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Home My WebLink About0046 ELIJAH CHILDS LANE a , o m , 4 v e - �r Town of Barnstable Permit# a 1 Building DepartmKtp4v4 e 6,nonrhsfrom issue Gate �„ST,� Brian Florence,CBO z Building Commissioner °�� V✓ • D v s639h 6� . i°rFpt 200 Main Street,Hyannis,MA 02601 411(7,0 h www.town.barnstable.� Office: 508-862-4038 �`� � ®,'� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL� Y Map/parcel Number 1-7t l sS Not Valid without Red X-Press Imprint a O� ( � I � ,., ( � �n ' 2 Property Address (e (III �Lt.�l ohltelk l�.t!/A.Q „Q�tC1 i �-(� ,"'� y�Jo� W Residential Value of Work$ 51 ��C> Minimum fee of$35.00 for'work under$6000.00 Owner's Name&Address Lai ke-,Dss - Contractor's Name Sprinkle Home Improvement Telephone Number 508-775-1778 Home Improvement Contractor License#(if applicable) 103757 `Email: S rink eomeast.net Construction Supervisor's License#(if applicable) CS-006643 WWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner` I have Worker's Compensation Insurance Insurance Company Name AIM Mutual Workman's Comp.Policy# WCC50050167472019A Copy of Insurance Compliance Certificate must accompany each'permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof] ❑ Re-side nn Replacement Windows/doors/sliders.U-Value 0 (maximum.32)#of windows ' #of doors: *Where required`. Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,ctc. ***Note: Property Owner must sign Property Owner Letter of Permission. cApV Af me improvement Contractors License&'Construction SuPervisACs License is re SIGNATURE: C:\Users\decoll ik\AppData\Local\Microsoft\Windows\TNetCache\Content.Outlook\9NNOKXYW\RESIDENTTLONLYEXPRESS.doc 09/26/17 ,. Town of Barnstable Building s _ Post This Card So That�t is V�s�bleFrom the Sheet A_, ,toyed Plans'Must beReta�ned on=Job and this CardM,ust beaKe :t , DAIR AABLe. ' ;,nS z • 4 P�o iMA 6stedUtll Final Inspection Haas BeenMade r ; s ° Where a n Certificate%of Occu't1 anc =is Re wired z such euildin'"shall Not�be Occ i ied until aaljlns ect�on has:beeri made erm It ,r" .>;€�., m srry ,y-?', z q,,-_ .,..� -w_�.,g.,. .,a,.s«-..R .>.,.,,_.F,...&s..� ;,pe:.Ys.., c .,,:-.,a.: .«p., .a?.....� >,. w,« ... .%$• Permit NO. B-19-2531 Applicant Name: SPRINKLE HOME IMPROVEMENT INC. Approvals Date Issued: OS/06/2019 Current Use: - Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/06/2020 Foundation: Location: 46 ELIJAH CHILDS LANE,CENTERVILLE Map/Lot: 171-255 Zoning District: RC Sheathing: Owner on Record: WHITECROSS, KENNETHB&CAROLYN J' Contractor Name SPRINKLE HOME IMPROVEMENT Framing: 1 N.C. Address: 46 ELIJAH CHILDS LANE 2 CENTERVILLE, MA 02632 Contractor,L�cense: 103757 Chimney: Est= Project Cost: -$5,870.00 Description: (3) Replacement windows s i` Permit F6,e: $35.00 Insulation: Project Review Req: i Fee Paid. $35:00 Final: p Date 8/6/2019 i s nh 4 a 4 h p , �� Plumbing/Gas �I �Crn Rough Plumbing: (_ Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work aup onzed,by this permit is commenced within sormonths`'a-fter=issuance. Rough Gas: All work authorized by this permit shall conform to the approved applicati h and the approved construction documents for whith this permit has been granted. All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning,by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. y ;, Electrical �. ' Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials arprovided on this permit. Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing 9, - - Rough: 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 'Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT w.g� i�or`dered_� ,. - .4� r 'au f` :}z"', 51,1 rs aE' rk� y,�� p'' �rLt 5x c'y F➢ �h t�mrYR.�' h'Fl,wi'''Y ' X\� t '' a:. .ru:'. .. �� c ,� � s � ��fri4IIIIer 1<s"t0 earryftre,S anal OtherrneCeSS � K b Worker's Com ensation Insurance: mstuance.Contractor's workers are fully covered t , y P 9 Fencin ca en N g� rP try,painting,plumbing,electrical,dry wells,etc.,and all other work necessary that is not contained in this contract,shall be the responsibility of the Homeowner. 