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Home My WebLink About0020 CHECKERBERRY ROAD ao � �y/�i - - - - - - -\ sk s s '� 4 .. :u i6 � . e, 3 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Hear Mr.Perry, This affidavit is to certify that all work completed for insulation work at 20 Checkerberry Road (application#201405310) has been inspected by a certified Building Performance Institute(BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Conor McInerney ConserVision Energy ;�a ran 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM ;; • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel o%"k Application�� t� Health Division Date Issued _� l P� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Address %% Telephone c :6.*b_1 vn Permit Request c,z, e,..-, nz z . .�a:o...�, a-�'Z.cJ Z ►��.,sZ.o� c..,e,.��.o�o SE � -3 t'7 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation�z-�vo Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attac pporting,doc�entation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure SV� Historic House: ❑Yes ❑ No On Old Kft s Highway: ❑ s O�No w ',, Basement Typ'q: a Full ❑ Crawl ❑ Walkout ❑ Other _ Basement Finished Area (sq.ft.) Basement Unfinished Area (s ft) - ,71 Number of Baths: Full: existing t new Half: existing rRew Number of Bedrooms: 1_\ existing =new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 3 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) Name Cry c-a- \r c..\),_� &-z uz)c Telephone Number �o cz- Address 3S S c_n ��sue.: a�v License# 'S IN oa A c.NA.- ,\ Home Improvement Contractor# z� o Z S ( Z Worker's Compensation # ALLL CONS N DEB FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE JI FOR OFFICIAL USE ONLY ;w APPLICATION# DATE-ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION uP;j F,�r r�-,s�NU 'W! r FRAME AiINSULATIONJL-a?,- :D' FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT. t„� .t1 �. .. J►.. .ra.`.`� III ASSOCIATION PLAN NO. ^»--.:� ..... xfN 6 f.Idt ddt�lt[t��z'F1Ff d� 5[T<r,d rrPJr,,+,at'f�.t ,. .•...,;...-..__.. .:�-;« _.._._...,..._...... ::. t?Inc,ol.c®nsanserAffairs&.Susiness Regalation License or registration v$lid for ind4itlul use only ME IMPROVEMENT CONTRACTOR. befirre the expiration date. if toond return to: gistratwn; 171251, Tyµec Office of C:onsut»er Affaim and Business Regulation: xplratson: 3111201 pai~tlership; G Pant lala -Sttlt�5,1711 Boston,HA:;42t,Eb: CON-SERVE ENERGY GQNOft.WINERNE f 376 ROUTE.130 SUITE { SANDWICH,MA 02563 L'cstf a5ecretarw _ �1ot`:va1'ui vi'itl�outsiguature 40 39. SAr Aft The Commonwealth of Massachusetts L= :Department of Indacsthal Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass govldia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Pipmbers Applicant Information Please Print Lezib1Y Name.(Business/Organization/Individual): ConserVision.Energy Address: . 376 Route 130 Suite C City/State/Zip: Sandwich; MA.02563 Phone #: 508-833-8384 Are you an employer?Check the appropriate box; Type of:project(required): 1.[ I am a employer with 8 4. O.A.am a general contractor and 1 6. `❑ New construction employees(Ml and/or part-time have hired the sub:contractors 2.El am.:a sole.proprietor or partner- listed on the attached sheet. $ ❑ Remodeling These sub-contractors have 8. Demolition ship;and have no employees ❑ . working forme in any capacity: workers= comp.insurance: 9. Building addatiori. [No.workers' comp:insurance 5; ❑ We area corporation and its officers have exercised their l0.❑ Electrical repairs or additions required] 3.[l I am a homeowner doing all work right of exemption per MGL n E]Plurnbiog repairs or additions myself. o workers' comp.. c. 152= §1(4) and:we have no: y [� p I2® Roof repairs ,insurance required,)r employees.[No workers' comp. insurance required.] l3 ® Otlier Weathetization *Any applicanethat checks box.