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HomeMy WebLinkAbout0020 MAPLE AVENUE �o tn� � � ���, � , }, - ;� e „ w ., n v � � .i � .. .. ... N ,. � ... 8.. .. u L " . ., r u , i - a 2 x5 X PERMIT Town of Barnstable *Permit Regulatory Services Xv"- °" ` °'' �"date 2012 Thomas F.Geiler,Director `' Building Division ' TOWN OF BARNSTABLETom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.batnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 _EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY rr,, r f Not Valid w#how Red X-Press hnprint Map/parcel Number V G 1 Property Address � v-Q ` v i ( 10 rvi -Residential Value of Work 600 n Minimum fee of$25.00 for dvork under$6000.00 Owner's Name&Address be et i.-.j M C,e (1 t .v " Contractor's Name -7--rn r rk-�oy L C:C _Telephone Number L5-0& yez E - �. Home Improvement Contractor License#(if applicable} Construction Supervisor's License#(if applicable) dWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name U n.i o r� R f e n S U r n C CO. Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit: Permit Request(check box) IF] Re-roof(stripping old shingles) All construction debris will betaken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum,44)#of windows *Where required: Issuance of this putt does not exempt comptiaaee with other town deparancut regulations,ie.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A c the Ho Improv ontractors License&Construction Supervisors License is squired. SIGNATURE: :\WP ; FEES\FO Q RMS\brdl, . ramit forms �P \E7Q'1tESS.doc Revised 09080 9 li/VIAZU11 1Z:LU kAA1�003 Clean & Remove - Debris from work area daily. NO MONEY DOWN-NO Payment at the"start or part way thru Payments accepted are. CASH- CHECK- MASTERCARD -,VISA o AMERICAN EXPRESS * Any payments not made within 30 days of completion will be charged 1.5 %for every 30 days the r payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is,not up;against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the ., plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. 'There are 6 Panels per sheet of plywood. Possible Fora—Any rotted`or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as, an extra at the rate of$60.00 per hour, plus 15% mark-up materials FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or.alteration from above specification will be executed upon written µ orders and will become an extra charge over and above the estimate. `All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC- Carries WorkmaI n's Compensation and Publiic Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: I � /r o a wngr Fraser Construction, LLG For coMpany use onlq; Date Received Date Started: Date Completed Job estimate: Dean/Mike # of squares: Billed Material ordered Extras Paid Available Discounts 3 ... - . 114assacbusett§-Uep:iq-tmeat of PubliE'Safta�" Board of Building Regulations and Standards Goastructfon Supervisor License License: is 97WB. DEANI AR r 104 TVillf�i?;; V�1filE. . EAST F. Yi *, 02536 Expiration: 617/2013 Conunissludcr Tr# 16692 J -� Office of Consumer Affairs and usiness Regulation 10 Park Plaza- Suite 5170 Boston, Massach setts 02.11E Home Improvement Contr :.tor Registration Registration: 112536' 1. r Type: DBA Expiration: 312312013 Tr# 209024 FRASER CONSTRUCTION CO. , DEAN FRASER P.O. BOX 1845 xt, . COTUIT, MA 02635 Update Address and return card.Mark reason for change. :Address [] Renewal Employment [] Lost.Card OPS-CAI 0 SOM-04/04-010121E ,,/r� OfiiceA, i mere rT ai-,s"'�Buliines� License or:registrationvalid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 312536 Type: Office of Consumer Affairs and Business Regulation Expiration: 36831R013 DBA 10 Park Plaza Suite 5170 F R CONSTRUCTION CO. .h Boston,MA 0211.E DEAN FRASER 104 TWINN VIEW L;QNE E FALMOUTH,MA 02636 Undersecretary of va tt ut si re • �C�e FRASCON-Oi MOSU CERTIFICATE OF LIABILITY INSURANCE °A-mommorf" 91am'!i PRODUCE R (508)676-0309 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Viveiros Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 375 Airport Road HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR Fall River,MA 02720 -ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NA[C# INSURED Fraser Construction LLC INSURER A:National Union Fire Insurance Comany P.O.BOX 1845 INSURER B. Cotuit,MA 02635- INSURER G. - - INSURER D: INSURER E COVERAGE$ 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER LRg GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABI LITY PREMISESS CLAIMS MADE a OCCUR MED EXP(Any orre person) S . - - PERSONAL BADVINJURY $ GENERAL AGGREGATE S- GENI AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPIOPAGO S POLICY F7 LOC AUTOMOBILEOUABILJT( CoM SINGLE LIMIT } .