HomeMy WebLinkAbout0194 BUCKWOOD DRIVE ,a,
ACTIVE
3//
' 1
i'.
Cape Save Inc. � t0 ,��{' 4t
7-'D Huntington Avenue`
South Yarmouth, MA 02664 2014 CIF+. �-i Ar, 10: 06
Tel: 508-398-0398 Fag: 508-398-0399
9/29/14 r _
r r
Town of Barnstable
Thomas Perry CBO
Building Commissioner
200 Main St. Hyannis,MA 02601
A
RE: Building Permits
Dear Mr. Perry,
This affidavit is to certify that all work completed for 194 Buckwood Dr. has been inspected by a
certified Building Performance Institute(BPI)Inspector.
Ceiling: R-35 cellulose; R-24 cellulose
Basement: R-19 fiberglass blanket in box sill
All work performed meets or exceeds Federal and State Requirements.
Sincerely,,
Y
William McCluskey.
y ;
Y. + TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Ma p 0 Llne,
arcel C/0�0 APP lication # �O��n /0.")
Health Division Date Issued ( ,
Conservation Division Application Fee S`Z�
Planning Dept. Permit Fee JS
Date Definitive Plan Approved by Planning Board d� PP 3--{`l
Historic - OKH _ Preservation/ Hyannis
Project Street Address L� L (-J
Village
Owner Address I c7 �c8
ul 0 b
Telephone Sv ei - IS-
Permit Request ® l te 01 /4t4 4 iu-i a c
w/74 Q kt,
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation -99 D 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 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
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 ❑ CD
Commercial ❑Yes ❑ No If yes, site plan review# =
Current Use Proposed Use
0
w
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name d(�qTelephone Number
Address J C License #
yav,*ok � OOV6 1� Home Improvement Contractor# f /��
Worker's Compensation # ryc 3_Weol
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE 45 l3
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
c
FIREPLACE
ELECTRICAL: ROUGH FINAL
t PLUMBING: ROUGH FINAL
t
GAS: ROUGH FINAL
FINAL BUILDING
c
DATE CLOSED OUT "
ASSOCIATION PLAN NO. `
yr ;:
The Commonivealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 LVashul,ton Street .
Boston, tM 0 111
it.,wxt nwss.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/El Please Print m bs
Applicant Information --�+
lv
Name(Business/Organization/Individual): C(1L o c;
Address:
City/State/Zip:satt���+ ya,,.cl'netb.-t'� M� W-W Phone:
Are you an ertiployer?Check the appropriate box: Type of project(required):
Q �. ❑ I am a general contractor and I ❑
I. I am a employer with 6. New construction
employees(full and/or part-time).* have hired the sub-contractors
listed on the attached sheei. 7.. ❑Remodeling
2.❑ I am a sole proprietor or partner- These sub-contractors have 8. ❑Demolition
ship and have no employees employees and have workers'
working for me in:any capacity. 9. ❑Building addition
[No workers'comp.insurance Comp'u'sitrance' 10.❑Electrical repairs or additions
required.] 5• ❑ We are a corporation and its
3.El I a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
right of exemption per MGL
myself.[No workers'comp. 12.❑Roof repairs
insurance re aired. z c. 1�2,�1( ),and we '[' SU��A�t'ion
q ] employees.[No workers' 13. Other 1%
comp.insurance required.]
`Any applicant that checks bowl must also fill out the section below shoving their workers'compensation policy information.
r Homeowners who submit this affidavit indicating they are doing all work and then lure outside contractors must submit a new affidavit indicating such.
,Contractors that check me this box must attached an additional sheet shoving the na 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 t/tat isprovidill ruorkers'compensation insurance for my employees. Below is thepolicy and job site
inforntatiorr.
