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0017 GOFF TERRACE
i� ����� ���� - - cab4-(—c aFIKE V qe%oown of Barnstable *Permi I Erpires 6 rn p 7rs from issue dal JA Re W atory Services Fee t �%5R�Erdi639, 0 V.Scali,Director RFD MA'l� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ___ Not Valid witlrout Red X-Press Imprint Map/parcel Number L71 Z-0y Property Address /7 Ci o-(ZT /erraC P 1.P/f�rr✓� ��� P'kesidential 11 Value of Work$ /O 5 7 Minimum fee of$35.00 for work under$6000.00 ' Owner's Name&Address A4cY-em) 17 CLf ei- ,' D 2 3L Contractor's Name W D� )Ordloific 1� (�,� Telephone Number 79'r!" �c3Z SIT of 8�N Home Improvement Contractor License#(if applicable) J&(p OZ,!!r_ Email: Construction Supervisor's License#(if applicable) 87 Z77 Z. [[)d�Vorkman's Compensation insurance Check one: ' ❑ I.am a sole proprietor ❑ [am the Homeowner P (�I have Worker's Compensation Insurance Insurance Company Name_1qftTh0(2K ��/ �NSeejz {,pM�¢}- I ? Workman's Comp.Policy# ZZ W�4(-.T Z6 345__ 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) ❑ R de eplacplacement Windows/doors/sliders.U-Value .L '1 (maximum.32)#of windows� #of doors: El Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i_c.Historic,Conservation,etc. ***Note: Property Qwner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is equired. SIGNATURE: C:\Users\Deco\"t ' ua\ callMicros mdowsUemporary Internet Files\"Content.Oullook\2PIOlDHR\EXPRESS.doc Revised 040215 Window World of Boston,LLC MA HI Reg)stratlon r Offices&Showrooms Number, .l I i8A Cummings Park LI295 Old Oak 166025 i Wobum MA 01801 Pembroke.MA 02359 Federal ID (781)932.4805: (781)826.6291 27 1381665 'Simply the Bast for Use' www.WindowWorldofBost6n.t0m Customer: ree^. CDP ^i Install Addr / City: e/1U11P� State:MA2ip 3 Email _. . ...... WINDOW WORLD GLASROPTIONS i �y _1000 Series Single-hung,All-Weld Slag iSolarZoneMite S99 1 iS _MOD Series DH Mech/Welded'.Sash $ig5 Triple Glazetf TG2• S175 40M SedBs.DH All-Weld $205 ('Series¢0000Mr) .. - _6000 Wes DHAlI-Weld $240. WINDOW:OPTIONS l2 UleSlider S334 _Glasa Breakage Wanerity Si INCLUDED $lite Slider t' i sndr ;ia;is t $525 112 Screens. / Picture/Fixed Ute .$334 `Foam insulation on Jambs and St t'INCLUDED _Awning sm _Double Strength Glass S15'INCLUDED _Casement 9290 _DoublisLocks(?:261 SS INCLUDED _2 Ute Casement 5575 �/^'Ful)Screens S22 3 Ute Casement. ua ,>im. ,r dn;i+i $860 `n 6loniaf Grids(ContouredlRat) $45�. Basement Hopper 5334,. __Prairie Gnds: $St Diamond Grids $69 _Bay Window-Soffh Mouni/INS Seat$2680 _slmulated.Oivided;Ute $182 .. _Bow Window=Sof11t Mount/IN1S SeetS2795_ _Temperetl.DH Sash(BSO)1T50$ S65. Garden Window $1880 _Obscure Glass(BSO)-(TSO) 135 —Specialty Window $ Oriel Style(40/60 oc60/4% $30 _Beige/Almond $413 Foam Enhanced Frame 535' Wood Grain tnterlor(Sertesa0Wi6W0onyj-$100' pR)!-1978 BUILT HOMES(Federal Lead Conta(nm (Light Oak!Dark Oakl Cherry.!Fox Wood f/L/'Ll�d Safe Practices Required S25 Rich Maple, MY MOMS WAS BUILT IN THE YEAR/9 3 InNtat _ Brown Fxter(or:(/trch,Bronm 1 Amedisn:Tepa)5100 _Designer Color Exterior, $155 MISCELLANEOUS Custom Exterior Aiumfnum Cladding Window Color !_ ( J Textured VSTooth G-8 VS S & OuWde Facing Color 1 _... Metal Window Romovdl 550,_. NON CUSTOM DOORS New ConsWetion Yoryi 061" $175 -L.Vinyl RoIR64 Patio Door ML of 6h. 5985 :Specialty Window Exterior Trim $ Vflryt Rolling Patio Door Sit. S10i)5 Muli to Form Multi Unit S3D Add to base price for Custem_Rating P35DDDor-.