#1 musi also lilt outYhe sec idn belowshowing their workers'c6mpensation pol forma icy intion: t"Homeowners who:subrru this affidavit indicatini;they are.doiug all work and then hire outside contractors must submit anew afdaeit indicating such. 3Contractors that check this box:must atlaclicd an additional sheet showing the name of the sub-contractors and their workers'romp.policy t ormation. I am an employer that is providing workers'compensation insurance for my:employees. Below is the poC:ry and job site.' information. Insurance Company Name: CS&S/WORKCOMPONE Policy,#or Self-ins. Llc.# 601;.1316349 Expiration Date: 03/11/2015 job:Site Address; CitylState Attach a copy of the workers'compensation policy declaration page(showing the policy:number and;expiration date)e Failure to secure coverage<as required under Section 25A of MGL c. 152 can,lead to the.'mposition of criminal penalties of a . fine up to$1,500.00 ancUor one-year i nprisonmeft,as well as civil penalties in the form of a STOP WORK GRDER and a fine. of up to$250.00 a clay 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. I do.hereb' fy t der th p 'rrs nd.penalties of perju that the information provided above is.trne and correct Si ature `----- Date: Phone M. Offciat use only. Do not write in this.area,:to be canmleted by city.or tnu�n officiaC UIV City or Towni .. PermtlLicense# Issuing Authority(circle one): I..Board.of.Itealth 2.;Bt ildiine Department.3.City/Tbwn Clerk 4.Electrical Inspector 5.Plumbing inspector. 6::Other. Contac€:Person: Phone#:.. �y�j DATE(MMIODtY" -iA�. CERTtFIC/�7E ®F'LIABILtTY INSURANCE , 03h 7)2014 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 ISSUIN61NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER;AND THE CERTIFICATE HOLDER. ` IMPORTANT:if the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)`must be endorsed: if SUBROGATION IS:WAIVED subject to the terms and conditions ofthe policy,certain policies may;require:an endorsement. A statemenf;on this certificate does not ccnfer rightsto the cenffi to holder In IIeU of suoh endersement(s). PRODUCER CONTACT. ° CSBrS/WORKCOMPONI NAME PO BOX 946580 PHONE FAX (A/C,No,Ext): (AIC,No): MAITLAND,FL 32794-65.80 EfitAa ADDRESS: _:. ..__. .. Phone-877-724-2669: Fax-877-763.5122 . - INSURERS)AFFORDING COVERAGE': .. :..... NAIC# INSurti II A. Continental Casualty Company 20443 INSURED INSURER 8 CONSERVISION ENERGY 376 ROUTE 130: INSURER Cs:. SUITE C INSURER O_Continental Casualty Company 20443 SANDWICH,.MA 02563 INSURERE::Continental Casualty Company. 20443 INSURER:F: COVERAGES CERTIFICATE NUMBER: 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 GONTRhCT 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 ANb CONDITIONS OF SUCHPOLICiES:LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS:' ADDL.,SUBRI POLICY o LTR TYPEOP INSURANCE: INSR tNVD PoucYNUMBER pgn}D Atp p .' LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED .T $300,060 PREMISES(Ea:occurrenm). - CLAIMS MADE �OCCUR: - A Y N 6611316336 03111/2014 :. /3/111,2015 MED EXP( one ersan' $10,000: PERSONAL'&ADV INJURY $1.A00,000 77 GENERAL AGGREGATE $2,Q.O0,000 , GEN'L AGGREGATE LIMIT APPLIES PER:PRO; PRODUCTS-COMPIOP AGG $2,000,000.: -�. � � .� POLICY JECT ZLOC AurolxoelLE laaett COMBINED SINGLElTv LIMIT $9;000,000 . - (Ea:accttlent)� . . _ ..,: ... ANY AUTO:. - BODILY INJURY(Per person) ALL OWNED SCHEDULED:. BODILY INJURY Per aaadeatj A AUTOS. AUTOS.. N N. 6011316335 03111/2014 0 11112015 ( HIRED AUTOS ro0N-OWNED" .. - .AUTOS PROPERTY DAMAGE: (Per acadeni),. UMBRELLA LUtd. OCCUR 1 000,000 . EAGH.00CURRENCE i D EXCESS.L1Aa CLAIMS-MADE. N N 601131.6352 03/11/2014 . 01/1112015 .AGGREGATE'. 