Insurance Company frame: �eG�n o� o �t+sv�.�otn ce G M n v
Policy 9 or Self-ins_Lic.r: -T W C 3 31 8 0 Expiration Date: 4 3
u / l Job Site Address: R ` K C`` t ✓�° Cit}dStat2/Zip:
Attach a copy of the workers'cnmpencation policy declaration purge(showing the pokey 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 S1,500.00 and/or one-year imprisonment as well as civil penalties in the form of a STOP RrORK ORDER and a fine
of up to$250.00 a day 2Qainst the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DI,A for insurance coverage verification.
I do hereby eertr,..under the pains and penalties of perJun,that the information pror-ided above lis true mid correct
Signature: Date: 0. 1
Phone 9: 3 98 034R -
Official use onh'. Do trot turite in this area,to he completed by cite or town ofjiciaL ^
City or Town: Permit/License z
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbina Inspector
6. Other
Contact Person:
Phone=:
�ACO CERTIFICATE F DATE(MMIDDIYW1)
® LIABILITY INSURANCE 11/9/2012
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(ies)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 endorsement(s).
PRODUCER NAME:cT Shannon Sperrazza
Risk Strategies Company PHONE (781)986-4400 (jj
No:(781)963-4420
15 Pacella Park Drive E-MAIL ss errazza ies.com@risk-strate
ADDRESS: P g
Suite Z4O INSURERS AFFORDING COVERAGE NAICIf
Randolph MA 02368 INSURER A-Selective Insurance
INSURED INSURERB:Safety Insurance Company 3618
Cape Save, Inc INSURER C;Technology Insurance Company
7 D Huntington Ave INSURER D:
INSURER E:
South Yarmouth MA 02 644 INSURER F:
COVERAGES CERTIFICATE NUMBER:CL1211954576 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR A OL SUER POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE VJVnPOLICY NUMBER MMIDD D LIMITS
GENERAL UABILnY EACH OCCURRENCE S 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO(Ea occurrence) s 100,000
A CLAIMS-MADE a OCCUR 199448001 0/16/2012 0/16/2013 PREMISESMED EXP(Any one person) S 10,000
PERSONAL&ADV INJURY S 1,000,000
GENERAL AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 2,000,000
X POLICY PRO LOC $
AUTOMOBILE LIABILITY COMBINED BI SINGLE LIMIT $ 1 000 O00
B ANY AUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED 6208200 1/6/2012 1/6/2013
AUTOS AUTOS BODILY INJURY(Per accident) S
X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE
X
AUTOS Peraccident S
X UMBRELLA LIAB Underinsured motorist 81 Split S 100,000
OCCUR EACH OCCURRENCE S 1,000,000
A EXCESS LIAB CLAIMS-MADE
AGGREGATE $ 1,000,000
DED RETENTIONS 199448001 0/16/2012 0/16/2013 S
C WORKERS COMPENSATION Officers excluded WC STATU- OTH-
AND EMPLOYERS'LIABILITY YIN X
ANY PROPRIETORIPARTNERIEXECUTIVE from coverage OFFICERIMEMBER EXCLUDED? ❑ NIA EL EACH ACCIDENT S 500000
(Mandatory in NH) rWC3318007 /9/2012 19/2013 E.L.DISEASE-EA EMPLOYEE S 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 500 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space is required)
Issued as evidence of insurance. Issued as evidence of insurance. National Grid Corporate Services LLC
d/b/a/ National Grid, Action Inc., Colonial Gas Company and NStar Electric are listed as additional
insureds as respects General Liability as required by written contract.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 427/SCH
3195 Main Street AUTHORIZED REPRESENTATIVE
Barnstable, MA 02630
Michael Christian/SMS
ACORD 25(2010105) 01988-2010 ACORD CORPORATION. All rights reserved.
INS025 r7mnnm m The nrnRn Mmm=nnA 1—ern►enio+n 4—rlrc of ArTPNiR
•- Massachusetts- Department of Public Safet��
Board of Building, Red-lulations and Standards
Construction Supervisor Specialty License
License: CS SL 102776
Restricted to: IC
A
WILLIAM MC CLUSKY ='
37 NAUSET ROAD
WEST YARMOUTH, MA 02673
Expiration: 6/26/2013
('unuuissimr, Tr#: 102776
Office of Consumer Affairs and Business Regulation
} `-- 10 Park Plaza- Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Re
tiistration: 171380
_ Type: Corporation
- Expiration: 311412014 Tr# 222184
CAPE SAVE INC.