$1150. �..,: iriiiw Interior/Exterlor`S tops. $50 . �F ench"ll Sliding Patio Door50.or.6n: $1295 Insta111ntetior Casing StaftAt $95 _French Sell$11dmg Patio Door Bit, f1305 In.. .,W., soR- $2D French Rat Sliding Patio Door 9N:. $1495 Rif for Bay/Bow Windows $SDO �Custom Exterior Claddutg $15n Existing New ConsL Ext:Re"FN. $150 SotalZwe Elb or ETC Glass S175 �Removat of.Ex sting Bay/bow 5250 _Grids Patio Door S129 Repair'sill,:la mb or replace sill nosing $50 - _Waodgrain Utertars 5295 Full Sub-Sill(Singtii replacement. $1 _Exietior Desig re. $395 - . _L-InteriorCesing Z' 3i'1� SITS —Mumoow convey $30 _Bay/eow Conversion Exl RrsVo Fl $.50 _Handleset.OpBans S (Nev siding Will Not Match) C _... S. �'BuildingPermN $150 �J Door Color � L ( O ROUND UP FOR WINDOW WORLD CARES �.; v SLJtI�CAUdrat'e RtlsttaM ltospihl S �: Customer declines exterior wrap and understands nting Ari or repair may be required tnttia Customer declines rids on windows/dOo1s Initlat illS!$81�E8:CuNonier o re�onsPola loi hie labaeig to come�witlitl�coaBacG PaYtxp.stafn�Abim sYs�dscaneeYreroo _8utdn9 t�eim4 t�s in acess of 112-01).Normwer antl or CmdD Assaeidan Approrat,19sitift fti t AwoM.C*of Soft pit a sidewA Pamd reel In connection wM installation. No EXTRA WORK ff NOT IN WRRINGI ustomer egress tot the terms oll paymen^t as follows. Extra Labor&Materials $ d d o l�cas�.p(ac1 y ? Site Set Up,Disposal 8 Dotivery.Fee $ . $195.Q0 Tblal Custom Order Deposit 50%. S Ck# Balance PaW:tp,Instafler,upon Comptetian S fJ''�7 -._ Amount FOvcad $ Whitlow World of Eton arakipatas stu ft oft work on n nd tcekig SIIDatandatY corttplRM mU Ys Security hunt Yes a Any deposit required In atfvatta a the start of the work 113%of theioW contract pke a cost of airy matetbl a of sWW order or custom made nature,which must be ofde2d In advance oils skrt of Uiswtitk ro assure Btal the profit writ proceed an sGnilileC O final payment shall be demanded until the *M Is completed to Gte satisfaction of both partles- AS htxrta.ttnprovemerq Con9eclmsand subcontractors Ntae be apbtedl and Drat arty itqulres abmla tx raa or subconuxior idaft to a reprstra6mi.ilwtld be duetted to:OIBa of Caoromn ABaUf ettd;8osiuess Fkgu4limt Tan Pui Php Smtn5170 8oato4 D118 tgmae(617►97J-BtW No work ahaN:Otaat prior to Ids alpalnp dittm aaUeot sari trarmotttal iplhe or rwr ar aalry d sem'wrtrael W nixwrV.bral e1 Boston wWu prexBbtrof:Clmptu t42A of the pent2l b'es b reytired to apply to and obtait aA tonsbudknt-reWted perttbs.W6>dOw,World of '. Boston stta-be deemed resports#b t aeeys fi Rro work dtsaiwd tnBis ag eenta t wtaM oy/ 8 pa :ttruahe apccies aaUro es a ttt9vttluafs: Nona:II Oro PURCNASER(8)obtsim Ids Otba tsttsVucUd61e1dW peme�a Por the 11mR tesGtbed ItMertltl:aprnameot of deab tralftmreetsltucd.cosirtutars the PURCWER(S)tekerahv adrkW Uutln fhe eval ota d6ptt4 pldlemeC an0 rm psytreat 1ba PURCNASERIS)DUI no be toiRbd W a»ke'aefaim,m tetisdioefrom We parinnry fon0 utsbUaMil by dNpter112A e181 _ _ __. you we fi rw neaticelbransaction,atany Ill 9 prior to midnight of the third busimiss- 81tar the date of this"ise t. out»of r ancBl must be i0wrltinq ptlstmatteA no later than midnight of the lolloirtnq tldN tiittiness day THIS IS A CUSTOM ORDER NOT[a RESAI PI .Thb is mMeill ud ofietatoll by WON tdof Boston;U.C:WON license Win Wwww Won Nis; l Us } . Owner,Do not aw itthem any btm*speooe, Data ' e 1!� Solawnon: 0 1h harry blink apaus Date Owner.Do not alga If there are ow blank spaces. Om ooe�ai•tb� - WMil:dpY-Oitgkat' 1'lllorCoDY-Fea PF4cC6nY� ,. FBassacnusei,s?epaf�, En_ai?uelic Sa'et.; - =1 Boas Of Suildina?ecula,icns and 5`andards JEFF C STEELE 24 SHERWOOD AVE - DANVERS MA 01923 Ca nmissione, 04/07/2012 -0_tliceorConsumerAffairs&BusinessRegulation - HOMEIMPROVEMENTCONTRACTOR -- - Registration: 166025 Type: Expiration: 4/122018 LLC WINDOW WORLD OF BOSTON,U.C. JEFF STEELE 24 CUMMINGS PARK SUITE 15-A WOBURN,MA 01801 Undersecreta" , I { I License or registration valid for individual use only before the expiration date.If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 ;Not valid without signature E The Commonwealth of Massachusetts Department of'Industr iad Accimdents Office r�. -- of Investigations 1 Congress Stree4 Suite 100 Bostom; MA 02114-2017 www mmaass gov/dBa Workers' Compensation Insurance Affidavit: B ufllders/Contractors/Plectricians/Plumbers Applicant Information Please Print Legi<b� Name (Business/organization/Individual): WINDOW WORLD OF S®ST®N LLC Address:24 CUMMINGS PARK SUITE 15-A City/State/Zip:WOBURN, MA 01801 Phone#:781-932-4805 Are you an employer? Check the appropriate box: Type of project(refired): I.Q I air a employer with 20+ 4. I am a general contractor and I employees (full and/or part-time).