$ s .. ALL OWNED AUTOS BODILYINJURY, $ SCHEDULEDAUTOS (PgP�n) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per exldeno PROPERTY DAMAGE $ OAR mUABILRY q AUTOONLY-EAACQDENT $ ANY AUTO EA ACC $ . - - OTHmTHAN AUTO ONLY: ACXa $ EXCESS BRE LIABILITY MADE - _ EACH OCCURRENCE $ D CLAIMS AGGREGATE 3 . q $ DEDUCTIBLE S RETENTION S S_ WORKERS COMPENSATION �( WC STATU OTH AND EMPLOYERS'LIABILITY YIN A ANY FTtOPRIETOR/PACUJDED�CLRNE 09930601.. 91=011 912612012 E.L.EACH ACCIDENT, $ XDFFICERlMEMBER EXCLUDETYJ a . I.NH) E.L.DISEASE-EA EMPLOYEE S 500,00( be IALPROOMS�ION Sbeloww Y E.LDISEASE-POLICY LIMB I S.. 500,00( OTHER DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVIBION S CERTIFICATE HOLDER CANCELLATION SFIOULDANVOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Fraser Construction,LLC DATE THEREOF,THE ISSUING INSURER VWLL ENDEAVOR TO MAL 30 DAYS 1MaTTEN PO BOX:1"s NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEF;BUT FAILURE TO Do So SHALL Cotrrit,MA 0205- IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND.UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. 05mimm REPRESENTAmE ACORD 25(200W) 01988-2009 ACORD CORPORATION. All rights reserv" The ACORD name and logo are registered marks of ACORD IV The COYMWnweaft oJMassachusefls .�00ndrtstria!',40dde ngs 0jTrhe orts . . i 600 &va NA 0211I W-xWsL9vv/dk WW I 'workers'Compensation Insurance AMdavi t.Iicant Inform 'o ers/Coutrac� ec �mbers f Name(s Prat L •b T as2 Y Address• Cans-k'U cA� o n L 1 'a' [3.[] em7635' Pfion�e#:: y28 :o '9a? P Cf+eeti t.e appi+pptk*boom employervi th '5 4 []Iam a general ViandITypeofye=(dill�Worp�r have hu�edthe 6.sole m' s Q New caagruction .Prof orpartner- listed on thed have ao employees Ihese sub-comtr haveR�odeliirg g formeim a�ceaa andhave8 ❑Damrkers' -Dance. t 9.5,D inaace wilding addition J P ion andits 10.0 Etectrioal eowiaer doiug alI work officers have eirercised d eir or[No workers'�• . r4 t ofeacemptipn per MGJ I I.0 plmbing repairsoradt$tiots ce required.]t ' c 152,§1(4),and we have no 12-[1 Roof repass ; employees•No workers' 13.0 oti:er f '�Y applir�a if�t ohxks boadI s]so ffi!oat tha s k5smnMIMe required.) ec�a �P. tHomwwnwwho sebmit&b a�. showhigt fr I ICD m that ehaek•h box n= a�g&B9 am doing aawork end gm WM outride IWoY won Ifthe sboo�oY�, povt workers codeors a°d soda w or A+P PAY mnnbW. . . Iammu ��� werkers'cvn�sa�oR. ce or o' f Allow a tJiepolicy turd fob sfte InMaWO sty Name: i Policy#of Self-ins.L is Sob site Add: ® Expiration Date' 2.6 a o Lv Attach a copy of the woriraes'comma rise - CitY/5t : el Fafiare Pommy. laration pap(sltowiog•he polity number and i in segue coverage as required under Section 25A of MGL c 152 can Iead to the' eiPiratlon date), i fine up to sl,S0o.0o and/or one-yen mrp as welt as civil Pere s is the form of TOP�Vp IgOER aes nd of fine ofvp to SM-00 a day againstgw violator. Be advised that a Investigations of the DIA fm-ice �PY°f �ma 'be forwarded to the Office of verffication I do herby c ; 000JOY datthe rjornt oRP�»w�ded above fs&m and156 # Qffld ad useonly. Do nut irofte fit �to he consfted by 'ortocvrr o .lam CiRy or rows: pelmtt/I+iCEtrBe f Inning Author (Chvie Otte): L.Board of Raft.2. Department 3. &other G"ityfIowg Cleric 4 F Jearkal J=ltector 5.11'Imnb lag Contact Person: Inspector i i S ESS PERkOwn ®U Barnstable *Permit# ,1)cS D,�S I R MMAO G 15 .2007 RegulatoryS� ���� Plres6,monlhsfromissuedale MAU Fee • C�3 26� OF BARNSTABL Thomas F.Geller,Director �uilding I)IVIS To m Perry,CB® Buildin g Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bairnstable-ma.us 508-862-4038 _ Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTL�I,ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address c2 Q I [ 04esidential Value of work ]Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address y'h Contxactor's Name Telephone Number, g—t(A --,,I g 4 Home Improvement Contractor License#(if applicable) 119,S 3 Construction Supervisor's License#(if applicable) zworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance i Insurance Company Name Workman's Comp,Policy# C( I R Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to 4 ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: ro Owne ust sip Home e �wuer Letter of Permission. ense is required. SIGNA7(RE: Q:Forms:expmtrg Revise071405 f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,/VIA 02111 5• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: CD JDpal 1 gyp City/State/Zip: T,11, WOL 96 S5 Phone #: +So g—C A q" A o�Q Are you an employer?Check the appropriate box: Type of project(required): 1.VI am a employer with 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. 1 7. ❑Remodeling ship and 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 required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.. ` `?oof repairs insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] Re-S 1 *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. tContractors 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-:j Policy#or Self-ins.Lic.#: 7 / 1 Expiration Date: g �j Job Site Address:_ 0?0 City/State/Zip: m O 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 herebyserti er t ' sand ettaft s o per ry that the information provided above is true and correct. Signature: Date: Phone#: So C'9 g-S 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#: f 08/15/2007 10:03 FAX Aug, 15, 700/ 9:31AM No, 4094 P. 22 Payable immediately Upon a completion NO MONEY DOWN—..NO Payment AT THE START OR PART WAY TABU PaymeDU accepted are: CASH—.CHECK--MASTER CARD—_VISA--AMERICAN EXpRESS *Any payments not made within 30 days of compledon will be charged 1 W/o for every 30 day the payment is late_ POSSIBLE EXTRA CARPCNTRY:Any Rotted or Otherwise Deteriorated T Plywood Sheathing or Other Carpentry �m Boards, As an Extra at the Rate of$50.00 per Hour Plc Mat]pals Plus 20/be done a a d charged for The Total Extras. overhead Mark on FRASER CONSTRUCTION is the Only Approved Applicator/A4ember o SHINGLE BUREAU on CAPE COD f The CEDAR SHAKE and THE CEDAR SHADE AND SHINGLES BUREAU and the TREATING THE SHINGLES for 10 YEARS if installed by approved applicator. COMPANY WARRANTY Any alteration or deviation from above specifieadons,will be executed on orders and will become an extra charge over slid above the estimate.All agreementsly co tinge tten upon strikes,accidents or delays are beyond our control. Owv rfire contingent of Owner sh ould h necessary insurance upon the above work. FRASER CONSTRUICTIO ire'carries Woo, and Compensation and N Barrie , Public�,' s W Lability Insurance on the Withdrawn U s above by us if not acce ted within ve�'0r This proposal May P hw thirty days. lm Y be w�tftdrawn . DATE OF ACCEPTANCE: AC EPTED BY• r 14 OWNJB RASE1�colvsT>zU ON i lop, Board Of Bug1dIng R egulations and One Ashy ®� Place _ St �a�. s -B®st®�4 O®M 1301 Home p Massachusetts 02108 r®�'c�cnt.00 actor Registratio n FRANEE CO Registration: 112536 sA i�fSTRUCTIOd�I co Tme: pgq 1� P.O. ER BO M Exairation: 3/23/2009 ®TUIT, Tr# 127920 MA 0263E . - DPS-Cq7 da SOM-05/06-PC8490 . - IQX _ Update Address d return{o7rvhz a 0 — Ad Mark re ason for--- _ ❑ change. Board®fl$uildin - ------- -•- _ ❑ ene�yag � l;+gnpl®9'ffient NQ7@ryE 9fl/!i' g llegulations and 6tandards - . ❑ Lost Ward VEIWEMg CONTRACTOR OR .license or r Registration: i 12536 before the a,p On valid fE'xor insdivialu2 use Piration: Board of !ration date. -Tf found return to:®n ly 3/2'' 009 regulations and Tie: p f Try 127920 One Ashb Standards FRASER CONSTRU Boston Ashburton 09 1301 DEAN F CTIOIy�O• ) 91�a.O�lOfi RASER 4556 RT 28 COTUIT,MA 02635 , AdudWstrator ... Not valid Without signature .............