WILLIAM MCCLUSKEY °
7-D HUNTINGTON AVENUE
SOUTH YARMOUTH, MA 02664 = =
Update Address and return card.Mark reason for change.
Address 7 Renewal i Employment Lost Card
PS-CAI E9 SOM-04/04-0101210"
:'l�o Ga�rm zanioeQl •c�'..ltct;:urluretir License or regaistration valid for individul use only
Office of Consumer Affairs&B ness Regulation b
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
=,._ �; Registration:...171380 Type:
=r Corporation 10 Park Plaza-Suite 5170
`���:_- Expiration::_3/14/2014
_ Boston,A14 02116
WILLIAM MCCLUSYVVY ;
7-D RUNTINGTON AVENUE
SOUTH YARMOUTH.MA 02664 Undersecretary Not valid w' (i signa
Building Permit Authorization
I, 'ath YSorenson , 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
194 Buckwood Dr
Hyannis, MA 02601
Signed
Date 3 d Zo i
}
01/07/2013 1:31 FAX 508 790 6226 7'D{9i' LAN GER 003
The own of Barnstable
:Mauager.0 367 Main Street;HYMMiz MA 02601 t�ttr
R+ �— w:towm ble.mam om= sag-962- t� pax 509-79 6226
6 APPLICATION FORM
l75r"C1 ,P toPERT ivraaa sTMNS,rijiTaY. XS,ROAD]RACM 2W7
The approved appTcsiiom iaust be on file in the Town bUngge is Oface nt toast thirty go)dMys.prior to byent.
Par2delRoad.R.aace applicatiora Xanst be r=dved ninety M days prior tm scbedided date:
utc of applicoom _
FCC amount S43.00 per requed*.ToW paid:_ -- YES(cU l OR cash) . NO
*Eech requcst means tech event such as a.par34c�fbHowed by am event on the TDwn Grin,ffrr example-
-1 his appric atbn must be completelalr signatures pd;r to 5ubrttit[ing to the Tm m Manager for final apprnuaL
You maybe required to leave apprHmtiarl at various Departments'towait for app4riate.atnature-
1. CA 1 T TMN XA 3'r'XR'S OFnCE TO TWrAT''V.E..'Y RVI D}kTE OP E:VM-CMCK AYAUABBIIY
Request for -X—Hylmis Village Grrrn Ascl#on Park Parade
Bzvcfrt7t�l�lalls I ;)WTriel.lnlon Othertnte,,srspc--;
Certain%rwWea m y requcre addiidionat face for ser kes by ppw deperl4ing on rscaftora,use of staff&s1Je of
event. The fees witi be determined by DPW and paid diteEfly to tlat department
2. Name of Event h A nn ai l Y�,I a C(I r L 1 b'1 IA I
DayllSase of Event `I Ury- fl( �h ) l Rain rite-
3. ?•tame cf$ponsoring O gz�j ation:
HWaaws-M3++Isiling and physical addrzss• .� �'
a. Q/Y)
4_ Coataapm=: (c'qPLA . U i1f r/ Pbonc: Z '�; 1�A
5. PtMan in c'aarge DAY OF EVzdT Ccl1 phvna i}
S. 9et up tin, Actual cvcnt start and end time: n lcan up tims;
7. Esma3ed member of vG1 mt s/pardcipt t;:
Es'�matnd nunaber+�iFsptrs ��- �n !�l)l7 -
>>FOLXCF-Mn will d minc if ex a detail ncz=ary-
8. Adrmssiem fir LEA cl mgW%D pgrtiGipants? No Lf ycs Arnount `.5-
?Dl1 their :toad n� y5 t ercnt? X Yes Ale
>>XYM,ln6cal--the u1mber ofycndors and type food`m�cl• disr}etc),
>>WM these be merebndim wv2diablz for said L Yes NIA
VandwsI mead to crarnplet..apg=4on for special lice nsm A the l_,icemhig DDivisio�203 Alain StV4 HY&-V
9: map awea± ( Uam)f r rued rat`{p�z t v=t
�.�str elo�s r�uired: _Yes �70
>>1}!1w1 of rotes and rest swps an=bcd&jdjcat-d on map.
