HomeMy WebLinkAbout0088 ISALENE ROAD 9a ��.,G...�. n�..
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C"E0 A SAS
Weathenzation
508-398-0398
December 14,2011
Town of Barnstable
Thomas Perry CBO
Building Commissioner
200 Main St. Hyannis,MA 02601
RE: Building Permits
Dear Mr. Perry,
This affidavit is to certify that all work completed for permit application#201103660, Status A,
Parcel 267043 at 88 Isalene Street,Hyannis, Permit type: RADD, and issued on 7/14/2011 has
been inspected by a certified Building Performance Institute(BPI) Inspector. R-18 Cellulose
insulation was added to the attic. Walls were dense packed with R-13 cellulose insulation.
Basement sill was insulated with R-19 fiberglass batts.All work performed meets or exceeds
Federal and State Requirements.
Sincerely, r
William McCluskey
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map a 6 Parcel �� 3 � Application #
C)b U30(00
Health Division Date Issued
Conservation Division Application F J -
Planning Dept. Permit Fee S�
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address 9 6 J- sal&(Ie, c��
Village WAS Cr v ann 1`5 p oc+
Owner GOLI � G I o Sin Address S+, C654ny`+"
Telephone b �" ` 144 — Q 0 g g
Permit Request Arlot ae5)o see a.s nec �'o aaAs'eVe )?-Y8 in ee i, 1. ���,
'y' S�a.� V�'�C ��.�r' ��t✓t,e5 k����avn.�n ec eca.s� Q�l�r� V e �- ` �Q1-rare •t o �� [a9�
r�d�'- v� .�-�'h� . 1 r�v�Sp �4��C �QIIs 4-o )?-IT
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
S2
Zoning District Flood Plain Groundwater Overlay �
Project Valuation 5 OOG} o'J Construction Type ;
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting"J documentation.
Dwelling Type: Single Family Ell Two Family ❑ Multi-Family(# units)
10
r
Age of Existing Structure 90 Historic House: ❑Yes ❑ No On Old King' Highwan ❑Y#p ❑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: Q�, existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other
Central Air: 9Yes ❑ 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 WII1(km Ca. Save Telephone Number ��� ' 3 9$ _ 0 .3
Address +C �Ue License # a:C t �.�'T 6
SoA 1 aim aJ I ' 11' 1 � b Home Improvement Contractor# 16 C/`1
Worker's Compensation # 9.9 3 5
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Y"PMOQ J
SIGNATURE DATE
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
C
ADDRESS VILLAGE
p OWNER .
»l DATE OF INSPECTION:
f FOUNDATION
FRAME
INSULATION '
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
{
r
FINAL BUILDING
s
DATE CLOSED OUT.
{ ASSOCIATION PLAN NO.
08l25l2010 09:23 9193212955 PAGE OV01
CAPE SAVE
weatheriza' tion
1 -
508-39 -039
t August CZ, 2®10
To Whom It May Concern: h
William J. McCluskey is an cmployee,pf Cape.,Save. _He is authorized to negotiate
contracts and building.permits for our.company.
. , J
Michael McCluskey
Cape Save—owner
919-593-5939 cell
s
X I•luntington.Avenup,,South Yarmouth, MA 02664
`IE= Office of Consumer Affai s and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration
Registration: 164432
Type: Supplement Card
CAPE SAVE Expiration: 10/6/2011
WILLIAM MUCCLUSLEY -- _..___.. .___._-_.--..
8201 S. HOURD CT --- ---— _ ....
CHAPEL HILL, NC 27516
Update Address and return card.Mark reason for change.
