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0185 KNOTTY PINE LANE
� . 0 • o d . Town of Barnstable Building �� XAM �PostyThisCard So That ahe`Street..-A "rouedRlans IVlust b'e%Retained:on Job and thiszGa'rdMustbe.Ke t Posted Until Final Inspection Has Beenllllade e s ;. = a ° SbfQ �� ,, ., ° Where a�Certificateof.Occa anc =�sRe wired such,Bu�ldm sh°all Notbe Occu iedunt�l aFinal Ins ection haseen�made s Permit Permit NO. B-18-890 Applicant Name: SWEET,ANDREW Approvals Date Issued: 03/29/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 09/29/2018 Foundation: Location: 185 KNOTTY PINE LANE,CENTERVILLE Map/Lot 191-087 Zoning District: RC Sheathing: R W" Owner on Record: DESOUZA, MARIA T ` Contractor Name $WEET,ANDREW Framing: 1 Address: 185 KNOTTY PINE LANE Contractorense 112785 2 CENTERVILLE,MA 02632. � Est 4 Project Cost: $3,480.00 Chimney: x, Description: reside r Permit F e: $35.00 Insulation: Project Review Req: . FeePaid:' $35.00 e` k Date 3/29/2018 Final 111 2t - Plumbing/Gas !F Rough Plumbing: . I AN" .,Building Official y, Final Plumbing: ino Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this.permit is commenced within six nths,after issuance. � All work authorized by this permit shall conform to the approved application and the approved construction documents fo wr hich this permit has been granted. All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning by law's 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 y work until the completion of the same. x s —, ,Ifl Electrical The Certificate of Occupancy will not be issued until all applicable signattAn u esi h BU ding and Fire Off als are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing 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 1 vb Town of Barnstable '�Permrt ti p� lvapires tS monthsfront issue date Regulatory Semices Fee Richard V.Scali,Interim Director " Building I) i®u AMR Tom Perry,Cl3®,building Commis 4V 200 Main Street,Hyannis,MA 02601 t • www.to�vn.barnstable.ma,us Office: 508-862-4038 F/9690-6230 EXPRESS PERIY r APPLICATION - IZE91DENTLAL ONLY Not Valid withortt Red X-Press Impriirt p Map/parcel Number_ 910 a 7 / Property'Address_ t S ..[�Ilta`�'�y I n°� G a A L+I�rv 'fle— MResidential Value of Work S — Minimum fee of S35,00 for work under$6000.00 Owner's Name&Address Ma f (CL- Loo--Sp u'r—A Ms 1-"fly pine- L� Contractor's Nam ez07 /- r;, Telephope Number` 01-7N Home Improvement Contral:tor License m(if applicable) f�ZX-r_ Email: Construction Supervisor's License#(if applicable) [ Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner XI have Worker's Compensation insurance p' •Insurance Company Name j4T V PAS (1 .�)p iLJ lOt1 S Workman's Comp.Policy 9 9,3 S I Copy of Insurance Compliance Certificate must accompany each p mit. 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 ❑ Replacement Windows/doors/sliders.U Value (maximum 35)#of windows T of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. required Issuance of this permit does not exempt compliance with other torn department regulations,i.e.Historic,Conservation,etc. **-Note: Pope caner must sign Property Owner Letter of Permission. o y f the Home Improvement Contractors License-&Construction Supervisors License is it I SIGNATURE: Q:1WPFILES\F0RMS%uil(rMgpe ' f IXPRESS.d c _ Revised 061313 Home Depot Contractor License Numbers: MA: 107774, 112785 Salesperson Name and Registration Number: Janice Campbell : R-1-073-13-00016 Home Improvement Agreement Home Depot U.S.A., Inc. ("Home Depot") or Service Provider named below will furnish, install and/or service the equipment listed below at the price, terms and conditions as outlined on this form. Customer Information: Maria De Souza New England South 10704326 First Name Last Name Branch Name Lead# 185 knotty pine lane rENTERVILLE MA 02632 Customer Address City State Zip (508) 776-9741 F_ Home Phone# Work Phone#. Cell Phone# robsouza2000@yahoo.com Customer E-mail Address NOTICE OF RIGHT TO CANCEL: YOU MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO HOME DEPOT AT: 908 Boston Turnpike Unit 1 Shrewsbury MA 01545 Address city State Zip or Email CustomerCancellationNorthEast@homedepot.com BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING, UNLESS THE STATE SUPPLEMENT PROVIDES A different CANCELLATION PERIOD. THE STATE SUPPLEMENT CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN YOUR STATE. YOUR PAYMENT(S) WILL BE RETURNED WITHIN TEN (10) BUSINESS DAYS AFTER HOME DEPOT'S RECEIPT OF YOUR NOTICE. YOU MUST MAKE AVAILABLE FOR PICKUP BY HOME DEPOT OR PROFESSIONAL, AT YOUR SERVICE ADDRESS, AND IN SUBSTANTIALLY THE SAME CONDITION AS WHEN DELIVERED, ANY MERCHANDISE OR MATERIALS DELIVERED TO YOU. OR YOU MAY CONTACT HOME DEPOT FOR INSTRUCTIONS REGARDING RETURN SHIPMENT AT HOME DEPOT'S EXPENSE. THE LAW REQUIRES THAT THE CONTRACTOR GIVE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL. PLEASE SIGN BELOW TO ACKNOWLEDGE THAT YOU HAVE BEEN GIVEN ORAL AND WRITTEN NOTICE OF YOUR RIGHT TO CANCEL. Acknowledged X 03/07/2018 Customer's Sig ature Date 1 I /�R �nfnr»nirrrHvil/� r•,r`�lis.an��nx//; �- pffice of Consumer Affairs&Baaiaess Reyalatiom -HOME IMPROVEMENT CONTRACTOR � Registsation: 15g788 I 0.,.x Individual -y Expiration: 5lZ9tZ0�8 UBALDO MILLER UBALDO MILLER — 28 LESLIE LANE OAK BLUFFS, MA 02557 Undersecretary lV12Ss r.acesetts Ve artmeni of Safety VW �a7e� ,. P r• i3GcPd of Bil'tidng Reg1;IBiCiis and SlBC1Cf3t�B LiCCnse: CSmj09205 UBALDO C MILLEP. P.Oe BOX 3238 T 28 LESLIE LANE OAK BLUFFS•MA 02557 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): U bA LI�,D M I LL E R Address: A 9 4-es I ie�, L Q rim z557 City/State/Zip: 0q K 3 I ut$s MA . Phone#: 50 e"6`�T% 9`�Z Are you an employer?Check the appropriate box: I am a general contractor and I Type of project(required): 4. 1.❑ I am a employer with ❑ 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 g, ❑ Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑ Building addition [No workers comp.comp.insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing'all work officers have exercisedAbeir I LEJ Plumbing repairs.or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.�Other - comp.insurance required.] *Any applicant that checks box 91 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.#: Expiration Date: Job Site Address: City/State/Zip: 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 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 herebytc t"y utWer the pains and penalties of perjury that the information provided above 's true and correct. Si nature: Date: 3 2 Phone#: 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#: i The Commonwealth of Massachusetts Department oflndustrialAccidents yQ Office of Investigations 1 Congress Street, Suite 100 Boston,!NA 02114-2017 www.mass-gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plunnbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): go Ine, V b Address: l /City/State/Zip: • d/5'Y.S' Phone#: / / L�� 7S ' ;2 s��sb /� 1 Are you an employer?Check the propriate box: I Type of project(required): ]_ I am a employer with 4. L, I am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. El New construction j 2_❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling h have ship and have no employees These sub-contractors8. ❑Demolition working for me in an capacity. employees and have workers' o Y P t7'• 9. ❑Building addition o workers' com insurance comp.msurance.+ required.] p 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.,❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 1 ��6 employeeg. (No workers' 13.[ Other comp. insurance required] /ram�` :Any applicant that checks box#I 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. tContractors 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 infonnadom Insurance Company Name: r Policy#or Self ins.Lic.#: /� W �i / / � Expiration Date: 3 Job Site Address: City/State/Zip: Ul A 1 �S Kn pry /t/l� �. ll /R 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 25A of MGL c. 1.52 can lead to the imposition of criminal'penalties of a i nine 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 f 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 s f r" auce coverage verification. I do hereby certify unde ins and penalties of per' that.the information provided a isTie and correct Si ature: Dal Phone TM: — ,;2 (v Official use only. Do not write in this area,to be completed by city or town offidaL City or Town: Permit/License# i 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#: i i k / Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvemen ntractor Registration .