1,000,000 . . ., DED RETENTION S 101000 WORKERS COMPENSATION - WC STA.TU• 0TH- ANO EAAPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECIITIVE. YIN E:G EACH ACCIDENT $1.00,000 E OFFICE.RIMEMBER EXCLUDED7 N. N 6011316349; 03/1:112014 0311T12W5 (Mandatory In NH) - If yes,tlesuibe udder E.L.DISEASES EA EMPLOYEE $1U0,000 DESCRIPTION OF OPERATIONS.beloww E.L.DISEASE:-POLICY Limit $500,000 DESCRIPTION OF:OPERATIONS 1 LOCATIONS t VEHICLES (AtiaLh ACORD:i0:1,Additiwiai Remarks Sctieduio,it more space is nmuin d) Certificate Holderis;added as an additional insured as provided in the blanket additional insured endorsement. ..CERTIFICATE:HOLDER_ . __. CANCELLATION tSe ngineering_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1341 Elmwood Ave THE EXPiRATION:DATE THEREOF,NOTICE WILL BEDELl.iRED l Cranston,RI 0291.0 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE: p Q'1988.201:0 ACORD CORPORATION. All rights reserved, ACORD 25;(2010105): The:ACORD:name and logo are registered marks of ACORD cacxtaEs. �o s . a ter, rah OWNER AUTHORIZATION FORM owner of property located at hereby authorize ConserVision Energy, to act on my behalf to obtain a building permit to perform work on my property. Owner Signature ,/ ,�r\ Date Town of Barnstable *Permit#4Gd a -PRESS PERMIT Expires6montlisfrom issue date Regulatory Services Fe5;�� OCT-'— 5 2007 Thomas F.Geller,Director - � Building �� TOWN OF BARNSTABL g Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTL ,L ONLY �i Not Valid without Red X-Press Imprint Map/parcel Numbers go d Property Address vJ p ck y-c, Ao e ON \ vI _ Residential Value of Work y y 76-+ 6 D Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address kt A, A— >( SeN Contractor's Name " 1.;?r y- Telephone Number 'c�� / D (0 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner. []Ihave Worker's Compensation �I/n�s,,urance Insurance Company Name \✓ ' ° ` J �� W orl man's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 1 Re-roof(stripping old shingles) All construction debris will be taken to \I a ❑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: Property O r mus sign p Owner Letter of Permission. A c py of e Impr t Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise061306 Tj r ♦ * 5 4 E. � 'r4 . r , a MARK HERBST $i 35 PEEP TOAD ROAD CENTERVILLE MA 02632 508-420-6216 CELL PHONE 774-238-2938 's www. MarkHerbst.com PROP OS S TED TO: WORK PERFORMED AT: Harold&Alice Basset 20 Cheekerberry Lane SAME Hyannis MA 02601 We herby propose.to furnish the materials and perform the labor necessary for the completion of the 7 t following;New Roof on rear main, breezeway&garage Remove 1 layer of existing shingles ' Install 8"drip eedge '+ ' Install ice&water shield at edge&in valley areas Install 15 lb.felt paper Install Certainteed shingle to match front Install jet shingle to dormer ' Cover entire dormer with ice&water shield t, Cut ridge&install cobra vent All shingles will be stormed nailed € All debris cleaned daily Not responsible for gytter gyards Price includes material, labor&dump fees All material is guaranteed to be as specified.The above work will be performed in accorandance with the specifications submitted and completed in a substantial workman-like manner for the sum of; Four-Thousand Four-Hundred&Seventy-Five z dollars($4,475.00 )with payments as follows;full amount due upon completion LL: &4 *Any alteration(s)from above proposal involving extra costs will be added under a separate written " P w agreement and become an extra charge. RESPECTFUL SU _ 09-27-07 V� Mark Herbst ACCEPTANCE OF PROPOSAL ; r_ The above price,specifications and conditions are satisfactory. We herby accept this proposal. You ' f are authorized to do the work and payme is will be s specified above. `¢ ' Signature (� —►► ('may *This pro s t may be withdrawn by said company a not accepted within 30 days R x .; 5 Yam. A i S i t � 4 1 ,P� - .l ft� U/09IJ//YLO'/ZCIJ�2LLiL 06�✓I�GQ.dOQ�fLICJP.