i Employment Lost Card
Address 7 Renewal '( Employ
}PS-GA1 0 50M-04104-G101216 — — r.__
,,�. ::lie f�nz.zruLnruerxl.� r.�_Ftrr,.aar.�ircye�i
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
` HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
-`- Z' Registration:
164432Type: 10 Park Plaza-Suite 5170
Expiration: 10/6/2011 Supplement Card Boston,MA 02116
CAPE SAVE
P
WILLIAM MUCCLUSLEY
7C HUNTING AVE.S.YARMOUTH,MA 02664 Undersecretary Not valid wit ou signature
♦laksatchusett. - Department tit PtjI)Iit \alfl4�
Board of Buildin-, Re,4,tjlattisrns atnd �taiitil;tstl>
Construction Supervisor Spec a t°i ucense
License: CS SL 102776
Restricted to. IC
WILLIAM MC CLUSKY
37 NAUSET ROAD
WEST YARMOUTH, MA 02673
Expiration: 6128/2013
t .,niuii.w twer Trn: 102776
I
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information } Please Print Legibly
Name(Business/Organization/Individual): m l a A ei �1��1C�a _�Tl��rt� c r;' SA
Address: to rZ II t\i Q1h t� &1E
City/State/Zip: YA aAos -1 Ma 6VO one#: 3`
Are you an employer? Check the appropriate box: Type of project(required):
1.1K I am a employer with (( 4• ❑ I am a general contractor and I
employees(full and/or part-tine).* have hired the sub-contractors 6. New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g. ❑ Demolition
working for me in insurance
any capacity.ca acit . employees and have workers'
9. ❑ Building addition
[No workers cotitp. insurance comp. I
required.) 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers
q have their airs or additions
ave exercised r 11.❑Plumbing repairs
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] c. 152,51(4),and we have no
q employees. [No workers' 13.�Other-�t'St} �t t�f1
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 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:_
Policy#or Self-ins.Lic.#: VU0 G 3 - 6�1 Sf i Expiration Date: Z
Job Site Address: $ e City/State/Zip: lJ_ A%3 0 a r 0 u:F�
Attach a copy of the workers'compensation policy declaration page(showing the policy number andexpiration 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties erjury that the information provided above iss true and correct
Si ature: Date:
Phone#: � � ' ,&- Paq
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
b.Other
Contact Person: Phone#:
-��'� DATE(MMlOOlYYYY)
CERTIFICATE OF LIABILITY INSURANCE 11/1/2010
TAS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the poiicy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such sndorsement(s. COTA
PRODUCERN$�E; Shannon 3perrazza _
Risk Strategies Company ;PHONE (781)986-4400 fAX (781)963-4420W
MAIL s t3rrazza@risk-strate
15 Paceila Park Drive AooREss: sP glen•coz►
PRODUCER Q0Q1$476
Suits 240 STOMER ID tt Randolph MA 02368 INSURER(S)AFFORDING COVERAGE �?_NAIC#�
INSURED ;INSURER A_Seneca Specialty Insurance Co
1 INSURERS Aeating Grpup Zns Services
Michael McCluskey, DBA: Cape Save INSURERC:Chartis Insurance
7 C Huntington Ave INSURER D
INSURER E:
South Yarmouth MA 02644 INSURER F -
COVERAGES CERTIFICATE NUMBER:CL1011132675 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. NOTVATHSTANDING 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, i
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR L; '- POLICY EP I POLICY EXP
LTR' TYPE OF INSURANCE POLICY NUMBER w 01001YYYY I: LIMITS
GENERAL LIABILITY ' EACH OCCURRENCE 3 1,000,000
rX" COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES R oocwrencs} $ 50,000
A i CLAIMS-MADE I X OCCUR SAG1002600 10/16/2010 10/16/2011 INFO FxP(Anyone person) $ 10,000
f ;
i PERSONAL 8 ADV INJURY S 1,000,000
I f GENERAL AGGREGATE S 1,000,000
� -
_GM AGGREGATE LIMIT APPLIES PER: i _PRODUCTS-COMPIOP AGG :S 1,000,000
X;POLICY PRO-JECT !OC $
AUTOMOBILE LIAILITY COMBINED SINGLE LIMIT ;$ 1,000,00Q
ANY AUTO j6208200 11/6/2010 "11/6/2011
(Eaascioant}
I BODILY INJURY(Per person) S
F- ALL OWNED AUTOS
X :SCHEDULED AUTOS {BODILY INJURY(Per accident) S
I PROPERTY DAMAGE
�X HIRED AUTOS (Per a00klent) :$
X 'NON-OWNED AUTOS j S
h
t$ 'UMBRELLA LIAR OCCUR i ' EACH OCCURRENCE _ '$ 1,000,000
EXCESS UAB -^+CLAIMS-MADE I { AGGREGATE S 1,000,000
_ DEDUCTIBLE
B i RETENTION $ I P23578601 �, 0/16/2010;10/16/2011; $
c ;WORKERS COMPENSATION ; Michael McCluskey - ' WCSTATU- ; ;OTH-�
AND EMPLOYERS'LIABILITY YIN ! X 'TORY LIMITS; ER __
ANY PROPRIETORIPARTN ERIEXECUTIVE I V is excluded from.coverage
OFFICERIMEMBER EXCLUDED' j N I A j i E.t.-EACH ACCIDENT $ 500,0Q0
(MendatoryinNN) 19930951 10/2S/202010/21/2021;EL DISEASE-EAEMPLOYEB S 500 QQ0
desaebIf yyeess RIPTIOe OF O i El DISEASE-POLICY LiAAtT $ 5Q0L0QQ
DESGRIPT�N OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Renurks Schedule,if more space Is required)
Issued as evidence of insurance. Contractors-Executive Supervisors or
Executive Superintendents.