* _ 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 8. Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance required.] 5. Q We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 I.❑Phunbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.[�Other Ow-4 o�,J comp.insurance required.] re(7 la< e Pn to t 5� *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. 1 am an employer that is providing workers'compensation insurance,for my employees Below is the policy and job site information. Insurance Company Name:HARTFORD FIRE INSURANCE COMPANY Policy#or Self-ins. Lid-.#:22WECLJ2635 Expiration Date:0 1/27/2017 Job Site Address: • (: K1 4V -errac e-- City/State/Zip: Cnfecv, �.. l� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25Asf-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 h he'violator. Be advised that a copy of this statement may be'forwarded to the Office of Investigations of the DIA for a covepgaiyerification. 1 do hereby certa,fy Bander t pa' and p a 'es o•f perj that the information provided'above is true and correct Si tune: Date: Phone#: 781-932 Eff ®fjtclal use only. Flo 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 �.1 WINDO-2 OF ID:an IDD CERTIFICATE OF LIABILITY INSURANCE DATE( ) 03121/2016 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 endorsemen s. PRODUCER W.CT C.Timothy Ward,CPCU,CIC Senn Dunn-GSO PHONE 336-272-7161jam,):F 33�-1397 3625 N.Elm St : Greensboro,NC 27455 ADDE4MS:tward@senndunn.com C.Timothy Ward,CPCU,CIC iNSU S AFFORDING COVERAGE NAIC>i INSURER A:Groans Ins Co of America 31534 INSURED Window World of Boston,LLC INSURER B:Almerice Financial Benefit 118 Shaver Street INSURER c:Hartford Fire Insurance Co. 19682 North Wilkesboro,NC 28659 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 NTH 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. POLICY EFF POLICY EXP WTSRR TYPE OF INSURANCE POLICY NUMBER M LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0 CLAIMS-MADE rx]OCCUR OB6790252707 04/01/2016 04101/2017 PREMISES a occurrence $ 500,00 Business Owners MED EXP(Arty one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,0 POLICY PRO- LOC PRODUCTS-COMP/OPAGG .S 2,000,00 11 OTHER: AUTOMOBILE LIABILITY aBccid DMSIN LE LIM y 1,000,00 B X ANY AUTO AWS8757615 06/16/2015 06/16/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Par acadent S X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 A 7EXCESS LIAB CLAIMS-MADE OB6790252707 04/01/2016 04101/2017 FAGGREGATE $ DED I I RETENTIONS $ WORKERS COMPENSATION X STATUTE ER H AND EMPLOYERS'LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 22WECL.J2635 01/27/2016 01/27/2017 E.L FACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? NIA 600 00 (Mandatory in NH) E.L DISEASE-EA EMPLOYE $ If ges,describe under EL DISEASE-POLICY LIMIT S 500,00 DESCRIPTION OF OPFJtATiONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Renwrks Schedule,may be attached if more space Is mquireM CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. - AUTHOR®REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ° I Parcel Application# Q �C/yS Health Division �IyD41; W`�/ � L Conservation Division 04 ) Permit# Tax Collector Date Issued Treasurer Application Fee ©: PTD Planning Dept. Permit Fee ®o 00 TINGTIC SYSTEM -q#OF BEDROOMS EP Date Definitive Plan Approved by Planning Board EXISLIMITED T Historic-OKH Preservation/Hyannis Project Street Address / 7 Village (' . 