10. For roofing,the above pricing is based on a single layer strip unless otherwise§pecified. Should there be an additional layer or Iayers of roofing they will be removed and disposed of at an additional cost. Re-leading of the chimney is not included in quote unless specified and will be bill additional,if required. 11, For Window installation,contractor is not responsible for removal or reinstallation of window treatments(i.e.curtains,blinds,etc.). 12. Contracts not fully executed within thirty days of contract date are subject to pricing adjustment if applicable. RIGHTS U.J CANt'I I 1'he Owner may cancel this Agreement if it has been signed by the Owner at a place other than the address of the Contractor,which may be his tnuin office or branch thereof:provided that the Owner notifies the Contractor in lvritin-a at his main office.or branch by ordinary mail posted.by telegram sent or by delivery.not later than midnight of the third business day tbliowing the signing of this Agreement. �ARRANMES The Cont_r ctor warrants that the work furnished hereunder shall be free from de period of two 2 defects in workmanship fora ( )years following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship,or damage caused by the Contractor,his subcontractors,employees or agents, is discovered within two years after completion of any job,including clean-up,the Contractor shall,at his own expense,forthwith remedy,repair,correct,replace,or cause to be remedied,repaired,or replaced such damage or such defect in workmanship as long as the owner has paid their agreed contract in full. The foregoing warranties shall survive any inspection performed in connection with the agreed upon work. All warraritigs for product supplied liy the Contractor under this Agreement shall be those given by the manufacturers of such product,which shall be and hereby passed directly to the Owner. Such manufacturer's warranties,the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such product in order to activate such warranties. The Owner's failure to send in or register such documentation,which failure voids that manufacturer's warranty,shall not create any responsibility for the Contractor to warranty such product. ii. Note: Any changes in the contract during the duration of the project which resu�t�in additional monies dug will be paid in full to the contractor at the time of the change- I authorize Sprinkle Home Improvement to act on my behalf in all matters relative to the work to be , Performed on this job(i.e.permits,applications etc.)if necessary. e ._.� Z4 9 Authorized Signature Date Contractor Signature Date 'Ken Whitecross Brad Sprinkle-Registration number: M �,J? r �. s ,� ''u `' r �rI Y J Gs�{� r�r ''r ` r d �. -: � s,�� wo-_�� : � �r:�u �S �� i� � '� ,t�,: �K 5 ':r s5 r�.n�-� � �} t• <,��'ta �Y t'r x '��r, F The Commonwealth of Massachusetts z o Department of Industrial Accidents d 1 Congress Street,Suite 100 Boston,MA 02114--2017 www mass.gov/dia NS'orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual):SPRINKLE HOME IMPROVEMENT, INC. Address: 199 Bamstable Rd. City/State/'Zip: Hyannis, MA 02601 Phone#:508 775-1778 Are you an employer?Check the appropriate box: Type of project(required): 1.❑✓ I am a employer with 10 employees(full and/or part-time).* 7. New construction 2.[:]I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] T. I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 10 Building addition 4.MJ am a homeowner and:will'be hiring contractors to conduct ailwork,on my property. i will ensure that all contractors either have workers'compensation.insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.17 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.$ 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other e C w 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 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: A.I.M.Mutual Policy#or Self-ins.Lic.