CERTIFICATE HOLDER CANCELLATION
(508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
. Housing Assistance Corp -
ACCORDANCE WITH THE POLICY PROVISIONS.
Attn: Ruth
460 west Main Street AUTHORREDREPRESENTATIVE
Hyannis, NA 02601-3698
chael Christian/SMS
ACORD 26(2009t09). 0 1988-2009 ACORD CORPORATION. All rights reserved.
INS025(20OW9) The ACORD name and logo are registered marks of ACORD .
( , �'`,—� .(•:.�•`1--1-�'.C.7 i- L� i-i i��1 i_ I\Ll'i�tl`:
ptT {r y t 7t [ cO1���(; ' Z.i
C✓:JS`T)OR 1. i ION I � `i oil :Ili 1111:._
LANDLoRD G'V'%'I G l ,5� , TENANT
PHONE 6 I-7-2-7?- oo q f PHONE Lt 5-oS-3 ioc}-85 �4�
Dear Landlord,
Your tenant is eligible for services through the Weatherization Program. Program regulations permit us to spend
an average of$5,000.00 in materials and labor per dwelling unit-
Program regulations require us to weather-strip and caulk doors and windows;insult attics,sidewalls and floors.
All work is professionally done by established private contractors. We will conduct a final inspection to make sure
that all work is completed to specifications. Prior to making the inspection and doilgg the work we must have your
permission. if you want your tenant to participate in this program,please sign the agreement and return the form to
me. This agreement states that:
1. You will not raise the rent because of the Weatherizat ion work or for one year from the time the work is
completed.
2. You will not evict your tenant for one year following work completion date except for good cause related
to the tenant's failure to pay rent or serious or repeated violation of the terzus of tenancy.
3. If you sell the property during the specified period,either the new owner Daust assume the obligations
under the agreement prior to sale,or you must refund to us the entire amount of materials and labor we
` spent in weatherizing the unit-
If you requests you will be informed of the estimated measures before they are done.and provided with a list of the
actual measures and costs following the completion of the work.
We also need proof that you own the property. A copy of a CURRENT TAX BIC.L OR DEED listing you as
the owner will satisfy this requirement Please fill in all blank areas of the enclosed agreement and return with the
proof of ownership as soon as possible. Failure to fill out the entire form will reMIt in a delay in processing the
application.
if you have any questions please call Michael Saton at 508-771-5400,x. 105.
Sincerely,
e
Ruth Bechtold
Assistant Director
Energy and Home Repair Department
TENANT/PROPERTY OWNER/AGENCY WEATB FJ ATION AGREEMENT
1. The Parties to this Agreement are the following-.
Li►,1c PUe.a (hereafter known as Tenant),
(print your tenant's name)
Gib+l L4 SC(- (hereafter known as Properly Owner),
(print your name)
and Housing Assistance Corporation(hereafter known as Agency). In consideration of the mutual
promises hereafter stated,the Parties agree as follows:
2. The date of Agency's signature will be the effective date of this Agreement. The Agency will sign and return
a copy of the Agreement upon completion of the proposed Weatherization work.