2 c Ile Owner r IU M n Address Telephone Permit Request WIQ W�An e, Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay (.Project Valuatior6� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family C Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes olio On Old King's Highway: ❑Yes W-No Basement Type: iFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing .3 new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil 21 Electric ❑Other Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed:Ualexisting ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ 1 Commercial ❑Yes @ o If yes, site plan review#Current Use Proposed Use BUILDER INFORMATION — Name t�,�1,(�,�G�r IN Telephone Number 9 l?s— Address / cU f ytq P±— License# 12- d 9 b1 1a L�M_Ttd v) �f�l. J� !� 02�3 7 Home Improvement Contractor# Worker's Compensation#a2 J E ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO ash e SIGNATURE DATE l fr FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL'NO. r .ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME -•s INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL _ N ' PLUMBING: ROUGH m FINAL T �i9 GAS: ROUGH O FINAL m FINAL BUILDING(iVA G 1)S) C7 0 N DATE CLOSED OUT f� ASSOCIATION PLAN NO. _ 1,1 TIQNs I4 - � F SU1LDING SUPER 1SOR gOA CONSTRUCTION License:/ ►dumber CS 0$6125 41J 0212A 11968 86125 Birthdate Tr.no: V ^p. 0212112007 Expires `� ��I ails, cted fl0' �r t pUCHARME C RAC L Aam�n�strator ` 218 BROOK ST 1 pLYMPTON, MA -- -. Board Bail ,� of di� .. HOME gRegWatioAs R� 1MpVMEWT .. , $adStandards Cp !Str om 'V r TO ,� 1436 RAC /2 sr 6fi f� �` 11�/20p6 1� 100° CARPEN f xd q - I RICK OV TR' f CHgR a , 1 YPRp, K Sl M ` r s1 0 jN MA 0236 _ -- - 4-j ministra.tor d r /� d _-11 2x Zyl zu� n 2 K ze 2� 2yr , � -- . - - --------- ----- _ --- - IV _..... -and In .....BARNSTABLE - Centerville g Paula Mullen,......................................... Bulon ing to ....... u en, et al i......... 4096 133 Deed in Book ................ Page.......... Land Court Certificate No. ............... in Book ............... Pa Barnstable ge ... to .. .. .. Registry of Deeds 'ecorded Plan .... and..in„Barnstable ICY Newell B Snow SurveyFeb. g, 1 Barnstable °r.... Date of Plan ............................................ .............973......... in ..... .................. Registry of Deeds, Book ......... ..... No. ...55.... Filed Plan ...... AORTGAGE INSPECTION PLAN THE BOSTON FIVE , CENTS SAVINGS BANK FSB *an No. 17 Goff Terrace, Centerville-Barnstable Louis V. Sorgi,. Jr. , Esquire LOT 2 ' x�r ncN , N ------------ ----- 3 '1Z s 70,VY �. M 1 waon �, No./7 PvOpTME To,ty Town of Barnstable hw °� Regulatory Services BnxNszaBi.E, a . MASS. ; ThomasF.Geller,Director APED pAA�'10 Builffing Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby au orize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Sig of Owner Date 74 0. P ' t Name I Q TORM&OWNERPERMISSION f °F�►+E r Town of Barnstable Regulatory Services 9 B erg' Thomas T.Geiler,Director 039.�p`� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508-790-6230 Permit no. Date t AFFIDAVIT I HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction, renovation,repair,modernization conversion , improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj aceut to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost -Address,of Work.