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HomeMy WebLinkAbout0024 LONGBOAT DRIVE a?�l bo � d Y X.p P� P .. • 9 it + �.c ,o p p x e , Qr,,. {�� �' � �� _ ., ... �. .. � ' " _. p• a `.. _ ,. .s , a n + � F Town of Barnstable *Permit# Expires 6 months from issue da{e Regulatory Services Fee 3 S. — anatvsTnBte, C p�Ap 4 Thomas F.Geiler,Director X-PRESS PERW' 1 . Building Division Tom Perry,CBO, Building Commissioner JUL 10 2013 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 www.town.barnstable.ma.us TOWN OFp �T� A EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY t i�� Not Valid without Red X-Press Imprint'p Map/parcel Number 143 I n , Property Address 2 'I C;> b `Y�[residential Value of Work$ V Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C_4D 1(? ' 1 t Ltd t Contractor's Name Ca otuj d L F,ril elephone Number 500— 6 / 7—00 7 Home Improvement Contractor License#(if applicable) I 5 O Email: � �J Cons ction Supervisor's License#(if applicable) OS 05 e 12� . Coal orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑�am the Homeowner 71 have Worker's Compensation Insurance Insurance Company Name � � `� l n� t t I tv I vl/t o_ t cc— Workman's Comp.Policy# 1 12 C) 5 1 d 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 RR"Re-side roof(hurricane nailed)(not stripping. Going over existing layers of roof) ftT e Y-b Yt SS',� ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows - #of doors: ❑ 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.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: TN� Q C:\Users\decollik\AppData\Local crosoft\Win s\Temporary Internet Files\Content.Outlook\8R76BDVA\EXPRESS.doc Revised 061313 Assessing As-Built Cards Page 2 of 2 CAPEENT-01 DCOSTELLO DATE(MMIDDIYYYY) ,a►�cc�,Ro� CERTIFICATE OF LIABILITY INSURANCE 412212013 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,subjecIthe the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: FAX Rogers&GrayInsurance Agency,Inc. PHONE (A/C.No AIO No Ext 434 Rte 134 E-MAIL South Dennis,MA 02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Arbella Indemnity Insurance INSURED INSURER B Capewide Enterprises LLC INSURERC: J.P.Macomber&Sons INSURER D: PO Box 763 Centerville,MA 02632 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. POLICY EFF POLICY EXP LIMITS INSR TYPE OF INSURANCE INSR POLICY NUMBER MM/DDIYYYY MM/DD/YYYY 1,000,000-LTR GENERAL LIABILITY EACH OCCURRENCE $ 8500050813 4/3012013 4/30/2014 PREMISES Ea occurrence $ 250,000 A X COMMERCIAL GENERAL LIABILITY S,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PO- $ R COMBINED SINGLE LIMIT 1,000,000 POLICY E T LOC AUTOMOBILE LIABILITY Ea accident $ A ANY AUTO 58944400004 4/20/2013 4/20/2014 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED PER ACCIDENT X HIRED AUTOS X AUTOS $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000,000 _ A - EXCESS LIAB CLAIMS-MADE 4600050814 4/3012013 4/30/2014 AGGREGATE $ 5,000,000 . DED I X I RETENTION$ 10,000 $ WORKERS COMPENSATION X WC STATUS O TORY LIMITS ER R AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 9120510412 4/14/2013 4/14/2014 E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? �rNIA E.L.DISEASE-EA EMPLOYE $ 500,000 (Mandatory In NH) 500,000 If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space Is required) With regard to general liability,blanket additional insured and blanket waiver.of subrogation apply if required by executed signed contract CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD http://www.town.barnstable.ma.us/assessing/HMdisplay.asp?mappar=140179&seq=1 4/19/2013 r .. ., .. ..._.,...__._.Q_�,__._...__.._.._....._/ CJ�B ZQlo ..,69Z vea'(.C4,,/lV!/CILd�Q.0 Lf.JP-CI1 License or registration valid for individul use only Office of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR before the expiration'date. If found return to: kregistration: 143358 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 xpiration: 718'/2094 Ltd Liability Corpc: Boston,MA 02116 CAP EWIDE ENTERWfI: 6i .L;LC RICHARD CAPEN 4507 R RTE 28 � �— COTUIT,MA 02635 Undersecretary Not valid withou gnature t mas';'4ctrinsetts -Depeto ent of Put)lty Safety trcrrirfx c,€f3t�€Ir.:tin g #�egiil<�attuns a.1 fit nc!