii?:::�5''' ...:v ............... 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I understand that s copy of this statement maybe forwarded to the OMce of Investigations of the DIA for coverage veriftcation. I do hereby certify under the pans mid penalties of perjury that the information provided above it tru,and correct Signature CZ zc� -z_c-/� '/� �CL �i.s' Date `- Prim name �C oibdal use only do not write in this area to be completed by city or town offidal city or town: permittlicente is QBuOdhrg Department ❑Liceaasu Board ❑check if immediate response is regmred ❑selectmen's OMm ❑Health Department contact person: phone#; ❑Other Urmw 9195 PJ.V I APR-30-99 FRI 01 :39 NA CAP IZ71 PRODli I0N FAK;-084"')164 PACE a'�c•�.uazU,wo�tr�� p�..LlaeWAeruel' . H0ME'INPROVEME,IT CONTRACTOR Registration 10o;4O y:4, Ca�O�k ?r il Type PRIVATE CORPORATION i YC' �... Ezpi.ratida CAPI.ZZI HOME IMPROVEMENT, INC as Capiui, JT. aoMiNisArc5 Newton Rd, CotUir MA.0205 ✓1`e (nry»rN,ao,aursu�(..� cI..b�a;:•au/,,,�c�Cl� OEPRRFMEBF OF PUCII'C WEN ''�`�} C4NSiRl'C'I4Ev SOPERUIS9R iICENSE NuraOer: Expires, 3i�t�ra'^.: r..r.,; � CS d51032. 64�?C�f!999 3926�i9b' iKONR.`� X F,R4iZtI iR 230 srRCi�lii� 6R ` 'd BAP,tdST�di 19 �^560 lR nd9).11l t.7llOd'R f�. ![UuB•J s.? OEPPRIMENi Of PUCIaC SAfE7Y ;a, ,�y'. IONS??'J;':iON �UPerVI'iNR IICENyE G Resrrict:a Ta: _ cREdE�ICp '! nnSCN t': J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r4cu Parcel �O L Permit# C� 1 fiea#fa-Bivisi Date Issued Fee ��, Treasurer. T 141 11 111 1t• G • ' £ . 1 t Date Definitive Plan Approved by Planning.Board kli R%SeNa iertit*Pis . Project Sfreif Address FVillage Owner A )"W CS)klAICS Address 54�e Telephone 6�' cl Co i Permit Request So t I d v L RePL. Ul llil�a r�S s % csao 1� O,3q kacd E UiN L SJ• 1u64 R15VL • 0 FrOMT R Aa2sf ►vUCEsiD�� ►� R 'Ul. T • �� Lei 5 i Q� e f�i e �- A'1..��►•►. �lti►'► C'Q�1 e. Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Estimated Project Cost t"� 3QU Zoning District Flood Plain Groundwater Overlay Cpnstruction Type f Lot Size Grandfathered: ❑Yes Flo If yes, attach supporting documWntation. Dwelling Type: Single Family O' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes Qqqo On Old King'sAHighway': q❑Yes a1do Basement Type: ❑Full 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) F 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 Er o" Fireplaces: Existing New - Existing wood/coal'stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing 0 new. size Barn:O existing ❑new size Attached garage:O existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ - Commercial ❑Yes Elrlq'o*� If yes,site plan review# Current Use fi Proposed Use BUILDER INFORMATION Name / it �021����— / Cif, TTE Telephone Number y F Address 16 45 . ME 67DW a License# CS � 70? rl � b_jk I T- , M A '6c2 to,32_ Home Improvement Contractor# l DU Worker's Compensation# wC (� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO egZlu( 6Lt! rAi5 , SIGNATURE V DATE _ Ll -,30 —q�3 bv9 LZ1 f r ~y FOR OFFICIAL USE,ONLY .: y PERMIT NO. A ,t DATE ISSUED MAP/PARCEL'NO. ADDRESS' 4 VILLAGE"; OWNER ti i i DATE OF INSPECTION: ' x /✓ - _- - FOUNDATION t FRAME ' INSULATION 1 j FIREPLACE N ELECTRICAL: ROUGH FINAL' PLUMBING:` ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION_ PLAN NO. _ ` } 1 - 1 N 1 t � 0 g 7 i W, � i3v Oo � r J R` Q-3229 t � 32s7 73 y y 1 y I h , I � [ CERTIFIED PLOT PLANE L0CAT1ON 5 C A L E- D A T E R E F E R E N C E ,Bt„vim f pT B8 g _5 ?v,v ,',v A 4N0 r A,�; 2 709y i ` HEREBY CERTIFY THAT THE 6U1 LDfNG R1 6 l 0P SHOWN ON THIS PLAT: 15 LOC ATE Ci ON THE GROUND AS SHOWN HEREON A rj .) T *+ 4 T t T D p ,­5 C O N F 0 R M T• ,: T H E L ON f NG BY - LAWS OF THE TOWN OF W H E N C O N 5 T A U C I f =' > NS`l- ABLE SURVEY C0J jSUt I- ,A , T5, i WEST YAR �,iD UTH Rn A 5 S zs� Asks ors -map,and lot number d�_ �Z L SEPTI-C SYSTEM MLWT BE. • � .: �� INSTALLED IN CUM'LIANCE Sewage,-Permit .number., ............ ............................................. ': WITH AiTiCL.E II STATE SAN I T A�:Y CO %AN:D TOWN yDi?NET��♦ .y TON ' O.F BARN 'AE WP o U iA"" TA13L -1639. DUI{L�DIHG LN-SPECTOR Sop i639. �� D,YPY c�. ' r APPLICATION FOR PERMIT TO ............ il.GZ`Z..e! ... TYPE OF CONSTRUCTION ......... . . . ............................... ....... rr, ....� .............19,2K TO THE INSPECTOR OF BUILDINGS:' The undersigned hereby applies for a permit according to the following information: ........ Location ...... .. 2,1/ J ......................................................... J ProposedUse ..... . . .......................................................................................................I......................... �19 Zoning District ......... ��1. Fire District ..., �t2�kl. ........... ...... . . ............................................ Name of Owner ... ......Address .. ,c....: �t T'.�. ...v/.? Al rJ Nameof Builder ...............:....................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .......... ..................................................Foundation .............................................................................. Exterior ........./..`1.