�b � -...... . . i Board nf.Suilding Regulations and St.aAdards } License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR. ! before the expiration date. If found return to: `126480 Board of Building Regulations and Standards Registration One Ashburton Place Rm 1301 Exp�rat on 6)8/2008 Boston,Ma.02108 Type IndJiBual MARK HERBST r� xr.f MARK HERBST `` a 35 PEEP TOAD RD�`u�_� Not valid w�tho f CENTERVILLE,MA 02632 Deputy Administrator nature The Commonwealth of Massachusetts 1 � Department oflndustrialAecidents Office of Investigations 600 Washington Street ` Boston,MA 02111 , www.rnass.gov/dia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Elecfricians/PIumbers Applicant Information Please Print Le 'bl Name(Business/Organizetion/Individual):. c,ke_ E?f Address: ,q' \ �e 7• U I}l f`d City/State/Zip: (fe rti Phone.#: Are you an employer? Check the appropriate box: Type of project(required):. 1.[�I am a employer with,_ 4. El am a general contractor and I . employees(full and/or part- have hired the stab-contractors 6. El New construction . 2.El am asole proprietor or partner- listed on the-attached sheet 7. ❑Remodeling ship and have no employees These sub-cofactors have g, ❑Demolition working for me in any capacity. employees and have workers' insurance.$' 9. ❑Building addition [No workers' comp. insurance comp. required.] 5. ❑ We are a corporation and its ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myselL [No workers' comp. right of exemption per MGL 12.[f R of repairs insurance required.] t C. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp, insurance required.] *Any applicant that checks box#El must also fill out the section below showing their workers'carnpersation policy information. t Homeowners who subrnit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees, ff the sub-contactors have employees,they must providh their workers'comp.policy nurnber. I am an employer that is providing workers'compensation insurance far my employees ,below isihepolicy and job site information. nn Insurance Company Name:_ 1•hl Y11, ' V f]-. I Policy#or Self-ins,Lic.M r3 4 o2 ExpirationDate: Job Site Address: ® CC Le 6eor 'City/State/Zip: � � p►� • . Attach a copy of the workers' compensation policy declaration page(showing the policy n er and expiration date), Faihire•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penaltirs in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the JDIA for' urance vera a ve . cation. 16 hereby certi nder e ' s• d pe tie of perjury that the information provided above is true^and correct: Signature: Date: r / Phone #: -1) Official use only. Do not write in this area,'to be completed by city or town of icial City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone M CERTIFICATE OF INSURANCE NCE 103/1612007 ISSUE DATE(MMIDDIYY) PRODUCER �1 ��1 1�,J �f THIS CERTIFICATE( ATjIS,ISSUED AS A MATTF,R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE Leonard Insurance Agency Inc DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O Box 494 Osterville, MA 02655 COMPANIES AFFORDING COVERAGE INSURED Mark Herbst COMPANY A.I.M. Mutual Insurance Co 35 Peep Toad Road LETTEtt A Centerville, MA 02632 COVERAGES THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BF.L.OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY RBQU1RI3MHNT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE POLICY R)a4RATIM LIMITS LTH DATS(MM/DDIYY) DATE(MMMDIYY) GENERAL LIABILITY GENERAL AGGREGATE_ E MMERCIAL GENERAL LIABILITY PRODUCTS COMPIOP AGO. S (AIMS MADEE:::DCCUR PERSONAL A ADY,INJURY S NI$R'8 A CONTRACTOR'S PROT- EACH OCCURR ENCE S FIRE DAMAGE(Any one Ere) $ MED.EXPENSE(Any um perms S AUTOMOBILE LIABILITY COMBINED SINOLE ANY AUTO LIMIT $ ALL OWNED AUTOS BODILY INJURY SCNEDULkV AUTOS {Per Prmw S J HIRED AUTOS BODILY INJURY NON-OWNED AUTOS Per eccidmr) s GARAGE LIABILITY PROPERTY DAMAGE f EXCESS LIABILITY EACH OCCURRENCE T MBRELLA FORM GGREGATE $ HER THAN UMBRELLA FORM • WORKER'S COMPENSATION AND X A - OTH EMPLOYERS'LIABILITY T Y LI 7Qt63i30)20(}7 01111)nM7 O1110/2008•- 131:tAC1iA t )En f A THE PROPRIETOR) INCL hl DISEASE—POLICY LIMIT $ 500,000 PARTNERVEXECUTIVE OF01(°GRS ARE: HX kXCL EL DISEASE—EA EMPLOYEE $ 100.000 OTHER DESCRIPTION OPOPERATIONS/I,OCATf(kYS/MIICLKS/SPHC1A41TEMS CERTIFICATE.HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 1 MAIL 10 DAYS wRrrTPN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABTLrTY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTROR)7,Fn RFYRFgFXrATIVR Town of Barnstable ermit: 6 v9' a � . Regulatory ServicesDate://a�'/o o� Thomas F.Geiler,Director 9BAR LE,g Building Division 1639. .0 Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner:t�Q ®er,?