<'�r Unrestricted-Buildings of any use group which (onoructinn Super%i.ur . w contain less than 35,000 cubic.feet(991m3)of License:CS40273 = Y= enclosed space. ut� 9,101AR D 161 COE.N M WHITMAN R1Jt r4, T � t Failure to possess a current edition of the Massachusetts v ^' Ff utit `'� Expiration State Building Code Is cause for revocation of this license. Commissioner 1.112712013 For DPS tdcensina information visit: www.Mass.Gov/DPS The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: / J 5 orn n eill-c I City/State/Zip: �I Ill 1� M&49hone#: Z/7 7 Are you an employer?Check the appropriate box: Type of project(required): 1.EDY am a employer with ? 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.3 7• ❑Remodeling shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL ME]Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),'and we have no 12.❑Roof repairs l insurance required.]t employees. [No workers' 13.[ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ?Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and Job site information. Insurance Company Name: �7 2 Policy#or Self-ins.Lic.#: J v U J�� t� Expiration Date: L413-01Z-4 Job Site Address: P bM+ City/State/Zip: Attach a copy of the workers' c pensation 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 hereby certt&under the pains and penalties of perjury that the information provided above Is true and correct. Signature: Date: 7 G 13 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#: Town of Barnstable. Regulatory Services BAMN918 g Thomas F.Gamer,Director 039. $ FDNJ+�A Building DivisioII Tom Perry, Building Commissioner. Nd Main Street,,Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-4038 r Fax: 508-7.90-6230 Property Owner Must Complete and Sign This Section If Using A Builder HC-j2A ,as'Owner of the subject property hereby authorize ( -i to act on my behalf, in all matters-relative to work authorized bythis building permit application for: '(Ad4F6ss of Job) -PrJ � Signature of Own D to Print Name t S:O%,PJERPERvIISS10N :r 0RN_.. . r F t. r IRE T� Town of Barnstable t# 3 a ti P Expires 6 nrofrogr issue date ' Regulatory Services Fee + BARNSTABLE, + r MAC'639. Thomas F. Geiler,Director pTFD Mp't A Building Division Tom Perry,CBO; Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barns table.rna.us Office: 508-862-4038 Fax_ : 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ` &1 3 1 l 1 C tResidential Address 7 ' f�11✓ ,/ LA } �/1/ �r,As'1 /✓ • 0 Value of Work 7 7/ 7 Minimum fee of$25.00 for work under$6060.00 Owner's Name&Address A/4 11 Y(?­,1_A Contractor's Name `� ri / (�( ,/ Telephone Number Home Improvement Contractor License .�- #(if applicable). . 7nsction Supervisor's License#(if applicable) kman's Compensation Insurance' -PRESS PERMIT Check one: ❑ I am.a sole proprietor MAY 13 2010 ❑ LZm the Homeowner I have Worker's Compensation Insurance TOWN OF BARNST'ABLE Insurance Company Name �(,✓��' Workman's Comp.Policy.#' a Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) . ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over`. existing layers of roof) ❑ Re-s e /. � CC/ #of doors Replacement Windows too /slider�U-Value �• :)J (maxtmum +44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i:e.Histo.nc,'Conseivaiion,etc.. ***Note: Property Owner must sign Property Owner Letter.of Permission. A copy of the Home Improvement Contractors License.& Construction Supervisors License is required. SIGNATURE: Q:IWPFILES\FORMS\building permit forms\EXPRESS.doc i. . Revised 090809- The Commonwealth of Massachusetts Department of Industrial Accidents W Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A plicant Information ^ n Please Print Le ibl Name(Business/Organization/In "vidual): �J V � se C a J v lc Address: VC_ City/State/Zip: �' 9 Phone #: Arl an employer?Check the appropriate box: Type of project(required): 1. a y emp to er with .4. I am a general contractor and I _ 6. ❑Ne construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. D4emodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' 9. F]Building addition [No workers' comp. insurance. comp.insurance:$ 5. We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their l l.0 Plumbing repairs'or additions 3.