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HomeMy WebLinkAbout0041 MERIDETH WAY ~ � � �/ /'fie��`��� � - - _ � _ _ I o 9 �� C I DEPT. Application number /....,(...`.,l�� ...<<.. .....q: .,........ DEC 2 3 2019 Fee...........................r�, 1>AxxsrAo�t„ a+Ass. $ Building Inspectors Initials.: ., 16)9. ,0 RNSTABLE j Jj i�phyp TOWN OF.BA Date Issued.....J/,�(.......... Map/Parce1..:...,:;26..1..::.".,,o3,3...:.:.:...:... i TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATI-IERIZATION PROPERTY INFORMATION Address ofProject. / 4*ff 1, .NUMBER STREET VILLAG)? Owner's Name:. �, "'?�2�, ,, t PhoneNuinber e4o 5yl_ Email Adiiress: Cell Phone Number Project cost$ Cleck ogre Residential y Commercial OWNER'S:AUTHORIZATION As owner of the above"property thereby autborize o.make,application for a bui)dii%.permit in accordance 71 8,1 0 CMR 1. Owner Signature: Date: ' TYPE OF WORK. ,l e. . Siding Windows(no header change)# O Insulation/Weatheriation D Doors(no header change)# Cpaunercial boms rer uim,on hispecto.,Is)-eViesp g E�oof(not applying.more than l layer of shingles) 1 Construction Debris will be.going to.---�C ., i CONTRACTOR'S INT.ORMATION Contractors name_ I4o,ne Improveln.ent Contractors Registration(if applicable)#. attach co t. Construction Supervisor's License# ? �a2 (attach copy) Email of Contractor } &,µ Phone number ALL PROPERTIESTNAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A'P'ERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached..Provide a site plan with the location (s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date y i APPLICANT'S SIGNATURE Signature Date l M /1-7 All permit applications are subject to a building official's approval prior to issuance. t 3 AC�® DATE(MMIDDNYYY) CERTIFICATE OF LIABILITY INSURANCE '04/01/2019 THIS CERTIFICATE IS ISSUED AS A M.TTER 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 t the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to he certificate holder in lieu of such endorsements. PRODUCER CONTACT Jen Davis Mark Sylvia Insurance Agency,LLC PHONE 508 957-2125 FAX e: 508 957-2781 404 Main Street EMAIL ADDRESS* mark@marksylviainsurance.com INSURERS AFFORDING COVERAGE NAIC M Centerville MA INSURERA: Farm Family Casualty Insurance INSURED INSURER B: Complete Home Group LLC d a Hostetter Homes INSURER C: 770 B1 Main Street INSURERD: Osterville,MA 02655 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 PQLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE A OILSUBI POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 RENTED CLAIMS-MADE �OCCUR PREMI E DAAGET Ea occurrence $ 100,000 MED EXP(Any oneperson) $.5,000 A 14 N 2001 L6914 12/4/2019 12/4/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY JECT PRO ❑LOC PRODUCTS-COMPIOPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED X 'SCHEDULED N 200105913 2/11/2019 2/11/2020 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED perOacaideTMrrDAMAGE $ AUTOS ONLY AUTOS ONLY $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ REXCESS UAB CLAIMS-0AADE AGGREGATE $ D RETENTION $ WORKERS COMPENSATION X ST TUTE ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBER EXCLUDED? � N A N 2001 W8025 3/23/2019 3/23/2020(Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(ACORD 101.Additional Remarks Schedule,may be attached If more apace Is required) General Contractor Insurance coverage is limited to the terms, nditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived or xtended the coverage provided by the policy provisions. . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of BarnstableACCORDANCE WITH THE POLICY PROVISIONS. Building Department 200 Main Street AUTHORIZED REPRESENTATIVE..,,.,;,.,; Hyannis MA 02601 Fax:5087906230 Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26(2,016103) The ACORD name and logo are registered marks of ACORD f -- -- — The-Commonwealth_of-Massachusetts— Deparbnent of Indushial Accidents Office of Investigations. h 600 Washington Street Boston,MA 02111 . www.mass.gov/dia Workers' Compensation Tnsnrance Affidavit: Builders/Contractors/Electricians/Plumbers -A-pplicant Information Please Print Le 'blv Name (Business/Oronanization/IndMduai): evi 7 Address: City/State/Zip:j�2W)' ✓ Z Phone #: Are yo n employer? Check the.appropriate box: Type of project(required): 1. I am a employer with /L 4. [] I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 am a sole proprietor or partner- + listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, Q Demolition working for me in any capacity. employees and have workers' [No workers'comp. insurance comp, insurance.# 9: 0 Building addition required.] 5. We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12:7 Roof repair; insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.0 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. lContractors 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 oli number. I am an employer that is providin;workers'compensation insurance for my employees. Below is the policy and job site + information Insurance Company Name: Policy 4 or Self-ins. Lic,tt:_Z-op� w�ZS' Expiration Date: A&C. Job Site address: ,4 City/State/Zip:eo!1&i, l . ,LA 42652 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 tine up to S 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 S250.00 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 un the pains and penalties of perjury that the information provided above is true and correct Simtature: Date: )Z I ahone 9. Official use only. Do not write in this area, to be completed by city or town official City or ToRn: Permit/License n Issuing Authority'(circle one): 1. Board of Health 2. Building Department 3. Ciiy/Town Clerk 4.Electrical Inspector 5.Plumbing In j 6, Other Contact Person: I Phone r: CJ��n,��r�zoneir.cuecc�/�n��C-;•��xJscc<�ccdn•Clti Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:LLC before the expiration date. If found return to: &SLgratim"., Expiration Office of Consumer Affairs and Business Regulation 178455 +:04/15/2020 one Ashburton Plac -Suite 1301 THE COMPLETE iH6ME GROUP.11-C Boston,MA 0210 c - t ADAM HOSTETTER �2 C — no MAIN sT N t valid without signature OSTERVILLE,MA 02655 Undersecretary e _ F. �..'� `-.�& . rt�^= y .� "`� .,ii,� -•�,.�i�"�,».nsun. '"7"�'S -t r><-=: `' R+ .��L., ae }4'* w � 1 +. , v � i � -' '''� a. r -' -�� ..\���.�'. .�.�j'F 3n !" ♦� i< a' -'n 4t'�•N't���! 1`.... A � 1Y� '� t`k�.:v�i�rfu�.� �`,�+3, � Z S aekc •`�.R, - e��� ', j�3("`�. - �- u.,. � �F'H 2 N�s'3 +;,:. ar�.u, ..�-..,a„ s � �;? 