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HomeMy WebLinkAbout0032 CROSBY ROAD (wu 111-1111 J31 i�,V iV'-F.Ilill,�l�'1"'4 41, 41 I Via, :11 R. "Au 1'4 Ow 1,1* 01116 M71"".I, it po 1-y" Tt, j '02o, f4i ix el j't NA 10' itIf Y,tItf.......... ILI iVIttiyi� fttr i Town of Barnstable *Permit# Ila -MVIres 6 months ro issue 3' Regulatory Services snnxsrasta MAM a Thomas F.Geiler,Director OK u 3/I Z s6;q �0 Building Division Tom Perry,CBO, Building Commissioner 200,Main Street,Hyannis,MA 02601 , www.town.barnstable.ma.us" - Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERAM APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 3,t Ch of6 ,2 04 i) C-e4M?X11.�1-e t Properly,Address, [Residential Value of Work e2/00 i 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �AN t 4— E s e e I-1.4ti /?0 tMll r'l le lkA e Z 6-1 Contractor's Name J o a IV 7. S 4'✓✓M 5'k 1, _ Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Worlonan's Compensation Insurance X PRES PER MIT Check one: ❑ I am a sole proprietor ❑ I am the Homeowner JA N 2 4 2012 [�I have Worker's Compensation Insurance 4. SO(14fe1) Insurance Company . ���1© C�'i<J �et✓S� t�/C� �o Y P . UVY19 OF BARiVSTABLE Workman's Comp.Policy# 1 3 0 z 13'24 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old'shingles) All construction debris will be taken to ❑Re-roof(hurricane'nailed)(not stripping Going.over e existing layers of rool) ` ,,. — , ❑ Re-side ,r : #of doors M-l'4nzo Iry •WReplacemerit Windows/doors/sliders.U-Value (maximum.35 of windows r ' *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission.' ' copy of the Home Improvement tractors License&Construction Supervisors License is equ , SIGNATURE: n C:\Users\decollikrocaiMciDsoft\Windows\Tempomryta\Local\Micinsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS doc 110 Revised 072 - ,. .v `Fte t✓`orittFotwerIth� • assFitrsetI � ,� . l���rrrtrrtetft a�`,�ticficstra��c�ici�nts . - ,� Office of fnvestkadd=, ` 600 Washirivott street "k Boston,MA 0211.E w w.Hiassgov1diI Markers' CQmpcnsatiot�iusuraizee affidavit: Buz�derslCrsfiearslPleCixieiaIIs/PiumF�er� Appliednt Thftrrma'don gIegse Ptitrt£le4ibi 1) �. Maine(Business/ar*.�—zizaaon/Tndi-viduai): Mdress: f. S� lV til- �r�a-� R f tCyfStat Zig: : £t` rts MA 614,�s' i'haae#. J���.f�� ��•1� Are you an emplaper?Check the appropriate box: ; L7Re:] prof ect(required}: I Mare a euipinyer with 40 ' 4. [] I am a general contractor and I eiployees(full agdlorpait time}. Dave hired the sul-contractorsew construction. v`2 Q I ar2i a sole proprietororpartber listed-oa the attached sheet emodeluigshipand have do employees These sub-contractors have emoiitioiiWorkingfor ine in nay capacity employees and have workerso arorkeW co co ins m c t ui7diug additiaztrep ;nsuiance rep• eregmre&] 5. Q We are a corporation and its :. lectrical rcpatrs or additionsr einahomeowaerdoiag alt work ofncers have exercised theirumbing repairs or additionsmysele f Io workersIcomp. right of exemption per MGL: insurance regWred.,j ¢ c. B2,¢I(4),and WChave adof repairse Ia es o workers' her 0 a'oeCt�rcoup_insurance require /�E �4<e j�j �/ ti *el ny anpicaat ttmt cfi mks bait must aisb fitt out roc sxhaa beiaw sho s wing!beet x c vk-is`compsahon pscy nzacmahgn t Ffontrnwnets whts submit tbzs af�tdavtt mdreatuig tfiey are doing all work and then outsido contiactots a,ci`�st submua a^w (favit iudieating su b=Contcacto6 that ehxk rlus 6oX truest aua hat an additiaaai shwt slwrag tf�none of tfic sub.oattactcus and state why or not dsnse eatici�Uavc,emts[oyces If the sib cantxactirs Fsa�a eniployecs;they most*ovido:tEt r wotir^is'co do numb _ mP�p°' Y - I one as etrtpfayer#hat upravcduta wariCers'catnpensaa insurance for my employees $elaw is the�roficy and job site Insurance:Company Name- �i�Jnt�41e .:497h? Policy#.or SeL=fill.Lic.ff: ,, .. C�� ram,on Date s vZ� r/ C' P / /� j IOI]$ite address: �^ City/$ta-ZiV: . C -e i f Te ✓f�/l/� Attach a cope of the vt arkers'campensanaa poricy deciarafion page(shntviug.tine pasey rtumfrer snd expirstiaii d.,te) �.tQ Failure to secure coverage.as required undeF Secitan 