®:.::A:::.�:::ii:•ii:�:iiii':::;:.:;.i;i::::::::;::j:i:::::i::i:;*:i-::i:::::i':::::::::i': }:::::::::::!:::i:;::i:::::!,::::i::::::i:::::t:::::::i::iii:::::::i::::ii::i::::::i%::::::iii:::i:iiii ii::i:::..:4iii:i:?:Y:ii:;i.i::'::::::::.�::::::::::................... :. N!W�©��� I l -:}:. .. :,.iii :� ::�....�n .::i n v: .. ::..:.....:::::n�.�::::::::ii}i::::::::::::::::n;.;':::::::::::.�.4i::•.:�...:.::!pi::::::::.... �::::.:::::v.�:::::.:::::::::.: .........:.::::::::...........�:::.::...::::::.:....:::.:::::::::::......:.:::::-........:: .:.�: :. PRonuarER THIS CERTIFICATE IS ISSUED AS A MATTER OF IINFORMATIOH OHLV AHD CONFERS NO RIGHTS UPON THE CERTIFICATE WISE & QUINN INS AGCY 449 HOLDER. THIS CERTIFICATE DOES HOT AMEND, EXTEND OR., PLEASANT ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BROCKTON MA 02301 COMPANIES AFFORDING COVERAGE 24WC8 COMPANY A INSURED HARTFORD UNDERWRITERS INSURANCE COMPANY COMPANY FRASER CONSTRUCTION CO B PO BOX 1845 COTUIT MA 02635 COMPANY C COMPANY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY O ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, IOD EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Co LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY FJIPIRATION DATE(MMWD\YV) DATE(MMWD\YY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ CLAIMS MADE El OCCUR. PRODUCTS-COMP/OP AGG. $ - OWNER'S&CONTRACTOR'S PROT. PERSONAL&ADV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Any one flre) $ AUTOMOBILE LIABILITY MED.EXPENSE(Any one person) $ ANY AUTO COMBINED SINGLE $ ALL OWNED AUTOS LIMIT SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Par Person) $ • NON-OWNED AUTOS BODILY INJURY (ParAccldent) $ PROPERTY DAMAGE $ GARAGE LIABILITY • ANY AUTO AUTO ONLY-EA ACCIDENT_ $ * OTHER THAN AUTO ONLY: EACH ACCIDENT :$:::;: EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ A WORKER'S COMPENSATION AND EMPLOYER'S LIABILITY (LIB-794X619-1-06) 09-26-06 09-26-07 STATUTORY UMITS THE PROPRIETOR/ � EACH ACCIDENT -•$---••••- PARTNERS/EXECUTIVE X INCL OFFICERS ARE: EXCL DISEASE-POUCY UMIT $ OTHER DISEASE-EACH EMPLOYEE $ 500 000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER -:>:->..::�$:FIX :`.F�::Q>�#�. .��I:•.�.�::::::.;:.;::::::::.:::::.::::::.�::::::::.;:;.;:.;::::::.�:::::::-;:.:.;;':::::::::::;::.::::;:::.�:.�:::::::::.:::................ AFFECTING WORKERS..-.:.:::::;::;•:.�:::::.�::::.::::;•::::�.:._:::;•:::::::.�:::::.;'::::::::.:::.�:.;:.,:.:::::::::.:.�:.;':::::::::.::::::;;•:::::::::::.:.�::::::.�::::.�::.�:: - : ......:.:.;.:..:..::.::.:::::::..................... RS COMP COVERAGE. HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEU ED BEFORE THE I EXPIRATION DATE THEREOF, TIDE ISSUING COMPANY WILL ENDEAVOR TO MAIL ERASER CONSTRUCTION 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE PO BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR I COTUIT MA 02635 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE w::::� '.�r§QM2�:. ':..�::.�:::�::.�.�._:.iii•.�:.::�.�::::::::.}:::::::::n�::•i}::•::::._.�::.�::^i;::.�::.�.�::::.�:::.�:::::::•.:::v;4ii;v:::::::.::::::.................... �............::::::::n�.�i;:v:::::::::::::::ii:�:::::::::.:�iiY:•.:�::.�::::::iy:.�::.:.�:n:�::;::::::::::::•::::::iii;:::::•:.�:::Lii;•.�.�:::.�::::::}:ii::::.: ..:::::::::::::::::.:i'.;:.:::::::::::::::. ...... r 7.. .... llr c�J T � � Q ...Ash ,map and lot. number .. .. ... ...._.... ...... .J \ I-NCE Sewage Permit number .........` .7�.. ......................... NiQ dTQM, r J y0F7MET��� TOWN OF BARNSTABLE i SAUSTADLE, i MASS. b a M BUILDING INSPECTOR � aY a' APPLICATION FOR PERMIT TO ......... ... �. ............................................. TYPE OF CONSTRUCTION ................. ..................... ....... ........ .............19�1��. l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit .according to the following information: Location .......... ................ j ProposedUse ................................................... ...`................. ................................................................................................. ZoningDistrict ........... ........................................ ...................Fire District ............................... / ffZ' � � � �,��f�ddress .....�.�...���`C .. ... .,�"./..,,tc� Nameof Owner ... ........................`�..........f.............. � ... .................... Name of Builder / ......Address Cr��!(,✓� r2�ffl'L LAB--....... ..... Name of Architect .......... 1. .. . ...... ...Address .................................................................................... c Number of Rooms ................ .............................................Foundation "rJf� f .............................................................................. �0 L Exlerior //,, ��! �+.—,o- ....Roofing ' ��� Floors .�.. .......................................................Interior ............./.. �S...... �.. ..... ........../...... . Heating ...... �' .�..��r ..Plumbing .................................................................................. Fireplace .................................................................................Approximate Cost ...........2"... 'L`. ........................... Definitive Plan Approved b Planning Board -------------------_-----------19________. Area .0 ��4 S Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �L B �'ro I hereby agree to conform to all the Rules and Regulations T of Barnstable regarding the above construction. ! ........ .. ..' ............... Dedecko, Anthony W. n ' 1 ...... Permit for two stor . . sf ngl.e family dwel.ling ......... ..... ..................................................... SO Location T' Maple Avenue ........................ - ................... Centerville " Owner ...........Anthony W. Dedecko ................................................ t Type of Construction frame 4 YP .......................................... , 2 A #4 it Plot ............................ Lot ................................ S Permit Granted November 4 19 74 Date of Inspection . ............. �" Date Completed ... �•,f�p 1 PERMIT REFUSED r _ r ................................................................ 19 ............................................................................... or ......................................... .... .................. ..... .......... r 1 ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... p- 0 QN SyG7l+�'.ii✓'G� �'.E���.2.:.�G.-' i��,�e�G.�"E f� csrr� , ' ��/7,/,�•��A�c/,+ i rv/ auxLZA � Valle 2...�0 /' /'CC%/�' N�`"",--"'�` f /tr'�C��G`"/�Tr Cam• r ylr✓/''"/��OI��r �o70 7 FEE ac T17WN OF BARNSTABLE, MASS. V 'Vc is .� wgpp THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED T6 ao4 (D Oq ° c �v = O .............................................................................................................................................................................. / ...._......._............................................................................._..... cis 0� (PROPERTY OWNER) (ADDRESS) SR.a TO ...........................................................................................__........................._.____.__.................................................................................................................................................. N ,. S'O (BUILD) (ALTER) (REPAIR) CD'Q a O O (TYPE OF BUILDING) (APPROXIMATE SIZE) ►d o ,p LOCATION ......_....._.._......................._......_.._.._...._..................................._..._ ............................................................................................._......_...... V d (STREET AND NUMBER) (VILLAGE) NAME OF BUILDER O R CONTRACTOR _ ...._ _..___._.. _..........._........_...__....._._...._...._._..................__........... 004 r._. APPROXIMATE COST -. -....._...._.....6�� ....._._...._._ ......................................__.... _.... .._._------ _._...___---------------- .._._..._.._ d to cis I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN °F OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION. m oM 0 . p.. b d cg h (OWNER) (CONTRACTOR) o ~O U w tU 9 BUILDING INSPECTOR Subject to Approval of Board of Health. r k2 r r• J 27