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Tom,.:�{�t'- ``f ..:.ti,<r' :5�. _ ^'a R`7. .- gP,..r _ ..!� t ';rJ t }�i"�i• ,�r( ar't - ,i,rx k'1���:>f��.,�.n-'�-ur �'p?z� ��*-:'���� r7`��Q�aWt�fa4 �z, s��'� i„`'��'��Tr fx �' F3 a^�, � ��. •r'§ ? r>:aa*�..a uw s. i .•f-����, p x„� i y L*F W. i I Commonwealth of Massachusetts Division of professional and Standards Board of Building Reg Construct!6 SuPewisor Expires: 1212212019 CS-094302W. ADAM HOSTETTER 170B1 MAIN$T OSTERVILLE MA:02655 Comm '� z E L `v s7 t � rx^e. d w �i 'r- i :.5 +: ' tz'+•�< 44 s- "� % F' ;"j r- .. ... .n:... .... -.- .r.:-..- .. •. a 1. -.x..:;.-: ... .,...,. ,... -. ...<,-..;. _t.::.:,:r,. E c• 't '.e Y a.,- ..r•s,,.:'>.�" a�..'..r.,:,-..try.(( H.r:h.Frsa ,.k,'.,;+,u.';_.,'h7'.. .k..-Y H_... . -.�.,.... a.' _.'i. ,•�-',S.}, ._�.� a,eiy . ,,1.�_, �.�:.. hF xrv.•..:;>Y'+.....qx i'x.. >;�a,. yz::«, .,�a:-:. �.-.. .�:< _,::>:. sue• 4s, ss--. > ,.. ..... .. .. :........." -':.. ,-' _..:. •v,.... m, r.. 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H �' 4 �� K e�"-��Y �'�':�? 1 y &. � Y i.}• Licensee Details Demographic Information Full Name: ADAM HOSTETTER Owner Name: License Address Information City: Centerville State: MA ipcode: 02632 Country: United States License Information License No: CS-094302 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 1/2/2020 Issue Date: 12/22/2011 Expiration Date: 12/22/2021 License Status: Active Today's Date: 1/6/2020 Secondary License Type: Doing Business As: Status Change Reason: License Renewal Prerequisite Information No Prerequisite Information No Available Documents Zttps://madpl.mylicense.comNerification/Details.aspx?result=5de6daal-7849-44e7-a775-cc 1 fbf624845 Town of Barnstable "Permit Ot .0 ro riw4se 6 monthrftom Qrue dace tt awxxer�a►s, _ Regulatory Services I!AN Thomas F.Geiler,Wrector ' Building Division �3t Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 •�RES PERMIT Office; 508-862-4038 - Fax; 508-790-6230 AUG 15 200 EXPRESS PERMIT APPLICATION - RESYDENTUL ONLY Not vdia without Red x Preps r tprint TOWN OF Bi NSTi4EL Map/parcel Number Property Address Y`l C . �c d (!Residential Value of Work Owner's Name&Address Ft) r6qS-LF/?L 111.?f q/ wccu CIa(03�( Contractor's Narrte,^C Gl�1 .� �G.Z-a,o_ Tclepbone Nui ber 5 0 9) �-A�,c�"1\-i—7 Home improvement Contractor License#(if applicable). Construction Supervisor's License#(if applicable) 0 Qlcp 5Workm2n's Compensation Insurance Check one; ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Inauaan�c'e^ Insurance Coulpany Name Workman's Comp.Policy# -7 PJ U —q'Q-a-A C 2 VJ 3 - �J02- Permit Request(chock box) ft"p-'e-roof(stripping old shingles) All construction debris will be taken to Q Q,r m o L mA LA N D f l L L- ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Wvodows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this patrmt does not exemyt compliance with other town dt-,tartrnent Mgulatioru,I.e.Iilstonc,Conscrvzdma ,tw. S ignatur Q:Fomns:Mmtrg Raviscd 121901 : ACORD- CERTIFICATE OF LIABILITY INSURANCE ��ATEIMMDO/QYY)�^ �1 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MCShea Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 749 Main street, Suite#m ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 0sterville, Ma. 02655 INSURERS