❑ I am a homeowner doing all work myself. [No workers' comp. right of exemption per MGL 12.[]Roof repairs insurance required.],t c. 152, §1(4), and we have no nlj Other 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. . 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: "� Ci /State/Zi (✓� _ . �p� Job Site Address: p' Attach a copy of the workers' co pensation 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 hereby certify under the pains•and penalties of perjury that the information provided above is true and correct Date: O Siafore: .-'—_�i'' �-•�-•---- — Phone#: d (kt� Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Pernilaicense# 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#: �1 f r y t..CK i It'1t..tl 1 C Ut' LIAMILI 1' T 11MbUKAIVt.►M. OP ID Jv 1 MOONA- 05/07/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hunter Insurance, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 389 Old River Road, P.O. Box 1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Manville RI 02838-0001 Phone: 401-769-9500 - Eax:401-769-9502 INSURERS AFFORDING COVERAGE NAIC9 INSURED Mb4ri Associates Inc. INSURER A: tiatlonal Grange Insurance co 14788 DBA Gutter Helmet DBA Renewal byy Andersen of RI INSURER B: Seacon mutual insurance Co. DBA mutter Helmet Roofing. INSURERC DBA Moon Works 1137 Park East Drive INSURERD: Woonsocket RI 02895 INSURER E: COVERAGES 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 MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN PAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR INSRO TYPE OF INSURANCE POLICY NUMBER DATE(MMfDDNM) DATE(MWDDIYYYY) LIMITS GENERAL LIABILITY t EACH OCCURRENCE $ 1000000 A X CO'v1MERCIALGENERRLLIABILITY MPS26619 69116,109 09/16/10 PREMISES(EaoGaurenoe) $500000 CLAIMS MADE X]OCCUR MED EXP(Any one person) $ 10000 i PERSONAL&ADV INJURY $ 10 0 0 0 0 0 GENERAL AGGREGATE $200OQO0 , GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2000000 , POLICY PRO- . - JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 A (X ANYA.UTO B1S26619 09/16/09 09/15/i0 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY ' $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 A X OCCUR F-1 CLAIMS MADE CUS2661 — -......._.._........ __.._.—. 9 09/16/09 09/15/10 AGGREGATE $ DEDUCTIBLE, $ X RETENTION . $10000 $. WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LLABILrrY' Y I N B ANY PROPRIETOR/PARTNEREXECUTIVE 28586 10/01/09 10/01/10 E..L.EACH ACCIDENT $S00000 OFF ICERfMEMBER EXCLUDED? —•—_—• (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000, OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION RENEWAL DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 ' DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Renewal, By Anderson+ 1137 Park. East Drive AUTHOR D REPRESENTATIVES. TATNE Woonsocket RI -02895 ACORD 25(2009/01) O 1988.2009 ACORD CORPORATION. All rights reserved. The AC4RD name and logo are registered marks of ACORD Ige v lwa 7� € ' 59 # palms MOONAS 00 ONSOCKET, R� Mrre#ary . 44*11 F =:soraft Mfybdy covv- es A ,y�.7iwb, GY' S:iS�.T 5`0 r'x f : • pfy� # i6Ydii w.A4i'All _ 446 8 mom m Rim .om c4dm dthe` i t: -80, Ego t oe is � [6 �I)/-1 v +7) 14c- 1 R71 Y Lowrt3oA b/Z Q � Customer Nam[. bA✓l a a -,ai t.A,a i/ Year Builr. �, Rmem ai by Anderson of Rhode Island& Address +L1 t.O ly&g)AA'r" D(�. Customer ID#: Cape Cod Sales Agreement JC&Z a W L �trdcr Numbcr. _, 1 I37 Park East Drive g Cityt Scare,Zip: ��......�-d.-�y�f � ~- Woonsocket,Rt 02895 bPhoao-Homc:4f_ ^`'7 0 1. ttttwoW aaruraenarrr mAOiatenCoapaoP CALL- Phone-Work:—Z7.. ^0,391 Page:_L of r♦_Date: `�" V license#RI-3M39 Rl-12259 MA- ErnA- 119535 CT-562725 tsdinkst Ma91nr GRILLES UNITI atmeutats , M t 21 Oil 1 1 l I?1. dry G✓ F rt A'I :are 7 LR- a F:R iL tom t ( K.W.so °ivo 1 Payment Method Propetetil Aa.d the altm•�w tt lnwr sal th.ra a.bs Pnnwkd fnrtba aei attttaotty�u�1 to eM .rna•tu.TAr v. n,ne.) Pn,)rwal M.tmain w 1ki Hn)9 tby+Ma it ao*vt at wraps,.br)xxh f:Ytuxue.toed&ttewd hY Ata!<'nm Alwnµr ar Pntewkai bL+;.0 Daalpdon/Nota S R .. ChKk / i ni c r v�.