10. Food prepa�&sra;d at v Yes /-1-0
»Tf yes,.t-1 titers be coolar_gfheating inv&md?-- Y cS x Al o
AYPROVED BY
Cam'OF POLICE DATE-. � 3
(Barnstablc Police Departcncnt, 1200 Phinney's Lang Hyannis 509-779-3807
CRI>-F OF FM DEPT(S) DA71:
(Village Fire Dcpartment Address v ,�� �e
RECRFATION DATE:
(Hyannis Youth&Community Center, 141 lmset Lar-c,Hyannis 505-790-6345)
PUBUC WORKS DATE:
(332 Falmouth Rd-]Hyannis 508-790-6400)
RZGULATORY SERVICES DATE:
(204 Main Strcct.Hyannis 508-862-4674)
-OARD OF MA EL DATE:
I (WA for Parsd acg r its unless se food.548�52��4644)
BUMDJNG DE T � Q -
M.A.for PaaadaMsee Ise emits unlcss cre ns tents, 508-3624039)
TOW i MANAGER DATY,:
i
(Town Hall,367-Main Street,2 floor,Hyannis 505-852-4610)
i
SPECat1L CONDITION- S and ANY FEES(As determined by Depa nrnea'i's above)
DETAILED AS l~OLLOW$:
i
j
P�oFt ' ti Town of Barnstable *Permit#
Expires 6 months from issue date
BARNSTABLE, : Regulatory Services Fee 9f, s- &L�
v MASS. 0� Thomas F.Geiler,Director
1639.
p'ED`A0�`A Building Division
Peter F.DiMatteo, Building Commissioner R�-®®� �
200 Main Street, Hyannis,MA 02601 P IT
Office: 508-862-4038
Fax: 508-790-6230 MAR 4 2002
EXPRESS PERMIT APPLICATION - RESIDENTIAL QhgwL, OF BARNSTABLE
a Not Valid without Red X-Press Imprint
Map/parcel Number 7 t ✓
Property Address ��'y Q����w el) 0 cC Y.-a `rl a�23'+j1�1 ,5
'Residential Value of Work_T 15 D
Owner's Name&Address U�A k�e r �k,
tJeJ9tJkJdf) ci �7n'nZS, � 6,21, �f
Contractor's Named�\n`?i kl �� E t J 1! /a � Telephone Number(56 R7 7 P-a S i b
Home Improvement Contractor License#(if applicable)
r
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
j5a I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box)
2—Re-roof(stripping old shingles) .
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
Signature
Q:Forms:expmtrg
Revised121901
Assessor's map and lot' number ... .: .. :.;5..,. 10S G/ :�
y
SEPTIC SYSTEM�MUST St -
;L, = � INSTALLED IN COMPLIANCt
Sewa a Permit number ARTICLE 11 STATE
g WITH
.......... :.1 ... .. t
SANITARY CODE.AND TOWN
QyofTHETo�� TOWN" OF BAR1NS ABLE
j. EARXSTAIRLS. }
BUrILDING INSPECTOR
MPY
:.... . ..��.:....... .... . . ........ ....o ..
APPLICATION FOR-PERMIT TO .... �:..........�.. r�'C.. ..........................................
TYPE OF CONSTRUCTION .........Ulk d ..................... ......... ............................ ................. ..................
........... `. ....................19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ........ .k.....'i!.c?..o�r........ ��t:................ yh A/P!—s. .........................................