� Phone: 5 oSs— 77�-� 1 3 6 "qo Install at: / Village: Zvi Map/Parcel: oCZ 6 Date: To,', Stove A. New/ se B. Type: . Radiant/Circulating C. Manufacturer: Lab. No. D. Model No.: r Chimney ? A. New/ xistin`;* (If existing,please note date of last cleaning B. Flue Siz ' C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer - E. Masonry: Lined/Unlined Hearth A. Materials: B. Sub Floor Construction: Installer Name. IV6 �^/dw�✓ Address: Phone: Location of Installation: APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector s Ta 4X224W d o 'No T %/{�i✓/r �/�E"� �.//c c 2�`L !/Sih �i Q:forms:stove Rev 122801 / T �� G l cds✓ fc ///9 S T/f r _. .>r-.•.. .. ,� - _. r. ... -..� ,..�..,:i.aa_... <::, .�":>,,, .» �...w...tis. .y,... --.. :L.ti ,a ,,....�,a.ai.,.r G 'y �_`J...,..•. '-- ,�- _� �,. Assessor's map and lot number � �� /� Sewage Permit number ............... rnt °`T"ET°�� TOWN, OF BARNSTABLE Q - Z 9AHB9TeDLE, i - "b 9 BUILDING - INSPECTOR • ATfD YPY Or• . APPLICATION FOR PERMIT TO .. :.. ! �?�,• A+ '� e(Y.:... . � ." .!'!................. TYPE OF CONSTRUCTION ........��,,.. ..... -r+a,. . . '�. ......... .................... ....................................... .. ' ....19........ TO THE INSPECTOR OF BUILDINGS: i The undersigned rh�ereby applies for a permit according to the following information: Location / ! .... 1 *(L( n is-.,i� ems.,, �-f^ .................�J x� 1�.I ProposedUse c_ =fir.`..........`~... . -!5. .............................................................................................. ZoningDistrict ...................... . ..........................................Fire District .............................................................................. Name of Ownerk.:. �, Arts � -�k_c6 ,Address ........z./?..... Q.* ..t' .. ... ......... -{� Name of Builder !.. ►1`� � ��. R-T�........Address , � .... ,.s . .. ....... �;-�t, �SiG�t7Q-►� �} Name of Archi-fect .......•• l �-r�n a -4? ..Address ............... .. . 6:oJ....)4.,L, Number of Rooms Foundation .-..�!nl... ?- ... ............. d ... �!�` ir.cl .'!.: ...............................Roofin � ..—, e.........�..��r.Q�.(1�.� ................. Exterior ......... ...__. ........ .....s. g 3 it Floors ..... ?L..... � �+ ..:.:...........................Interior n l �.......1 l -ti�'h'.;c k(':r11 ............... Heating ^*. .......................................................Plumbing ...........f.!!t?.h ....................................................... ....... 4 Fireplace C'r ..............................................Approximate Cost ............ ... ��A. ................................... 1 Definitive Plan Approved by Planning Board ________________________________19--------, Area ..........:5. q.. ............. Diagram of Lot and- Building with Dimensions Fee ... ..�.31 .. .................. . SUBJECT TO APPROVAL OF BOARD OF HEALTH ! r 60 ` f . 0 2� N • M I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... .. 1. .................... .. Ba Mr. & Mrs. Harold A=269~83 ' lQ oNo -- — Pennit — —&.. ...... to dwelling ' ---------.---.~------------. . � . ' . - 20 ' � locohon -----..��T..��--' ` . _.______. 1s..................................... , Owner Mr. &..Mrm .. �_Ba�old Bassett ..................... Type of ConstructionConstruction ---- --—------- . ' Plot "^. ' . -_ 8 6 ' Permit" Granted. . uo,e or Inspection ~ - ' CompletedDate . . ' . ' PERMIT~ ~E ~~E~ . / .. . . ................................................ ................... . - . ` ............... .... (..K. --.�'..�� ~"� --�. . .......................................................... ................... . � ` . - . . . ' . . Approved ................................................ 19 ' ----------------'—^----^---'' ---------------. .-----~—.—.—.' . U ' K � Assessor's map and lot number ............... SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE WITH ARTICLE II STATE N. Sewage.vPermit number .......:........��.. �., e. - SANITARY CODE AND TOWN °Ft"Er° TOWN OF ;BARNS i EARNSTADLE, 9o�Y i639 a R . NUkIl.01NG INSPECTOR O� • e0 w APPLICATION FOR PERMIT TO ... Fdr. yNl4�V��. :... �. ��.t t........:........ TYPE OF CONSTRUCTION ..1V Oi, VVIr-�+.�.0..................... ..................................................... .......... CL ....19.: . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to t1he, following information: ►�(� Location ..............zn.........� ct..................1'f (3 ni11 ..1. ...1'.t. .,,..............: Proposed Use U ZoningDistrict ............ ..,.��..........................................Fire District .............................................................................. .�.........Address ........ Name of Ownerr.>. ..1.1•le. .:.... Lt�E?�.tQE�.....�` -,A.& Lt aC- r. �„�Y�. Name of Builder ... ra . ...C,.. I. . .. ..........Address ...5 `..... .. �47.` ....] ,:........1. .+� Name of AfeH4440. ........ -. rA Gt O!..Address ... �...................................... ....... Number of Rooms ...............................................�J..............I.....Foundation ......L-P. : �... ..... Exterior ......1 �. . .....:.........................Roofing ....... �. .�� ` .` . 1 • Floors .... ........Interior ................. Heating ........... Q rtt :......................................................Plumbing ........... 2.11: 121..................................................... �. . ..............................................Approximate Cost .......�.7. v000 Fireplace ............. �!`�. �. .................................. Definitive Plan Approved by Planning Board ________________________________19________. Area ..........5.1.q..7. ............. Diagram of Lot and Building with Dimensions Fee ........../3?,e_ .. SUBJECT TO APPROVAL, OF BOARD OF HEALTH E'er; n � I hereby agree to conform to,all the Rules and Regulations of the Town of Barnsta a regarding.the above construction. Names. ..... . ... .............. Bassett, Mr. & Mrs. Harold No ...18701... Permit.for. add breezeway .....and:.gara&e..t�..aw��.€ .�.�. . .... � � • ,� � . Location ........20..:Checkerberry.,Lane............ ....................... ..............:......................... • � Owner .......... :...&.Mrs. Harold Bassett -y•_ , Type of Construction _ frame......................... , t> It + ................ .. .......................................... .......... ,,. �,,T., +'T Z-•- d T - 1 w r. Plot ..... Lot ..... R lei Permit Granted ...••Septtember 28 19 76 Date of Inspection J p ..�?.. � ' Date Completed ..1. . ........... , 19 PERMIT REFUSED ' . ........................................................... ...................................................... . 19 1A. ................. ....................................................... `............................................................................... '� r !'` _ �. - •�r � S, `r 't, .................................................................... ..... J. . ''V�• �� .fir + +4 �y +�t'"t it Approved ................................................ 19e, r .........................................................H ... �V �6 � � -�,�I • ...�„�> � it r' Y ± ......................................_ ........................ fti ' +�� ►�f� - -