►._�_ RPM+-tJrJ s'U y,a,totel wi..,e, T � � tom•maw L (] ctat Csnd Custom®[ You are barby auth.xb+•d to furniit eN wbtbaaa aa)ebam.rtayAnd at a.'Pkv tort Aa Or� egA V 1 1]O�f.i j� _ _ butt.C90ft of EXP946M _7Sa q%rnakrtt fin whkh utakeniatad ptm'+at Pry eha rmtwm eats{b dde allrrement and rsa.nitt�ut t1x qvm.heartf. - Ydtia-. 11td� See Reverse side for Tame and Co Iona oil sals.Yoa,the buyer,tray Sntte�l G/►�77�a�►9®ai a bit AVAJrtA"44 MY this transactilon at any d oe to t o the third business day eNet ow t"0 th�to Of this see notice of cancehatiarl ftn as F(yt A2rl/ Fv p v a Avn Coo AILS So � Tst .---- ei 4n�a�ti�O)tl�Of TOM Mbcdhtteow Crediu or&Peres _ �;"it Cost� � Atlatlond Orin rents Auld" AncPtnl't - (rety wen tool to tnlx.endh!apnea taiwnn v tIKM) & omens ebda as dw AwA +' Sprdal Order Note Toth AreleuK p1�RQmanr lftyftw M"am Amp'rd _._— ihspmltiNPIRd 7 0 rWdthrMYdgt t�tc 14mqvtnncwsl bl'Arxhrnn hlingRe�"IA�taetusv - hn �isla tlr � Y�►aareareRMr Mu lakntiDue at2a�lstfon pgptt�,rs t a1 b pjW ki iudes iubnr:ntutr6 s,installstaw �abon. •e atASMtitd At W/B d1M aBY�aMesatOY W rsmi•mai tMsywul a(ptoduclt tepiarai. nn,s eB daOwta nex.tmidmeat ass tNpip.-ww"d by Att&M YdM-i NO-Ikntota M 1 In `��„�•„'�.w TOWN*OF BARNSTABLE Permit No. --------.--_--------------------- i »n.� Building Inspector ( g • Cash --------------------------- � /YL f 0)0• OCCUPANCY PERMIT Bond --------------------------- "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 Suffolk Ree1ty Truest Address joy 108, ^entervi.11e, Mr n ter: Wiring Inspector . ` ' ' Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. 19..._._� .......... ................................................................... . Building Inspector Assessor's map and' lot number .. �-.:�. � ...�z:.�. ....1a.9 Q�! PC F-, Sewage cPerm�t:number ........................`............................... TH ART, Cp�p E ,. H SSq/V/7ARy CLE 11 S LIqNCE �FTHEr " TOWN ` OF' - �BARI *�► To wtv r 1�39- � DUIFLDING INSPECTOR 9 va:YPY Or ti 4 ZS AP�FLICATION,FORt5PERMIT ,T.O cS� l�.f?...... E. .C.? ... k'V.is.�...................................................... y i J .. ..7-"mil/.!C /�" Si:l/e.� .;L� ' TYPE OF CONSTRUCTION ....A/!v��.... }�..... .........................:................. .....�1!9,Y.,:��........................19.7.. .XTO THE 'INSPECTOR.OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .../� ....(V............ Q! j 1��i ...` ''/lO ............................. ......... ............... ... ............................. ' Proposed Use ...:4r1!�!�&�.....T..� /. ..r r� �. t'il/ iP.. .................................................................................... Zoning District ....Jam!. : iE':..................:.............................Fire District .. E... .... .....:....................................... Name of-Owner XAY...7A!!: ?7? -.Address .. :�?:....'�'3Ol.....3 .......(171 ✓/ ... Nameof Builder .........................................................Address .................................................................................... Nameof. Architect :..................................:..............................Address .................................................................................... Number of Rooms ..�� (/c dv Foundation ......A e. ............. .......................... ............ Exterior i��... .//.�1��k.5................................Roofing ... :: ..: Floors .... ............................................Interior ........................................................ ` Heating `:. .:. :...... ..............................................Plumbing . . t.. ... .:......................................................... Fireplace .. y- 7f �(J/f®�J� ..............................Approximate Cost ...r , .��G�.t ....................................... ....... Definitive'Plan Approved by Planning Board ________________________________19________. Area ..1..................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 7 s 4;elX3p IMN� ��T 1171 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. _ Name��, . Ct... !6............................................................ r ~ . . . / ` ' Suffolk Realty Trust 20179 one story . . single family dweIlinu -----,`--.---�.-----../:^�.—.---.. ' � ��_ �r��m Location —.-- ..�on��oa�----------. _ . . ' CenterviIl ` �'�'� �''' �''�������� ����������' ,Smf�w0k �ealt� Trmot - uvvnar ---.