— Owner's Name: Date of Application: oZ — I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 MBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date `Contractor ame Registration No. OR Date Owner's Name Q:fomis:homeaffidav { TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel /�©a � -' _ -�. i Permit# Health Division F - Date Issued d Conservation Division Fee 7 , - Tax Collector I 1 1 • Treasurer. Planning Dept: Date Definitive Plan Approved by Planning Board - x Historic OKH Preservation/Hyannis 1 nn Project Street Address 1 ,7 (�22:;P t--_ s Village - i 'Owner •��" A &e s Telephone Permit Request ae lso � A)r / E Z / A)a /if j 4 Square feet: 1 st floor. existing proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plainr Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family ❑ 'Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic'House: ❑Yes Cl No On Old King's Highway:- ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing new , Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas O Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New ,Existing wood/coal stove: O 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 0 Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name,-- Telephone Number Address "! License# =� Home Improvement Contractor Worker's Compensation# X ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE v 'FOR-OFFICIAL USE ONLY PE MIT NO. DATE ISSUED 1 w e e t t r MAP/PARCEL NO. ADDRESS i + VILLAGE 1 ± } .,4 OWNER 74 DATE OF INSPECTION 4 , •_ - +' FOUNDATION r "' FRAME INSULATION FIREPLACE — • "' - - ELECTRICAL: ROUGH FINAL, + PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. I" FINAL BUILDING v , DATE CLOSED OUT. _. ASSOCIATION PLAN NO. I The Town of Barnstable t ZL* • sum ' Department of Health Safety and Environmental Services 05 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME E%IPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: - Estimated Cost Address of Work: Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME E%WROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY a IhI he eby a ply for a permit as the agent of owner: W� Date Contractor Nam# Registration No. OR Date Owner's Name q:fbnns:Affidav x � The Commonwealth of Massachusetts lcr.- Department of Industrial Accidents _: Office OffOYeSti OOffS - -__. t 600 Washington Street �s Boston,Mass. 02111 �����A�,/10 0����,�,�,,i0l,,�y�,,���,://� Workers' Com ensation Insurance davit name: e- location: /^7 6 P city OEa�_ phone#7P/7'?tp —A-/�� ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one kin in ca am ''///%%%%%%%%%%%/%% % %%%%%%%%///%/O%MEME/%%%%%%%%%///%/ %%/%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%�%%�%%%%%%%%%%%%O///O//// //j f8"I am an employer providing workers' compensation for my employees working on this job. m as mate. t.l Q Y � . �}} ,: address.. :> .::>. .>::;>;:::::.:..:::: -::::,:.:.. .. _ .+. :::i::: >:ohane'#: ,� ' ' ..::-.. insurance co:: >` alley# .. ::; :. O ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have • the following workers' compensation polices: . m an name. xx Lb D Y ::- ,.: '1. _ :<:dd�C3 >> _ ;>><% >$ `...... » >;<�'; <:'''< «>> �<��`: `'�� >> > .... »> !%'` ; �>�<3i Z lei= <:--..i 3 >�>< >..................................... .':v`� <;vjz >)...... a r _. .-.:.::::.. 11 ..;. ::::•.�.�:::::j:•;•:: 6::. :�L�:` ;'!'!:':%i i:: :'.ii..>— f `:': :_:.:;.::x :[.:;; :: .:.,,%`':;'[:2.:.':;''=%::%::i%Si %'3i;i" i?i'<?' i£i;?i;i':ri;!! :::r:::c::. ....... . ;;: .::.. . :::::.. :�;:a>:;;»:;>.;:; . ...:::.;:: % : ::•.:..; :: ............:.. ......................................................... .:....-........-...........--........... ...............:::::.::::w:.::::::::::??ii:•i,-::%%:::::4$y;:•.rev;n�.4:.:.):... ...—..:.' nsnrattc O. _... :. ... . .:::. ... : .:..: X:... X. ...%...... .... /O�M .::.:. camp ny ...>:. .:;.:. ....;::..;:.: ... :::.;.. ;:::.....:: . ...;:...:. ...... .. ..... ,_ .......:.. ......:..........:....:..:•;:•:::;:.::..::::. Address— :..;.;: ............. ... city: ;. .....: . :bhbne# :::: > ' <>: ; '::>.x...:':<:::>`:>»':>`' ;.....: ......... .. :>< >< ;:; nsuranceca» uric.# _.