3. Property Owner and Tenant consent and agree that the Agency may do the following with respect to the
property located at(street,town)
WEST unit# , and currently leased or rented to
the Tenant:
a) Enter the premises for the purpose of performing a Weatherization inspection.
b) Enter the premises to perform.Weatherization work which the Agency determines in its discretion is
necessary and appropriate as a result of the Agency's inspection of the property and in accordance
with the appropriate priority list for the type of dwelling. The Agency and the Agency's contractors
may also enter the appropriate common areas of the building for the purpose of accomplishing the
Weatherization work. The Agency and representatives of the Commonwealth of Massachusetts,
Executive Office of Communities and Development(Office of Energy Conservation)may further
enter the property to inspect any and all work hereunder. The Agency will provide reasonable
notice of the timing of the Weatherization work and inspections. The Weatherization work will be
performed in accordance with the Property Owner's consent as further specified below:
--..•;Lam:�.r:S:.-n.-�;r................ _........_.... ......:.......<-....... ..
I consent to performance by the Agency and its contractors of any Weathenzation work
�
determined necessary and appropriate by the Agency as a result of its inspection of the property. I
understand that the Agency will provide a detailed statement of the actual work performed and the
associated value at the completion of work.
All
jf
`# 1 will provide a separate consent to performance by the Agency and its contractors of
Weatherization work following my receipt of the Agency's inspection report and a statement of the
estimated work and associated value_ This additional consent wiR be sent under separate cover as
Attachment A. I understand that the Agency will provide a detailed statement of the actual work
performed and the associated value at the completion of the work
4. The Property Owner understands and agrees that any and all work,including related repairs for which the
Property may also be eligible,will be performed at the Agency's discretion.
5. If the Property Owner is required to make repairs to the property prior to the commencement of
Weatheriratiou work by the Agency,the Property Owner will be notified by the Agency and will be required
to make the repairs as soon as possible. Except where the Property Owner receives a written extension from
the Agency,time is of the essence in the performance of repairs by the Property Owner.
b. The Property Owner and Tenant authorize the Agency to receive a statement from the fuel supplierlutarty
supplier as to the quantity of fuel/utilities used at the above address in each of the past three years and the
future three years. The information is to be used only to determine the cost effectiveness of the
Weatherization improvements.
7. The Property Owner agrees that the rent for the dwelling unit will not be raised because of any increase in
the value thereof due solely to the Weatherization work performed.
8. *In consideration of the Weatherization work hereunder,the Property Owner further agrees that upon the
effective date of this.Agreement and during a period extending one full year from the time the work is
completed:
'leG� a The resent rent${q{j
} p per month will not be raised for any reason. (The rent amount must
Co�'6 be filled in).
**However,this Paragraph(8a)will be waived by the Agency in writing if,and only if,the
premises are leased under a state or federal rent subsidy program,in which case the actual
rent charged by the Owner shall conform to the standards of the rent subsidy program. Please
state which Housing Subsidy program your tenant is on and through which
b) The Property Owner will not institute any summary process action for possession except in the case
of non-payment of rent or other good cause related to the Tenant(or any successor Tenant).
c) In the event the Property Owner decides to sell the premises,Property Owner shall comply with one
of the two requirements below:
—The Property Owner shall not sell the premises unless the buyer agrees(with a copy forwarded to
the Agency)in writing prior to sale to assume all obligations of the Property Owner set out in this
Agreement;or
—The Property Owner shall pay the Agency an amount equal to the cost,as certified by the
Agency,of the Weatherization materials installed and labor performed in the premises as of the
date of sale. Said amount shall be paid to the Agency immediately upon sale
9. (*Applicable only if Tenant's heat is included in rental payment and blanks are Wed in.) At the end
of the period set forth in Paragraph 8 above,the rent shall not be raised more than %per
for an additional period of one year,and the provisions of 8b and 8c above shall continue in
effect for such period. However,the rent provisions of this Paragraph 9 may be waived by the Agency in
writing if,and only if,the premises are leased under a state or federal rent subsidy program,in which case
the actual rent charged by the Owner shall conform to the standards of the rent subsidy program.