----------.../7-----.. . . \ ' . Type of Construction ...........frame..................... ~ ---.�................................................................... � ' ~ ' ^ #6 ' | Plot ............................ Lot ................................ / ' > . ' ! � 78 Permit Granted ----D���-------lV . ' Cate of Inspection . _--.lg ' / Date . ^ Completed . ` . . ' ^ PERMIT REFUSED l9 . . ............................................... .....— —'' ' ~.�.----....—..—.-------.--,^.—.. ' ' ' ' —_...--.~~..^—.—..------.—~.—,—.-^ ` .^,....�..—..�---~......—.-----.—.-.--. ` .^___,___.___,_._,_~^,,,,',.~'_.._,_ - --`-----------.-- ln . - . . ^ . ' ' � —..—`-----.—.--..._.—...--..—.....— � . -^^------.—.-----.--.—.—.—.—..—.` � �^ � ` | Assessor's map and lot number :..:.!:: ....?:•............ ` �/f. `%h ' ✓G 5 `� Sewage,Permit number .......................................................... FT.NETO�y TOWN OF BARNSTABLE i •$9,HB9TA$LE, i "b 9 BUI LDING INSPECTOR O G MPY Ar. APPLICATION FOR PERMIT TO :.Z? ..........h. ::Q:.?..`.. .......r'" TYPEOF CONSTRUCTION ......::.............................................................................................................................. / .....1??...v.............................19.......... -TO THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to the following information: Location .... ..............................................fin!..............."1�....�/L��............................................................................................. `: ProposedUse ... :/..�/lf/1..... i�.!�7/.�t/..:!P ;;`�. f'.;J ..... ...........................................................I......................... p Fire District `�f'i/� � -c ''� ZoningDistrict .................... ................................................ ... .................... .. .......................................... Name of Owner .....�[�. '•�n,f.>G„ 1�L '/t[/....7/:7e`..07/. 09 C�:....f�,�X......''�fir:...`...6:',,4...,'./L f�... (� y' Address Nameof Builder ......................................:.............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms :iE'1 f .........................................Foundation ...... ' ......................... .................................................................... Exterior ................................Roofing - S . Floors ..I' '"�� '�� "a .Interior r �J Heatin ._. n r . .`.................................Plumbing ....:. .., !/ Fireplace .!©� Approximate Cost ..... �..,...�, r^ ......::........................ .................. ...................................................... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ... ........{..'............................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r l - / I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Namek.........`..:u..11 .-.�Y......t�rrr.............................. RealtySuffolk �� . . ' . ~, 20179 one story '`" Permit" = ---' � ' aiool� �a�1�v �n�a � ` - ' . ` ---------.-.-----.. ^-.---- ` 24 t �' Location ................................... ... ��.�-----.. � y Centerville | � ----.^----------.-.----.-----. . ' ` Suff-o-1k Realty Trust Owner . ( | � '/r^ of Construction— � _ � \ ncx � / � � . lay 5 78 � ' Permit Granted > --- ---'l � | / ' � > ^ ~~~~^ ~~ l � 19 _ W _____________ � _---. --.-----------' � � ' . / . ----.�.. .----....---.....~--.~... . � '-----^'...^-^'-'--'--^^'-^^'-'^--~^^^' | ' / |� Approved ................................................ 19 / ________.____-._..-.-,-.-.---. ' / ...............-............................................................. ' � " ' | ` - | -- �rz Q NoTE.' 13.M• /s Co.c.,Q - . TEST PiT1¢ . ,5, . `.7 / tn,��"�' Boa ago• (�ssufl� /oG,Z o O K. '4 "'4 ` J ^ y .° /O�120P � ioROP. n _ G 4 T-"# t •: ! . 7 �"t � ;.0 �� s.T' �♦� /OLb. Via: 77. ivo JV 9TER 'e'NcauAd r EO //''��' TE S T� HOLE 3y 1� U f 7 G� P,ER T O JA//V ;e EC'O!2 D5 DATE . �9�R�L` ♦z, /978 T o W N I-2;Z' ''2 �ttS A'VA / L P L E. f IA/SP. P�9 u�Mu�PlPi9y M /n// /'/ U/'7 dJiU/,L / VE ,�5 O T To ` 'BE -OC TED PRO P OSE D 8 E D 000/�1,5 '3 DR wAyh, ,., OVEN 5 :. ;Tz ��. 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