25A of Md c. t 52 can Lead to the imposition of crunfisat penalties of a 3� fine up to$1,500.0(7 and/ one y ar imprisonment;as tzrell as civil penalties ME the form of a-STOP WORK ER need a fee of up to 25t1.0t}a day against the violator. $e advised that a copy qF this statcmant maybe fonvardeci:to[iie Office o€ Investrgatians of the DIA€or insurauce coverage"verifcatioii I do hereby :under the pains an penafti fgerjury that the ittformatzon provided above is true:gad correct. ate: LY Of}ictal u se oitly. D6 rent write ut thrs area,to be carttmifeled by fii£y or 49,wit a�ictaL. ' City or Tara . Permit(I,icesFse IsstitirgAiubrity{circle que} } 1 board a€Health Z l3uiidiu I�elsartiiieiit 3.Citf/ToWa Clerk .4_Electrical tifspeatar.S.Flumbiui t Inspector 6.'Offer. Coatact Person Plioae . n. S Client#:47298 CAPIHOM ACORD. CERTIFICATE OF LIABILITY INSURANCE - D/YYYY).DATE(MMID 1 DATE 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 - CONTACT NAME: Karen A Walther,CISR Rogers&Gray Ins.-So.Dennis PHONE 508.760.4630 FAX 877.816.2156 _LAIC,No,Ext: A/C,No 434 Route 134 E-MAIL ADDRESS: - - - South Dennis,MA 02660-1601 . . INSURER(S)AFFORDING COVERAGE - NAIC# 508 398-7980 INSURER A:National Grange Insurance Co. : INSURED INSURER B:Associated Employers Insurance - - Capizzi Home Improvement,Inc. CNA Insurance Companies Cap.izzi Enterprises,Inc. INSURER c: P 1645 Newtown Road INSURER D INSURER E:. COtulit,MA 02635 - 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 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 TYPE OF INSURANCE ADDL SUBR - POLICY EFF POLICY EXP LIMITS ? LTR _ INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY MP91075H 6/08/2011 06/0812012 EACH OCCURRENCE $1 OOO,006 X COMMERCIAL GENERAL LIABILITY - - - DAMAGE TO RENTED z PREMISES'Ea6dcuirence $500,000 CLAIMS-MADE OCCUR 'y,• MED EXP(Any one person) $10 000 r 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 PRO- LOC - $ JECT /.� AUTOMOBILE LIABILITY M1 MY8044 O6(O8I2011 OE,/OS/2O1 ,COMBINED SINGLE LIMIT - Ea accident 500,000 ANY AUTO`' BODILY INJURY(Per person) $ ' ALL OWNED SCHEDULED - BODILY INJURY.(Per accident)• $ AUTOS X AUTOS - - X HIRED AUTOS X NON-OWNED - _ PROPERTY DAMAGE AUTOS - - - Per accident $ A X UMBRELLA LIAB X OCCUR CUB1076H 06/08/2011 06./08/201 EACH OCCURRENCE s5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,1100 DED -X RETENTION$$1 O 000 $ - - B WORKERS COMPENSATION QQ730221321 12/25/2011 12/25/201 X We srATu, oTH- AND EMPLOYERS'LIABILITY 1 ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 - OFFICER/MEMBER EXCLUDED? � NIA - (Mandatory in NH) _- _ E.L.DIS_EASE-E_A EMPLOYEE $1 000.000 If yes,describe under - DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $1,000,000 - C Surety Bond 70011667 11/28/2011 11/28/201- $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) j Carpentry. CERTIFICATE HOLDER CANCELLATION t. Town of Barnstable' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 . AUTHORIZED REPRESENTATIVE ,M , ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 Of I' The ACORD name and logo are registered marks of ACORD #S75543/M75539 KW ...i, u1.a..uusu111c1 malls c nuswcss�crulauuli - LICBIISO Uf fUg1SL1UL1U11 Ya11U IUl-111U1Y111111 use u111y - m =I HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ��r Office of Consumer Affairs and-Besin.es Regulation �— eglstratlon:;.:100740 Type: 10 Park PIaza-Suite 5170 -�, txpiratlon::-6/23/2012 Supplement Card Boston MA 02116 CAPI=I HOME IMFROVEMENT"INC. _--:- — JACK STRUNSKI: ? 