ProposedUse 4°.H........... h........ .....................................................................................................
Zoning District .......&. .........Fire District .h.t. .. 1...................
Name of Owner . b..... .5-.V1 ...................Address .......6 .:............
Name of Builder ... .�C. .......Address ........ .......10.qII
Nameof Architect ..........................................................:.......Address .....................................................................................
Number of Rooms ..................................................................Foundation .�5. l ..e ........��.A13.... ......................
1
Exterior ......ir/1f1 ....................................Roofing .........T. ....��.� �. � ✓....................................'
Floors ......................................................................................Interior ........:.................................................................:.
Heating ...............................................:..................................Plumbing ...................... ..........................................................
Fireplace .........................:.........................................................Approximate Cost .....::..... .....................................
alb
Definitive Plan Approved by Planning Board ___________—----_—------------ _______. Area ......................:...................
Diagram of Lot and Building with Dimensions Fee ... ........................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH "
aTN
w� f
T
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. _
Name ..... �r �...... ... ...................
r"r Shields, Edward
IS 19341 add to dwelling
rNo ... .... . Permit-for ......................
1 .. ...........
l49 ..B6C'k*ood Drive
Location.............. ........... .................................
Hyantis w _
............. ............................................. t
Edward Shields:_'
Owner ..................................................................
t' frames
Type of Construction ..... ."
,.... a ....... ... ... .,_ ;., • - • f_, i
Plot .......: ............... . Lot .. " .................
June 28 ��
R
Permit Granted ` 19%Y. ..8......:.... u
Date of Inspection .. .......... ......19
Date Completed 1. ...................: ......19
:PERMIT",REFUSED
M �
............... ....................... 19 _ j>
.. ;; ...................................4..�) .,t. .:KIT ✓ r .�4 - +» ,Y
...... .......... ....................................................... e • _ 'n•, i
• �
.... ...................................................� /'• r r !.,
Approved ...:............... ............. .. 19 _
............................................................
................................................................................
Assessor's map and lot number —' ..?.................
� �C l
Sewage Permit number .................. J
T"E.r°�� TOWN OF BARNSTABLE
SAWSTADLE, i
9� Q�Ya`e� BUILDING INSPECTOR
` APPLICATION FOR PERMIT TO ....... . S( /.. .. po.f .. ..........................................
TYPE OF CONSTRUCTION .........
......................................................................................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location . L� y l�t�r .....► � < .. �J........ e /T YX/1/.�//
ProposedUse ....... .. .. ........ ,.A P.n.A..............................................................................................................
Zoning District ........!`A.......................................................Fire District . !;a`. /7................................................... .
Name of Owner ice, S�a./... /� 5...................Address /�/ r� ��ra �' v v � J
..... , ...... ...... ............... . .................'`......................................
Name of Builder AA 1q�r` . .0�� lr'+ 4. .......Address ...... . ....L .... ........./� �� t�
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms ..................................................................Foundation .... / /,/ .. ......... /,?.......................
Exierior ......!y �i t rt 11P .a,t ,'....................................Roofing ......... ....................................................
Floors ......................................................................................Interior ....................................................................................
Heating ..................................................................................Plumbing ..................................................................................
.,r
Fireplace ........................................Approximate Cost /- --)U ra
ti.
....................�..............................
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ........................................
� u
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
� I
- I
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. _
Name �J
.... ............... ...........:....................
Shields, Edward A=271-108
No .,,19341 permit for add to dwelling
....................`�4401'Buckwood Drive..............
Location ................................................................
Hyannis
...............................................................................
Owner Edward Shields
..................................................................
Type of Construction ...........frame
...............................
................................................................................
Plot ............................ Lot ................................
Permit Granted .........June...28...............19 77
Date of Inspection ..........:.........................19
Date Completed ......................................19
PERMIT REFUSED
......... 19.... .. ... .. ......
r....................................................
...............................................................................
...............................................................................
Approved ................................................ 19
...............................................................................
...............................................................................