#:WCC50050167472019A Expiration Date: 1/1/2020 Job Site Address: vG`1 b ,h 1/t�G`S City/State/Zip:PA A-,LL LL M (2(�,3� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification ' I do,hereby n atP:s and penalties of per jury that the iny-' ormation.p a'r'ide aJove is tr tie aid a^arrect Signature: I Date: 5' S Phone#: 508 775-1778 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -� SPRINA OP ID: DS ACORO® DATE(MM/DDNYYY) `,,, - CERTIFICATE OF LIABILITY INSURANCE 07/03/2019 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 hoid'er is an ADDITIONAL IINWREO,the poiicy(ies)'must have ADDI`UNAL iNSURO provisions or be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 508-775-6060 COAME:NTACT Kelley A.Sullivan Bryden&Sullivan Ins Agency PHONE 508-775-6060 FAX 508-790-1414 88 Falmouth Road A/C,No,E:t): AIC,No Hyannis,MA 02601 E-MAIL Kelley A.Sullivan ADDRESS: '- IN AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company 14788 .INSURED INSURER.9 Associated Employers Insurance rm kle Ho e Improvement Inc. 1aBLtd INSURER C:Sprinkle nis,, A1 INSURER D: INSURER E: 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 DD6 UB POLICY R POLICY EFF POCY EXP 9YPE OF INSURANCE POLICY NUMBER LIMNS A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _ $ 1,000,000 DAMACLAIMS-MADE a OCCUR MPT2640X 07/01/2019 07/01/2020 PREMISES Ea occurrence)E TO RENTED $ 500,000 REM X Business Owners MEDEXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑J � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: A, A AUT6M6911.0 LIABILITY COMBINED SINGLE LIMIT 1,000,000 a acc Writ-...----. ... ANY AUTO MIT264OX 07/27/2019 07/27/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE. $ 1,000,000 EXCESS LIAB CLAIMS-MADE CUT2640X 07/01/2019 07/01/2020 AGGREGATE $ 1,000,000 DED 1,X 1.RETENTION$ 10000 OTH- B WORKERS COMPENSATION PEATUTE ER ERR"S AND EMPLOYERS'LIABILITY Y WCC60060167472019A 01/01/2019 01/01/2020 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMgE�EXCLUDED? � NIA _ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule„may be attached If more space Is required) Home Improvement Contractor CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sprinkle Home Improvement IncACCORDANCE WITH THE POLICY PROVISIONS. 199 Barnstable Rd. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Kelley A.Sullivan ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Construction Supervisor Commonwealth of.Massachusetts Unrestrkted-Buildings of any use group which contain Division of Ptofesslonal Licensure Less thM 35.000 CUM feet(091 CUNC1118M)Of OnCWW Board of Building-Regulations and Standards space, Con strvctto;i'$OpOrvt$Or GS-006643 _- t;-Xhir es: 1010812019 k= BRAD K SPRINKLE, I 199 SARNSTA4LE ROAD HYANNIS MA 02601 Failure to possess a cwrent edition of the Massachusetts State Building Codes cause for Tevocation of this license. For information about this Rcense Caul(017)TV4=or visit www.rrrass govldpl Commissioner - �--- Office of Consumer Affairs and Business Regulation One Ashburton Place- Suite 1301' Boston, Massachusetts 02108 Home Improvement�Contractor Registration Type: Corporation , Registration: 103757 SPRINKLE HOME IMPROVEMENT,INC 4 ` _ Expiration: 07/08/2020 199'BARNSTABLE RD. � t HYANNIS,MA 02601 _-- Update Address and Return Card., Office of Consumer Afairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:,Corporabon before the expiration date. It found return to: 111291st6 o it Expiration Otfios of Consumer Affairs and Business Regulation 103757 y 07/08/2020 One Ashburton Place Suite SPRINKLE HOME IMPROVEMENT,INC.. Boston,-MA 0 e BRAD K.SPRINKLE 199 BARNSTABLE RD", :;/ C`) HYANNIS,MA 02801 Undersecretary NOt Velid W Sf atul'e `/z A6, Assessors map, and lot number ............................................ Hof THE toy Sewage .Permit number .......`J... ..................................... d�' o� Z BARNSTADLE. House number .......... ..f�.x�'...................................................... 90 NAB& 1639- \0� y. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... ........................................................................ TYPE OF CONSTRUCTION ......` —: ..................................................... ! .:............................................ t .�'. ................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... . ......X ... ........................ 1..f{ ...... .............................................. ............................... ProposedUse .. f........f.fGt"' .. ..................................I........................... ...................................................................... Zoning District ..... Fire District ......................... 