-: :.; ..:.. ..... ... ...::::.:...:::::-v S .. - .... Failure to secure coverage as required under Section 25A of MGL 152 can lead to the impositlon of uimtnaf penalties of a fine up to 51,S00.00 s udlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I utderstmd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby the pains and penalties of perjury that the information provided above is true and c rreet Signature0 Date 7. zn� _ Print name Y Phone# AP" J/ 7,2 official use only do not write in this area to be completed by city or town official city or town. permittlicense# ❑Building Department .. ❑checicff immediate response is required ❑Licensing Board ❑Selectmen s Office (]l[Wffi Department contact person: phone#; — ❑Other 4evued 9795 PJA) Information and Instructions z Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any cortrz , of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver c. trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has :not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of levesUgNons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 ,. CERTIFICATE OF LIABILITY INSURANCE 1'Nuouc[F+ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Pia story b Servant, Ltd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 5700 Post Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P_O. Box 1158 East Greenwich, RI 0281© INSURERS AFFOfTDINGCOVERAGE I1,15uNLD - - - INSURERA:Transcontinental Ins. Co. (CNA) Paul J. Cazcault & Sons Roofing _ IN:URER it: INS0141-14 1): INSURER E: COVERAGES TI W POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOfI THC POLICY PEIUOD INDICATED. NOTWITIiSTANDING ANY REQUIREMENT. TERM Oft CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BC ISSUED all MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI(E TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICICS. AGGFIEC.ATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN It I`[)IIGYKF FFCIIVF I'f)II�;Y Ei({'I IIA 11ftN 1IM115 I)f1 TYI'LOF INSUIIANCE POUCYNUMUEII QATEIMM1001PI MM DU 1,L'YL ..-.-- A GLNLIIALLIABILITY C160024822 04/30/99 04/30/00 tAG11OCGUHHtNGt 11 000 000 jt (:(IMMtH(:IA((:L-NI-HA I.I.IAHILII'! FIRt LIAMA(i F(A.vvne I".) %100 OOO._. 11AIMS MAPF. /L OGCUF; MFU FXP(Any ule Pasty) 25 L000 _-_-.._._-- X I�1JDed 1 , (�0n PFASONAI AAFIV IN.IIIRY Sy�_000� 000 —.` J U U _ (:FN tHAL AG(iH tGA1F. Q,OOO, OOO .....__—...._._.._.___._.._._._........... ....... .... .. . . _..... .........- .........._.._. .. (;I-NI AO(O-114,AiF IIMIIAPPIIFSPt H; PHOI)11G IS-(;OMP/OV A(:fi LZ OOO OOO PNO. -- POI ICY X .IFCI LOC AU IOMOU(L E LIABILITY CUMHINFI)1;INLiLF LIMIT S -- (tAecudenl) ANYAUTU - --- Ail OWNFO All IOS IIOUILYIN•IUHY S (Per person) F;G 1 I F 01)1.Im-0 AU 101; IUHku AUIU:; HOOII YIN.111RY S NON-OWNEOAUTO:i - (Per ecdAtnl) _ `--- y ..............._...._._. PHOPFH I 0A MAGF S (Per mudenl) �- GAHAGL LIABILITY AUIU UN LY FA ACCIUFNI I AN'(All Ill (1111E64 TITAN FA AGG S - AUIOUNLY: Aril: I EXCESS LIABILITY I.ACH OCCIIHH tNGF I -_J OGGUH -1 CLAIMS MADF ARORFGA"rF S S .................. S r)FfR1GTIF(I F ' HFIFN IICIN I S n W011KER5 COMPENSATION AND WC199413744 08/09/99 08/09/00 X IW IY'1 II IC IH f1 ---- _ LMPLOYER5•LIABILITY F.1..FAGH ACCIUFN1 $100, 000 F1.015F.A5F. EAEMVI.OYFF- S100 F 0,00 - F1.01:�AS� IKn,IGVIIMIT T.500 0O0 uIHLR DESCRIPTIUN OF OPEIIATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENOORSEM ENT/SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED:INSURER LETTER: CANCELLATION SHOULOANYOF THE ABOVE DESCRI BED POLICIES 0ECANCELLEDBEFORE THE EXPIRATION DATE THEREOF.TIIEISSUING INSURER WILL ENDEAVOR 10 MAI13_O--DAYS WRITTEN NOTICETO ITT ECERTIFICATE ITOLUER NAM EDTOTIIELEFT,BUT FAILURE TODOSOSMALL IMPOSE NO OBLIGATION ON LIABILITY OF ANYKIND UPON THE IN5URER,IISAGEN15 011 -REPRESENTATIVES. AUTHORIZ ED REPnES ENTAjIVE e. 1 0, ACORD 25-S(7Je7) U S8 2 8 9 4/M8 2 8 9 3 BAM 0 ACONo CORPORATION Igoe r R L i' f HOME IMPROVEMENT CONTRACTORS REGISTRATION HOME li hoard of [3uilding Rog One Ashburton Place - Room 1301 I Boston , Massachusett-s 02108 - --------------- -10ME IMPROVEMENT CONTRACTOR ► �jpMINO/N/M1/U -l�1dA "S"'�'' iration 07/09/00 Exp I �� registration 103714 