1645 Newton Rd. Cotuit, MA 02635 Undersecretary Not valid without signature tNlassachusetzs- Dq)artment of.Public Safety Board of Building R'eEufations and Standards ConstruetlDn Supervisor License '1_icense: CS 64817 JOHN T STRUMSKI ,.PO BOX 86i : BUZZARDS BAY,NfA 02532 :. `Expira#ion: 6H 8/2012 Tr1: 10573 - a • p. i Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF iMASSACHUSETTS . LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT ' OWN THE PROPERTY LOCATED At IN Zvi � , MASSACHUSETTS. r I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PER J IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING SIGNATURE OF OWNER: ` OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: 71 LESSEE'S ADDRESS: .LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS:, 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: Assessor's office(IsfFloor)::} Assessor's map and lot num T o�TM�ro SEPTIC SYSTEM MUST BE conservation(4th Floor). ::INSTALLED IN COMPLIANC Board of Health(3rd flo ��''°" `' ' o � _ WITH TITLE : sea»rknt,c Sewage Permit numbe rua Engineering Department(3rd floor):: ,asq. \�d° House number o� �JI w 7 MIR Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED.8:30-9:30 A.M.and 1:00-2:00 P.M.,only TOWN - OF 'tARNSTABLE 1 BUILDINGINSPECTOR APPLICATION,FOR PERMIT TO RTTTT,r) 1 A ONE STORY APPITI0N TYPE OF-CONSTRUCTION _ WOOD FRAMF, JULY 26 19 94 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora ermit according to the following information: Location &2 S . Proposed Use FAMILY ROOM Zoning District ,b� ) Fire District (2 04( ) NameofOwner TANizT SHEEHAN Address 32 GRGSBY GiRGLE' ,�. T'+�=ErD�►T�� TIR Name of Builder _ R .T BISHOPRIC— JNr_ Address PDX GST-ER�VILLE,NA. Name of Architect Address rT�p Number of Rooms ONE Foundation POURED CONCRETE Exterior SHINGLED Roofing COMPOSITION Floors CARPET Interior DRYWALL a Heating FHW Plumbing MOVE EXISTING Fireplace N/A Approximate Cost �2� ggg gg Area 324 9G__k T_ .Diagram of Lot and Building with Dimensions FeeGkV d. OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Siipervisor's License �^ SHEEHAN, JANET -7/ No `4—°94— Permit ForBUILD ADDITION Location 32 Crosby Rd, Centerville Owner` Janet Sheehan _ Type of Construction = , Plot Lot Permit Granted July 26 , 19 94 _ Date of Inspection: s Frame , �/ - 19 / Insulation 19 - `- Fireplace 19 Date.Completed :Z52Z 19 j 7 1 COMMONWEALTH OF MASSACHUSET�'S E— L DErMr,MENT OF T�DUSTR.IAL ACCIDENTS 600 wASHINGTON STR1' fames- Ganaoea BOSTON, )Y S ACHUSETTS 02111 -c--.-sstone• -woRKERS' COMPENSATION INSURANCE AFFIDAVIT Steven J. Bishopric Inc. (l ice nsee/perm i acc) with a principal place of business/residence at:. P 0 Box 687 (Ci ry/s zatc/Zip) do hereby certify, under the pains and penalties of perjury, that: I)(] am an employer providing ncc following workers'compcnsation coverage for my employees working on this job. Wausau Insurance Co. . 1513-00-070355 Insurance Company Policy Number [j ] am a'sole proprietor and havc no one working for me. l am a sole proprietor,general eontnaor or homeowner (circle one) and havc hired the eontraaors listed below who have the following workers'compensation insurance policies: Name of Contmaor. Insu=ce Company/Policy Number lame of Contractor lns=nee Company/Policy Number Aamc of Contmaor ln=mncc Company/Policy Numbcr 0 1 am a homcowncr performing all the work myself NOTE: Plcase Ix await that while bomcowaers who employ persons to do wainteasaa,eoanructka or repair%ork on a /welling of not roars tbaa thtcc units is which the homcowncr also resida or oa the grounds appurunaat thcrcto arc not gcacrauy considered to be eraployers under the varkCrs,Compeasatioa Act(GL G 152.sect_ 1(5)),application by a borocowaer for a lieeasc or permit rosy cvidcacc the legal sutus of u crploycr under the Workcrs'Corapcosar6on Act i unocritand that a copy of thus statement wiC be forwardcd to vac Dcpauz::cnt of Industrial Acddcnts'Orrkc of Inscrana for.covcra;C vcrification and that failure to secure coverage as rquired under Section 25A of MGL 152 can lead to the imposition oWminaJ pcnaJucs consisting of a fine of up to 51500.00 and/or imprisonment of up to one year and civil pcnaltks in the form of;Stop work Ordcr and a finc of S100.00 a day against MC. Signed this day of . 19 ty Licenscc/Permirccc Liccnsor/Pcrminor Alk �.r I ) f ,c": k,1• 1 � j i i I E i I k t. i , I i ----- -77 -------- ------------ --... ._...