10. The Parties agree that the terms of this Agreement are incorporated into any other lease or agreement
between the Property Owner and the Tenant,and between the Property Owner and any successor Tenant, and
if there is any conflict between the provisions of this Agreement and the provisions of such other lease or
agreement,the provisions of this Agreement shall govern. However,if such other lease or agreement,
including without limitation a lease or agreement under state or federal rent subsidy program,con tazn
stronger Protections for the Tenant such stronger protections
shall apply.
s"11. For breach of this Agreement by the Property Owner,the Property Owner shall reimburse the Agency in an
amount equal to the cost,as certified by the Agency,of the'Weatherization materials installed and labor
performed on the premises,as well as attorney's fee and court costs. The Property Owner may also be liable
for damages to the Tenant in accordance with applicable law,in such instance,the Property Owner shall
reimburse the Tenant for attorney's fees and court costs. Without limiting the foregoing,the Agency may at
its option terminate this Agreement,by providing written notice to the Property Owner and Tenant,in the
event of breach by the Property Owner or Tenant.
12. Performance of the Weatherization work hereunder by the Agency is contingent upon the availability of
funds to the Agency from the commonwealth of Massachusetts and the federal government,as well as the
eligibility of the Tenant under WAP program requirements. The Agency may terminate this Agreement,by
providing written notice to the Property Owner and Tenant,if the Agency determines that the unavailability
of fiends or ineligibility of the Tenant warrants termination. ,
13. The Parties acknowledge that this Agreement is under seal. It is intended by the Parties that the Tenant or
any successor Tenant is the intended beneficiary of the Agreement and shall have a right of enforcement.
Property Own
ea
Signature: I i�,t ILZ 7�--- - Date
1 � /
Phone: ;�✓,f'/ 7-- UL
Address: (1C�i f 4-) �[ '
� G1
iT
Tenant Signature zn 4,rV Date
Agency Approved Weatherization Company: CC.,
v&
All Cape Energy Caliber Building&Remodeling Cape Cod Insulation
pe a Creswell Construction Frontier Energy Solutions
Lour&Sons Peter Smith Resolution Energy
Rock Solid Construction Sprinkle Home Improvement
This Agreement becomes Effective as of the Date of the Agency's Signature. The Agency will sign, and return
copies of the Agreement to all parties,upon completion of the proposed Weatherization work. The Agreement shall
remain in Effect for one full year from the Effective Date.
Agency Signature Date .
I ET TOWN OF BARNSTABLE
i MARNSTABLB, i
M6 9 BUILDING INSPECTOR
o uav a'
APPLICATION FOR PERMIT TO ..., J?G' 1FS�.... .Ix'C�id.?............................................................................
TYPE OF CONSTRUCTION ....d'C2.- -,,W.e4�............GULJQ.. ...........................................................................
..dpz.lo....................19.1-71..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......Fe...... .�..$�L�.)-7..U.... ... :.....................................................................:............./4......................
ProposedUse ........ ...... r-a,e A..................................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of Owner /..........Address .........YY... �'c L. .0 . ........R ....................
Name of BuilderZ���.... .........Il.O..i;:P ..............Address ......�1/z/...T R1j/J........ a.........
Nameof Architect ..................................Address ....................................................................................
Number of Rooms .....................1...........................................Foundation .......... � ....... ./4, J.......
�'edXlC.�e �
Exterior ......Y.!!..00. !......... .. ~../L�'...........................Roofing ......../�.. �aS'1�i.
Floors ... ....................................................................Interior ..... .
Heating ha.?--.... e,......... .��.$ ............ Plumbing ......., 0..1 ..
p .oO
Fireplace ..............................yfQ. . e-.-:............................Approximate Cost ........,r�� —.....................................
Difinitive Plan Approved by Planning Board --------------------------------19--------. / VO 04n pC` �Rhf G
v �
Diagram of Lot and Building with Dimensions
'pope � 1
e
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .. ....4, ... ..... ..
Aoraoovzoh, rmuzriom
0CA/'~'` ,r '
No -. Permit for —
—..---c.—......----.---__.__._~_.
Location ..........8O...Zaa]emua..8oad._______ �
West �
�
-------.-----. .........'..-..-.-----.. �
,
Owner ............a�uur1ue_Abramovich___________.. . |
|
a '
Type of Construction ...................fr ouy
Construction —.------.
-----''^—'—^'^---^-------~----'' (
Plot ............................ Lot ................................ '
. �
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PPermitGGranted —_..D�tobmx. 2.6--..1g ?I/ �
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Dote of Inspection lQ
v `
-_- Completed` . — \ '
| ' �
PERMIT REFUSED '
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Approved ~__------------.- lA '
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