` Type: Supplement Card - ` x Registration: 112785 HOME DEPOT USA INC a Expiration: 04/22/2019 2455 PACES FERRY RD C-11 HSC A ATLANTA,GA 30339 1 'N Update Address and return card. Mark reason for change. SCA 1 E'n 2010-05!11 ❑ Address ❑Renewal ❑Employment ❑ Lost Card ti - ' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration Expiration , Office of Consumer Affairs and Business.Regulation 112785 04/22l2019 10 Park Plaza-Suite 5170 FTOME DEPOT'USA INC' Boston,MA 02116 ANDREW SWEET,. �,Q G � 2455.PACES FERRY,RDC-1:1`HSC ATL4NTA,GA 30339" '` Undersecretary d ithou Signature ACo i CERTIFICATE OF LIABILITY INSURANCE ATE(MoI Dom) �� 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 have ADDITIONAL INSURED provisions or 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 MARSH USA,INC. NAME: TWO ALLIANCE CENTER PHONE FAX A/C No 3560 LENOX ROAD,SUITE 2400 E-MAIL ATLANTA.GA 30326 ADDRESS: INSURERS AFFORDING COVERAGE NAIC 8 CN101642069-HomeD-GAW-18-19 INSURER Old Republic Insurance Co 24147 INSURED THE HOME DEPOT,INC. INSURER a:New Hampshire Ins Co 23841 HOME DEPOT U.S:A.,INC. INSURER C:HomeRisk Captive Insurance Company 2455 PACES FERRY ROAD INSURER D BUILDINGC-20 ATLANTA.GA 30339 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: ATL-004353439-16 REVISION NUMBER: 3 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 I DDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER JMMIDDIYYYYJ (MM!DOfYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY312717 03/01/2018 03/01/2019 EACH OCCURRENCE S 9,000,000 CLAIMS-MADE 1FA. I OCCUR PREMISES Ea occurrence S 1,000,000 LIMITS OF POLICY XS MED EXP(Any one person) S EXCLUDED OF SIR:$1M PER OCC PERSONAL s ADV INJURY S 9,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: u00,OCO PRO- GENERAL AGGREGATE S X POLICY❑JECT LOC PRODUCES-COMPIOP AGG S 9,000,000 OTHER: S A AUTOMOBILE LIABILITY MWTB312718 03/012 Ea accident018 03101/2019 COMBINED SINGLE.LIMIT S 1.000,000 X ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED SELF INSURED AUTO PHY DMG AUTOS ONLY AUTOS BODILY INJURY(Per accident) S HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per aaident S S UMBRELLALIAB OCCUR EACH OCCURRENCE -S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S B WORKERS.COMPENSATION WC 014122577(AK,NH,NJ,VT) 0310112018 031012019X I PER OTH- B AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETOR/PARTNEPJEXECLMVE WC 014122578(WI) 03/012018 03/012019 b,000,000 OFFICERIMEMBEREXCLUDED7 ❑N N l A E.L.EACH ACCIDENT S _ (Mandatoryin.NH) E.L.DISEASE--EA EMPLOYEE S 5,000,0W DUes describe under Can6nued on Add tional Pa DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT d 5,000,000 C Excess Auto 297-1=10011-00-2018 03/012018 03/012019 Limit 4,000,0W DESCRIPTION OF OPERATIONS.I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached:if more space is required) EVIDENCE OF INSURANCE CERTIFICATE.HOLDER CANCELLATION HOME DEPOT USA,INC SHOULD,ANY OF THE ABOVE.DESCRIBED POLICIES BE CANCELLED.BEFORE 2455 PACES FERRY ROAD THE .EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN BUILDING C-20 ACCORDANCE WITHTHE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee 6-Z ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: CN 101642069 LOC#: Atlanta ACORo ADDITIONAL REMARKS SCHEDULE Page 2 of 3 AGENCY .NAMED INSURED MARSH USA,INC. THE HOME DEPOT,INC. HOME DEPOT U.S:A.,INC. POLICY NUMBER 2455 PACES FERRY ROAD BUILDING C-20 'CARRIER ATLANTA,GA 30339 JNAIC CODE .EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insurance Workers Compensation Continued: Carrier:Indemnity Insurance Company of North America Policy Number.WLR C64783191(AL,AR,FL,ID,IA KS,KY,LA,MS.MO,NE,NM,ND,OK,SC,SD,TN,WV,WY) Effective Date:03101/2018 Expiration Dale:0310112019 (EL)Limit:S1,000,000 Carrier.New Hampsture Insurance Company Policy Number.WC014122576(DC,DE,HI,IN,MD,MN,MT.NY,RI) Effective Dale:03/012018 Expiration Date:03/01/2019 (EL)Limit:S1.000,000 Cartier:ACE