1.................................. Nameof Owner .. .. . ...... .............................Address ..................`-..�....... ........................................................ Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ....................................... ............................................ Number of Rooms ..................................Foundation Exterior .....: ..................................................Roofing ...� L ....... ......... ............................................................... Floors ...... +� J � ........................ ....................................Interior .......� ��;�. ... ......... . .............................................. Plumbing "r `�- .....Heating .......................... g .. Fireplace ...::"�.:f :: a.. ........ .............................Approximate Cost ... .................................... I. ..µ �;. .*/. Definitive Plan Approved by Planning Board ________________________________19________ . Area .... ................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town,of Barnstable regarding the above construction. t' Name:&.h........................ .. ....................................... SMALL, ALAN No .......23435 permit for „One Story S.i.ngle. ...Family. . . ....Dwellin. . . . ...g ............... .. ....... .. .. ....... . .. .... .. . .. .... Location ,Lot #55 46 Elijah Childs Ln. ............................................... ................ .................................. Owner ...Alan...Sma1.1...................................... Type,of Construction ...Fname.......................... ................................................................................ Plot ............................ Lot ................................ September 8, Permit Granted 81 Date of Inspection ................ ..................19 t Date Completed ............... i.....................19 PERMIT/REFUSED ...................................j........................... 19 ................................./........................................... 1 ............................................. .. ............1/1 ........ G. ...................... i Approved ................................................. 1.9 ............................................................................... ............................................................................... • r 35 TPRi.O� ;OF BARNSTABLE P ermit•No z • Building.-Inspector. l a�rr�u t Cash . °o' ,ego• �E�' 1��5 .J Ito epr e . OCCUPANCY PERIViIT Bond _-- - � - No :building nor structure 'shall.be erected,,and no land, Building'dr structure shall:be_ used for a new, different, changed, or enlarged use.'-:without a 'Building Permit therefor first:having been.obtained from the�Building.Inspector: No'building'shall be occupied until a certificate of occupancy has be certificate the Building Inspector." Issued-to Alan Small "�' Address. ; �.E'.I2�E'x�1.��-E' Lot # �5 4 Elijah Childs.)iane` Q me y . , Wiring Inspector , '. ',"Inspection date Jaim-- • Plumbing Inspectofi Inspection date i Gas Inspector} , 7j Inspection date Engineering Department, Inspection date//—� �•: ' w Jr THIS PERMIT WILL NOT,BE VALH);`µAND THE .BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE'BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE •WITH 'TOWN REQUIREMENTS,+ j• Y� Building Inspector StLY�L� t1 tL�! - 3 �3t�evo/vcS .s ; FG 54' ' �10 <Atzs;oC:.G lbRt atDFIL � � � Gl� G�S I Z' F �j 1 f � tc TA►�ltiC = 33ov ISO % • A-95 6.P,D. a U rl* l Ong 6Q.L. kA _j,)jSPCxALd PIT t..JSF- CDO0 4�Ydl.. -� aLL AZT 4; Cj SF'' +� 2.S • �rl'� G.P.L. �� 1' �` Cs.P To TA L T;)ESIGLI5Co ToTA t_ U,w t_ f F•Law = 330 6.�?D. ; * roauz>D 7-/04 /8t- $ i r 7 PF_tZC_DLQ'TIOLJ 04-m : I",w 2M11j'o¢ LE66. Rzop �J•^ �ArS i'4./l fn$' � � t rr t � 1 i � I� oor 1�'-s T' Al.J/ !�•loc.�-•iz�lz •G + .' '' lid ' ;• ` l .. .�� 4 /�� DA�.7 1�lV. 'SoK 5/.o F,�K t� �� • rind 490 f FIT JI • .i. wITGa I - - A Sis�1D f %VM"ED STONE So t . 6.o' CEQTtFiEL7 PLC5 pL.Aoti j . - a Paco -iL LOCATIo)-4 CAN46�W�C.