NOME IMPROVEMENT CONTRACTOR PAR TNERSHIP RTNERSHIP t Type I +�. __ Registration 103714 I = Type - PARTNERSHIP I { - PAUI_ J CAZEAULT & SONS ROOFING Expiration 07/09/00 ult Paul J - Cazea P .0 - Box 2781 I PAUL J. CAZEAULT b SONS ROOF! 22 Giddialt Rd ' ► Paul J. Cazeault Orleans MA 02653 I �e�42iddialt Rd. P-0. Box 278 I /1DMINI$[NnY011 Orleans MA 02653 I s• n�n nn Regulations la tIOnS Board of Beowi��uilding g Pace, Rm 1301 001 One Ashburton �•�1l�: .1:� Ma 02108-1618 Boston, Birthdate: 1012011959, License: CONSTRUCTION SUPERVISOR LICENSE Restricted To: 00 Number: CS 026325 Expires: 10/2012 HAUL J CAZEAULT' 1585 MAIN ST osTrlivlLLE, MA 02655 7665 Tr.no: a of address notification. Keep top for receipt and Chang I Assessor's map and lot number ...;-...... . Sewage Permit number ................... .... w 7 SAWSTADLE,.,.. S i House number ri.i l :� i rat j 3y v MASM 00 i639 e00 TOWN ` OF BARNSTABLE BUILDING INSPECTOR " APPLICATION FOR PERMIT TO .......>�.,:...:.... .: . ...............4-t ..Ss �,, . TYPE OF CONSTRUCTION 14.. ,r °79� t € ......................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies �for a permit according to the following information: Location .........< .!... ?_ �...../Jv � �.. .:......... f--''t� '.................................... ................................... . ...: . 1. Proposed Use ............� E!.................................................................................................... Zoning District .............. .::.. :........................................Fire District .... . ............................................... Name of Owner ... i•2A-.:,,. E.. � �. r< sl``OJ.E_jAddress ...... !� Y Nameof Builder ...................................Address ............. .,................................................. Name of Architect ...................... ' .............. ....................Address .. ...........-... ..`......................................................... Number of Rooms ....................................................................Foundation ... ...61. l E'. '-f. EE Exterior ..... ... .• ,fit.? (s ......Roofing ........... ............................... Floors ..... :..:.:... .. '.. f .................................Interior .......'^ 5 .. ..... `..................................................... . Heating ..0 1 e ? - Plumbing.......................... .............................. ..... _ ............................................................... Fireplace ................ ......... .� .................................Approximate^Cost ........��--` .............? ....................................... Definitive`Plan`rt'Approve by-,,Planning Board ______________________________19________. Area ........... ?........................ u t,� r Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 Supervisor's License' ...................... . BRADGATE BUILDERS A=171-1�02 No '.26133 Permit for One Story Single Family Dwelling ............................................................................... Lot 2, 17 Goff Terrace .Location ................................................................ Centerville ............................................................................... Owner Bradcate Builders .................................... Type of Construction F.rame... .... ........