American Insurance Company Policy Number.WCU C64783221(QSI)(AZ,CA,IL,NC,OR,VA,WA) Effective Date:03/01/2018 Expiration Date:031012019 (EL)Limit:$1,000.000 SIR:S1,000.000 SIR for the states of AZ,CAA,NC.OR,VA,WA Carrier.National Union Fire Insurance Company Policy Number.XWC 4595580(QSI)(CO,CT,GA,ME,MI,NV,OH,PA,UT) Effective Date:031012018 Expiration Data:03/0112019 (EL)Lint:$1,000,000 $1,000,000 SIR for the states of CO,ME,NV,MI,ORPA,UT S750,000 SIR for the state of GA S350,000 SIR for the slate of CT Carrier:National Union Fire Insurance Company Pot Number.XWC 4595581(QSI)(MA) Effective Date:0310112018 Expiration Date:03/012019 (EL)Limit:$1,000,000 SIR:$500.000 TX Employers XS Indemnity Canier:Olinios Union Insurance Company Policy Number.TINS C4916693A(TX) Effective Date:03/012018 Expiration Date:03/012019 (EL)Limit:S10,000,000 SIR:S1,000,000 ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r _ 1 7 . Z q o 43! rn f � . 40"T e CERTIFIED PLOT PLAN 'Ll7 7- KWo 7 Ty PING NEW 'CONSTRUCTION ONLY = iv'TR►fiL E . TOP..-OF FOUNDATION IS 3, FEET IN A®OVE LOW POINT OF ADJACENT ,D.9 �5 —� /3:L�" ROAD. SCALES = d. .DATEt ..7 k LDREDGE- E'IVOINEERING CO.INO, I CERTIFY .THAT THE Ft901A/®-4Por/: CLIENT SHOWN ON THIS PLAN IS LOCATED E819TERE0 REDISTERE® 8/t _ CIVIL ` LAND JOB NO. ON THE GROUND A9 INDICATED AND ENGINEER SURVEYOR DR.®lf+ ' ✓} CONFORMS TO THE .ZONING LAWS ` O Fit ASS. 712'MAIN'ST �N �9 �.E , , HANN'IS MASS120 _. > SMEM_ DATE . . �. TOWN OF BARNSTABLE Permit No. ----------_----------_______ Building Inspector Cash eO'r0 WAY \� OCCUPANCY PERMIT Bond ----------�1 "No building nor structure shall be erected, and no land, building or 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 been issued by the Building Inspector." Issued to ?? t�.vvq 7a �?*�j.1 r?�_ nr- Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department .,jam, ,, ..0 _P;il ,. Z. 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. ........................................I............., 19..._— .............................................................................. w_....�_.._ ._.. ._ Building Inspector Assessor's map and lot number ...1.91.................................. �pF THE TQ� ' SEPTIC SYSTEM UST Q • ` Sewage Permit number .... o" INSTALLED IN COMPLIA JHHSTADLE, i House number ...... .............. (2 .................................... t WITH TITLE 5 'oo M639• ENVIRONMENTAL CODE AI1I` OupX () tr TOWN OF BA=RNS�' AB�' IJ TIONS BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... �! °G .../ 11� 1.4' ''�.....J.... ... ........ ..... .................. . J TYPE OF CONSTRUCTION � .. ...... 6...............19 TO THE INSPECTOR' OF BUILDINGS: The unde//re�signed heeree�jbby applies for a perrvit according to the following information- / ..!....... .. ..1.....f. :..... ...'.....I........................... .......................... ProposedUse .u ... .:.. ..... .t ..... ..................................................................I......................... Zoning District fYY...........Fire District .�' .���`.......................................... Vv j� Name of Owner/... ...l...V .. /� ✓ ® Address .... /Ol .0 ....O:..I, ........................ Name of Builde �f J ..�J.?''>..6 ��.. ..�. ciclress ...... ... � ....... .. "A9.......... �f Ql �° _` .. I.AV.�, (!.. k ..(;i�" ....:��i.�.........Address ..!-�i 1..:. d. ..) ..Name of Architect ............................... Number of Rooms .......... ..............................................Foundation dU Exterior `.. . ... 0.....� oofin �� ............................................ Floors ...................... ...........................Interiorz464 �,.f ..-Z !I;a( &2�4 /��.,..�...... -Heatingkllx,��_IJ.�.. Plumbing...�✓L� f�' + L...:(�:.�.`� t?`C�l ..ly ..;.................. x . OptFireplace .. .8...,,,... t��✓.:�;a.....................................Approximate Cost:,��. � ..... ..... ............... p1 Definitive Plan Approved by Planning Board - ,c--------19 C3 l�Ar a ....... Diagram of Lot and Building with Dimensions /�� Fee .4......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH i r � Or A I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. co . Name ........1 . T _ _ BAj-S,IDt� BUILDING "CO. '^ One 1/ tory No ...2 310.6. Permit for ........................................ .Single_ Family. W .......... -, a k Location ...L.Qt...#18...1.85....X aotty...Pixae. Ln- Y" N Centerville ................ � ........................................................ t .`} "'' tJ, •/^ .^ _ L t' +. ! Owner ..Ur......&...Mrs._...aruce...Ande.rsan Type',of Construction .......Frame...................... ...........:.....✓` ......................................................... +' 4 „J f� •� - , Plot .......................... Lot ................................ Permit Granted .........July,, Ur... .19 �i81 Date of Inspection ...................1 � ` f Date C mpl tedn.:/.. _ .19 PERMIT REFUSED y ' ......... .:................................................... 19 �,% '+ :r . G /. �, _ ...7 ` •• / ..... a•............................... .... .... ..................'�' ... ...........................................;�:. .........� .......................................................i ............ `:/' - �� !J �.• r ri - - , .................................................... ................. • ! ti .1' f Approved ........................... ... ......... 19 .......................i....................................................... r- .................... Assessor's map and lot number ... . y�fTNEtO i� 3 Sewage Permit number ,... ,........... 7,,......................... " Z EA"STADLE, i House number '5:1.............. ° NAM f..ti. <......................................... 90 �a MAy a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... jt'r TYPE OF CONSTRUCTION ..........f.�1C:* # b ..... 1fir /?�J ....................... ................................................. .................... TO THE -INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location s):' `.j.. ....}'1./"�: .. i ' ...`. 1f.+...... .....� . .'.rl :.................................................................. Proposed Use .v r /. rt ` rr. ... •; � ..: ............................................................................................. Zo n District x` ,..'../..- '!'> ,`y ;; Fire District ./.,%.?.�............................................ Name of Owner�!%/ t3�lLf S•, f7.^, ^"�fi/ivt, Address ..... ;... �..1`i• l ......................... Name of Builder`-f-(-� .,, C' /r?L- � ,� / *tAddress ;� ....... ... y.'.%.` �..F.:::/:: ..._...... j :............. Name of Architect( /ll`�,. � r •'�% fir, .S -r1�..� , ......... .�« "Y� Address ............. Number of Rooms / '...................................................Foundation .!lJ .. .:!....../ �"3/ ,f .n: ,._.................. it Exterior J�, .. .. y.. ^`. �`. r 7 •"; p..�.: `� C:';�5 » C , :,Roofing .. Oi... .. . ............`:�.................................... .... Floors ...........................Interior,......�- >... .......... Heating :.. Plumbing ..........................:.c..:..::..:........... ...........F/,�`z; . Fireplace .: ......... .....................................Approximate Cost�..... ' r ................................... ✓. .. .. _ .... Definitive Plan Approved by Planning Board ____�'% 19 %_ %. 6 Area� .:-, � - 1 Diagram of Lot and Building. with Dimensions J;� Fee q ' .... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH , R N�v \ X�' y \ -- 3 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. `;� /� t/� Name .........l�.a ....Y-./�-r... ....................... � "^� ^ + .'/C/'. ' ] No _2�.29.6... Permit for .ODIP...l /a...S.tQ.-rY _._..7G.in�l��..Iraozilv—C�0�l], ' ---.. ^ ' Location — ...UI8—].U..J�DQ-ttY...I!ine- Lo, ..................Cent .__________. 8 Owner —.�]��!�..�\g�!eJ��.Qa........................... Type of Construction ......Fzcazue...................... ----.—.---.-----.—.---------.. .P|co ---------' Lot ----------' ` Permit Granted 2.1 lg 81 Date of Inspection Date Completed ................../................19 PmRmmn - + ^ . . ' ____.____— ---------. lq / -^---'---'—'' --------------~' . � ----'---'^^^X----^---^`--~'---'' / ' ' —^- ' --^ '^'—~^^' —'---- --. re^--.l ��.----.- . \ Approved ..................................... 19 . 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