------- - - ------ X�ST�1�6Ot1RRZ3pN �6 ��� ��Ufl�IUN r ' i •� r..a 5 4 1 � t f,. i' CEIL 63. EX\S i � !is �(�'' �{ ✓6 �_� �, ' i 3 + k t GT1e�oow.xoxuieal/li o��aaaac%uaetla TOME 7MPR0VtMtNT CAnNTRACT�AR b t Rc�iStrati0il �V6i4i � - ?Yp2 - PRIVATE CORPORATION { ° Expiration 07/22/y4 S Staved J. EiS iopriC Inc. s r Leven J. tliSilGPriC }` � s 6i nig 0c:int` Road . fi ADMINISTRATOR Marstorls K i,is MA 01646 COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 CAUTION EXPIRATION DATE FOR PROTECTION AGAINST I EFFECTIVE DATE LIC N0. THEFT, PUT RIGHT THUMB RESTRICTIONS f' 31 PRINT IN APPROPRIATE o BOX ON LICENSE. 0 0 BLASTING OPERATORS g ,MUST IN LUDE RHOTO;_- PHOTO(BLASTING OPR ONLY) FEE: NOT VALID UNTIL SIGNED BY LICENSEE'AND OFFICIALLY HEIGHT: STAMPED•OR-SIGNATURE OF THE COMMISSIONER DOB: THIS DOCUMENT MUST BE « SIGN NAME ly UL✓ABOVE SIGNATURE LINE IGNATURE OF LICENSEE l.—_ CARRIEDONTHEPERSON OF - ' THE HOLDER WHEN EN- COMMISSIONER OTHERS•RIGHT THUMB PRINT GAGED IN THISOCCUPATION. c ���•'"'>a TOWN OF BARNSTABLE Permit No. ---------------- Building Inspector { IL"ST.n Cash OCCUPANCY PERMIT Bond _---- Issued to S ,1 Address aa Wiring Inspector Inspection date Plumbing Inspector y„�� ! � > ,. Inspection date Gas Inspector Inspection date Engineering Department Inspection date y�f Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19............ .................................................................................................................. Building Inspector JOSEPH D. DALuz TELEPHONE: 775-1120 Building Commissioner EXT. 107 TOWN OF BARNSTABLE BUILDING .INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 MEMO TO: Town Clerk , FROM: Building Department - `d- DATE: An Occupancy Permit has been issued for the building aut orized by Building Permit issued to 46 � �3vC' . J t; Please release the performance, bond. c Jn�jr �t+ I \ aIVIV fi a �O�aG,.1 S•F. � �~ QF ro WIL.If:�ivi C. ri Y Irk} GL�OT F�I-A / / C'�.2T/,cy T,-/�17- TNT r=OUAJD6TIOA4 La6.4 T/OAC/ C E/�/?C-,a h/E,ez"o cl C yS SCALE T X ,,$"/O 6:X AA/�SETBA C/G �� it1 ,2EF E.2E�C� �2EQU/.2E�'!EX4 5 OC- T,L/E 7-ovt�it/aF M;TfiF��L ,QiC/L7 L o cA TEv OA TS ,QA XT,-oe,! /yE IM45 t /NST,2UiL1,Eit/T,$'U.el/EY T �j' c�sTE.21i/,C Z-L 0.�,�5-ETS.Sh�aL✓mot/S� ULI� �t/OT B� / -�4�/>- OS r 1 H. Assessor's map and lot number ..� G�a..�1(13.................. OFTHE TO Spwa a Permit number � � a ll o IG l Z 11AWSTABLE, i House number .................................3Z...........................,.:.... 9 rasa �0,�l639 a�0� �YPY TOWN OF BARN.,!'V T MUST 13E 1 C� , LIC WITH TITLE 6 BUILDING , IHSPEtTlR, F I AND - APPLICATION FOR PERMIT TO ...........—A/.Q........4. 2�...:S?...... ............................................................. i TYPE OF CONSTRUCTION Q...iF.... .MC....................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........4-r..... 1���-S�. %............�C T vI�'L� .............. .... .... .... ....................................................................... ProposedUse !✓ LLI +!.q.................................................................................................................................. Zoning District ��' g ............ ... :�..�:...........:................Fire District ...............�........................................:................... , p Name of Owner ... 5.......7..�ie�S T...............................Address I'l—e...�. �r�...... � � il//l// ................... Name of Builder /.E. SQ.LLgG S....��.E.(14--`q/.l!LL!'rAddress ..................................................................................... Name of Architect ........ �/tff�S�/�.t�.....`�f � .......Address .....Ec.l.. .....0?..... dU '1......................... Number of Rooms ...................................................................Foundation ........AU/1!50.....L.Q>�C/2F7� ..................................... Exlerior ....................... �t.�.cs...................................Roofing ................/.lSI..H LF......................... ...................... Floors /—v 1.A..........................................Interior -S rrr.!`.rfldc.� g#----------,F,� C g po1/CCOP EfP �1Th!s rieafin .............. F.C.TK. ......... ..............................Plumbin .. Fireplace Y..r�.................................................Approximate. Cost ..............y'lit. ........................................ 