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ....Mar.ch...2..................19 84 Date of Inspection Date Completed .......................................19 - Z -Z � � r _ I e TOWN OF BARNSTABLE Permit No. 6133 { »n.n Building Inspector Cash 0"& e3o• °"°"*� OCCUPANCY PERMIT Bond ,X. Issued to 1 radgate Builders Address Lot 12, 17 Gof f ^'r �t Wiring Inspector 3; Inspection date t Plumbing Inspector '�_ -. ! ,! ,� Inspection date Gas Inspector _ Inspection date 7 Engineering Department Inspection date 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 FROM TOWN OF 6ARNSTABL9 p�� BUILDING DEPARTMENT Mr. Fran Tah t,''(������ Clerk MAIN STREET � HYANNIS, MA . i Vlrt11 Clerk /gyp 'M {{20 VZ SUBJECT: J n{ FOLD HERE DATE MEsS'ACE f . .. - B'� 2 \33 � to `lde i�7ark �s'be�n ccrrr>pl�ted Wider Perm3. � 61 �Bradg�. rJ��. ) K Please release- . ' - SIGNED- {� • ic DATE REPLY . r SIGNED .. - N87-RMI t - :RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. i 3 M f F� ►� 7Z' - l � � I u - I - c+ sc WILLIAM C. �o N r E p`No. 19334 Vwvv / C'E•27-/,C-Y T.N.AT 7,4r �a-►�/D•4T/o� ,s',�,�OWit/f,�E.2EO.C/ CUNlPL YS Gt//Tf/ SCALE- / = Yv z SATE 7"NE s"/OE.C/.t/E ANI�SETBACk PLAN ,eE�E.2E�C'E• .. �E4vi.2EME�T-5' of THE 'r'oWA VC ,q,Rn/ST43LE Ait/O 45" x/o .44CA TEv 1•i/iT•5//� Th�E •�LOa�.pLA/�i! 7Y,4,,/ '139. Z75 PG. S5 OATS= Z//� "� f3,gXTE,e6 NyE /NC A�i/ �eEG/srE.�EO � 0 Suei�6Yr�v D.� ET.S Sfi�Gu/if/ShbUtD it/OT B� APio.L �T- _ Q AD G 47[,- U.SEp TO 7ETEP.Al/A/E .GAT 4/it/ES. • sbessor's map and lot number ..���/ .. .! ...1.® i 0Y��� CLERK �oFTMEro� 'ARNSTABLE. MASS. Sewage Permit number �....�. : #/7 Z BA"STIIDLE, i House number k LED y�y s�{�# h dU `I ��+ �3 ��P 15 PM 3 39 90o M6 9 TORN �B IP?N3,T)ABLE �- ^ TOWS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ....... ...... ........:...... ............... . . ..... , ... ......................... TYPE OF CONSTRUCTION .......w.::U ?�.�"-'. .IF ............................... !�- 2.1. ..............197 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: i Location Proposed Use .............._1j..?V..IG.1. 74./."../L,... ............................ ..................... Zoning District ................Y-.......2........................................Fire District ....C.. O......................................................... Name of Owner .A ..�c. .: TC &/�ddress .........�j����v.�r Nome of Builder ............. f Z?��.................................Address ............. .Y . - ' Nameof Architect .....................'.11.. ......................................Address ................ ,...+�...'........................................................ Number_ of Rooms .........�1 ,t...................................................Foundation ...Ovv.Cl� ��`�;....................................... .� . �.� yu.. ..............Roofing ........... .. .t................................Exterior ............. .... ...... . .............. FloorsCA..a,.-P � Interior ....... ..`>v..! ....................... ..... ............................................. rieating ... ...........................................................Plumbing ........... .. ..........................................:........... Fireplace ................ -...Y�.B ...................................Approximate Cost ........ -� �' (,�................. l... Definitive Plan Approved by Planning Board ------- ----------- _____--• Area ....... . r Diagram of Lot and Building with Dimensions Fee .....4A .CP�...... SUBJECT TO APPROVAL OF BOARD OF'HEALTH r t 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 Supervisor's License 001026; ADGATE BUILDERS 26133 One Sto No ................. Permit for .....................xy......... Sinq�j!�.J:ami1y...I�W!�ftlqin.g............ ................. ........ location L9t...2.f.......17...Gg.f f...Te.r.ra.q.q.... .... ..... .. .. .... .. .... Centerville . .................... .......................................................... Owner .... Badg�ate Builders ............................................ Type of Construction Frame............................. ................................................................................ Plot ............................ Lot ................................. . March 2, 84 Permit Granted .............. ............19 Date of-Inspection .....................................19 Date Completed ..... ...3.rnpleted .27 ... .......