^11..........................................................Roofing .................................................................................... Floors ip G- Interior ....sf�`����O Heating ......rl. ...............................................................Plumbing ... ../ .................................................................... �' o� O ode) Fireplace ....... .. ..................................................................Approximate Cost ........./............................. Definitive Plan Approved by Planning Board ________________________________19--------. Area ��... ............................. Diagram of Lot and Building with Dimensions Fee ...�—. .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... '' ............ ...... .;�........... • Smith, James ,K. 401 t�!' 18138 1 1/2 story, N ..................Permit for ..... 1.* . :1;U.......................... single -family dw6lling . ............................................................................... ��,//�Athi6ne Way Locatio ................................................................ Hyannis ............................................................................... James K. Smith Owner ........... Own ...................................................... • frame Type�afl Construction .................... ..................... ............................................................................... Plot ............................. Lot ................................. Permit Granted .......January -19 76 Date of Inspection ... ........... 0 Date Completed �.�1 .. ...... .1�.....Z1 9 ot PERMIT REFUSED � ' �r '4 Z ........................!�.............. ................. /9 ...............................................................;............... • ......................................................................... ............................................................................... V V .................................................. `Approved ............................................. 19 ............................................................................... Assessors map and lot number •. !'� "....... .::... Sewage Permit •number ......f.. !2..:n............................ :... �OF 711 E r�� TOWN OF BARNSTABLE Z ,•EBSTAMLE i "6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........... ....'..-f.: ,:::......:. TYPE OF C 1 ONSTRUCTION ����"�'� -��!.:�� � ........... ....... .....::.... .............. 9. TO THE INSPECTOR OF,BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locationr/5, ?c....... ...... :^'.. ..................................................... Proposed Use ................................. Zoning District s17...................................................Fire District Name of Owner ... ....... a, �4, ......Address ...f�•.......�. . .✓.....�t :, Nameof Builder ....................................................................Address ..................................................................................... Nameof. Architect ..................................................................Address ..................................................................................... Numberof Rooms ..........:�....................................................Foundation ................................................................. Exterior - /—I/ ...........................Roofing Floors ...................................................................Interior c ,r ................... ..................................................................................... Fieatin , !. / ................................Plumbing i t g ....... .`. ...................................... ........................................................... Fireplace ....................................................Approximate Cost ...........:......................................................... Definitive Plan Approved by Planning Board -------------------------- �( ' ------�9--------. Area ........:.....�.............................. }v Diagram of Lot and Building with Dimensions Fee .........'.... ......................... SUBJECT TO APPROVAL OF BOAR .OF HEALTH 0 � N ' O N . r� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. q / / Name .......4l% :........ „ ..... '-_--. --_-- K. . _ -'-~.-'- l8 / No .. . —� jp» .._ .. . singlefamily dwelling looe Way ^"c"'" --------- x�—--� ---' ris . ' ' . , - - . ' . . . ' Hyannis ' --------^-----------------. \ ' . ' Jumea `l{. Smith � . Owner ............................................... ' ' ' ' ' fame ' Type of Construction ' '� . _ ............................. --. ' ' ' PermitGranted^ ~^'^~ J ' Date of Inspedion ......... .........................19 . ' . Date completed . ' ' ' ' . . PERMIT~ ~~ . ' ` ..................................... � . ......... ..... .. .. ............................. ` . � .------.—.-----.—.,.. .----.—.—.—. . . ' . � . .---.--.---.--..—.— --..—.—^ .......... --. . � U , &� � � . Approved ................................................ lQ / � . ' ----------.. �*�.---.--.---. . . ' . -------�. . ��—,—.�-----.—....~.,. ' / . 0w~ '