�, i=1l �� ►Jo SaaLE- SC.ALC I G G tZ T t F Y. - -r"A-r TN G. o' lJ IjDA:n v9-s"C Aj u a E t1F_t�c_a1,1 : GaN�PLYS WmA TNT SIVE..t.tl-ram II L4r5. !��.1D SETL�AGK C-n uIV,ENtcwTS 01= TNT t, r owU or Q2t i �31� EJJT /IU.E� . 414,4LA, a 92CGIS TC--tZED "wo SuZvaYUes 'rl-CIS 17:L-AW 15 UoT ZASCt7 0� A�.i osT�evt�I.G MA le.-, TI{G UFq�ieT°i 514r✓Wt� AI�Pt_1GA1•JT 1'x>r cr u•;cc, r� net'ccMIN& �T L1We..: �� Srio4c_,L �WL. Ir Assessor's map and lot number ........./2.).................... THE Sewage Permit number ....... ............................... SEPTIC SYSTEM MUST S i MA"ST LE. ALI%House number ..........................................................I......... 1111STALLE-6 IN COMPLIAN Cg MA�& 1639-Ar.WITH TITLE 5 C f TOWN ' ND A OF -B A BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... .1............................................................................................................. TYPE OF CONSTRUCTION ..... �1- 4-------r....................................... ........................19.& TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the f6llowing.',informati6n: Location ... ......... ....... .................... .......... ... .................... .. ................ ................................................................... Proposed Use 4-411................... . ............. ... ............................................................................ .................................... ......................... Zoning-District' ............................... .....................................Fire District ............ ............................... -Name of Owner....., ...........................Address .................................................................................... Nameof Builder .................................:..................................Address ......................................................... ...............I........... Name of Architect ....................................................:................Address `.............. ....... ........................................... Numberof Ro s .....................................................................Fo6nclation ........................................ ...................................... Exierior .. .. ... . .. . ....................:.:..:}........................Roofing Roofing !;; ........... ............................................ . . ...... ... ..... e7ZJ� Floors ... ...... ....... ......... ........................................................Interior: ....................................................... Heating ....................:.....Plumbing ..,........................................................................ ........................ Fireplace Approximate Cost ... ........................................ ................................................... Definitive Plan Approved by Planning Board --------------------------------19--------- Area .....4...................................... I 1 1 —Diagram of Lot and Building with Dimensions Fee ..t. .5.. .......................... J SUBJECT TO APPROVAL�OF :BOARD',OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable arding the above construction. Nqrow'A. . ........... ................................................... SMALL, ALAN 23435 One Story l .....�Oermit for f ...Single...Fam1X...Dwelling.............. Location ..L0 t... .5...4Q..Zli.dah...C-h•ilds Ln. ..................Cpn.ter.vi llp.................................. , Owner .Alan Small a Type of Construction Frame Plot ......................... Lot ................................. September 8, 81 ' Permit Granted Date of Inspection ....................................19 Date Completed ... ..19 � PERMIT REFUSED ............................ .............................. 19 ............ J .................................................... yf; ................................rK r r ......................................................................... . T i. ✓' r s ... �y: ........................................ ............. ................ Approved ................................................ 19 t r ....................................................................... .... . .. ............... - 4 -