9�� Definitive Plan Approved by Planning Board _______________________________19________. Area ............... 47 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF .BOARD OF HEALTH " 1 OCCUPANCY PERMITS REQUIRED FOR NE W DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town Barnstable regardi th above construction. Name ..... ! ..... 0d• Construction Supervisor's License .................................... S ,L S TRUST , Y-No 27332....... Permit for ..l z Stork................ { Single Family Dwellin ......................... .......W.................... Location Lot 5 32 Crosb Road ,.......................Y......................... .................Centerville...................................... v Owner .S..L.S....Trust..................................... ...... Type of Construction ..Frame............................. f................`.......................... .......................... .Plot ............................ Lot ................................ i ' Permit Granted Pm r..17.,.......:..19 84 ' Date of Inspectiph .,. ...??2f✓.... 9 Date.Completed ... :-t .. '...........19!e-7;�y' L,i✓ r Assessor's map and lot number c TNe c f T Qy ... �_. sty � SA�anrdge Permit number ........... .�..�..�...!............p.IC u Z IMNSTABLE. i i Housenumber :............................... ,................................... ' rasa 16 3 9.Ar \00� ti TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 5-rala/ ! u�...............�..�y................... ............................................................ TYPE OF CONSTRUCTION .................... 4W1�...�'�.e�i� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ 1111 ..................................................... ProposedUse ................ !✓ L L I.Al JQ........................................................................................................I......................... ZoningDistrict ............:7� ....I .Q.1............................Fire District ..............C. ......................................................... Name of Owner .. S r ( S T..............................Address /4/9 ��t -72 .......................... ............. ............................................... ................................ Name of Builder (F. C-'L, ....�R.t�GGy G�IUELC�/u�ivTAddress Name of Architect ....... /�FSwQ,...........Address ..... 7 ,....E?. ...../ /fii%'!'U(/ T.F/ Number of Rooms ....................... ....................................Foundation ......../)61 O �dwr6PF77- ..................................................................... h Exterior Sh.�N L ....................................Roofing ................/!.10H � ............................................... Floors f✓G+iOd/�..........................................Interior Fr/20�/� Heating (' .{................"`............ .........Plumbing .........:l.:.vC............................................................... Fireplace .......................'/. 5.................................................Approximate Cost /Q................................................. Definitive Plan Approved by Planning Board ________________________________19___='____. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Y v v .may a � i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS t` I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License .................................... S L S 'TRUST A=229-1-" No' 27 .... P'e' r,,nit for ....Single„Family ............../ ag............ Location ...LQL.5 R.Q 99!?Y..Road............ .................. ..................................... Owner .....S.....L....S Trust .. .................................................. Type of Construction ZVAM. .............................. ................................................................................ Plot ............................ Lot ................................ Permit Grante d .....December 17, 19 84 .......................... Date of Inspection ....................................19 Date Completed ......................................19