AFFORDING COVERAGE — —� I INSURED paul J Caz•ault & Sons Roofing inc. - +NsuHER A_Western H®xitage Inca. Co. _ I INSURCRo TK&v lArn Indymnitv.. Ca of 1i=1 I 1031 Main Street INsuRERc Ooterville, Ma 02655 INSURER D j 190D-698-5559 INSUHrPF COVERAGES i THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTW Il"HSTANDING 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 _ PULI kY EFFECTIVE L-POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER TE MW E MWDDIYY) DENERAL LIABILITY I _ EACH OCCURP(NCE I I 1,0 0 Q�..4_�(L x COMMERCIAL UtNFRAL LIABILITY I TIRE DAMAGE(Any ono I.,e) CLAIMS MADE I OCCUR I IVIED EXP(My ule Dwwn) S A _ SCP0467325 'Of/30/03 104/30/04 PEHSONALAADVINJURY b" _o001 000 I` GENERAL AGGREGATE�b;2.QOO_,000 I . GEN'L AGGREUAI E LIMIT APPLIES PER'. PRODUCTS GUMY/OPAf,.G £ OOO.OQO_ POLICY El PHECTO LOC J AUTOMOBILE LIABILITY - COMBINED SINOLL LIMIT IEeaccidtrm) S I ANY AUTO ALL OWNED AUTOS FiODILY INJURY - (Per De%Qe ) £ SCHEDULED AU I OS HIRED AUTOS - BODILY INJURY NON,OWNED AUTOS (Pot accidem) % PROPERTY DAMAGE 8 (Per accident) { GARAGE LIABILITY AUTO ONLY-EA ACCIDENT g If ANY AU 10 OTHER THAN EA ACC 3 j' AUTO ONLY. AGG 8 EXCESS LIABILITY LACK OCCURRENCE 8 - OCCUR I I CLAIMS MADE AGGREGATE 8 8 DFDUCTIDLE -8 Ht(FNTION S - R _ WC S WORKERS COMPENSATION AND - }( T RV LIMITS ER _ EMPLOYERS'LIABILITY I 17DJU8-922X653-502 08/10/03 108/10/04 C.L.EACH ACCIDENT� �1100.00Q ._ I B E.L.DISEASC_EAEIAPLOYLE 1' _O.00 E L.DISEASE POI ICY LIMIT S� OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLF6IEXCLUSIONS ADDED BY ENDOR6EMEN71SPECIAL PROVISIONS _ ` I I I CERTIFICATE HOLDER, ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWn Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1:A_ DAYS WRITTEN i - - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE 10 DO SO SHALL { , Barnstable, MA 02630 IMPOSE NO OBLIDATION OR LIABILITY OF ANY KIND ON THE INSURER,ITS AGENTS OR - REP RESENTA 1 3-IN I r _ 508 420 45555 rALITMOR!ZEDR RE T i a ACORD 25-S(7/97) v v 0 ACORD CORPORATION 1988 rtl f li Board of BLIddin<< Ra lolls ai d Stan&rck One Ashburton Pldce - Room 130.1 Boston. Massachusetts 02108 Home Improvement Contlacto' r Registratloil Registration: 10371 Zl Type: Private Corporation Expiration: 7/9/2004 PAUL J. CAZEAULT &SONS, INC. Paul Cazeault P.O. Box 2781 Orleans, MA 02653 Update Address and rchiru card. Nlark1-cason for change. Address I Renewal h:mplo}nient host (':rrd Bo:u d of Building Regulations and Standards License o, tcf ish:Uion valid for inilividul i sc only HOME IMPROVEMENT CONTRACTOR licforc thr cxpiraliun date. If found rcluru io: "-% Registration: 103714 Board of Building Regulations and Standards Expiration: 7/9/2004 One'Ashl,w lon Place Itm 1301 Boston, Illa.02108.• Type: Private Corporation PAUL J.CAZEAULT&SONS, INC. - Paul Cazeault 22 Giddiah Rd. Orleans,MA 02653 Adminisdator I`'lo' BOARD OF BUILDING REGULATIONS H� License: :ONSTRUCTION SUPERVISOR Number CS " 026325 h BijUidate: 10/20/1959 Expires: 10/200003 Tr. nu: 7310 Restrictec: 00 PAUL J CAZEAULT _ 1585 MAIN STD—per OSTERVILLE, MA 026`,5 Administrator- 671 ���� ' i/l�'` -_ r� C���%'V//C/(/"y����L�'."".""'� f Q�L/ �>i.fi:✓'✓[�f/�l/i�u/�(/,1 .. Board ofuildin J Regulations' One Ashburton P ace . Rm 1301 Boston, ;;Ma 02108-1.618 License: CONSTRUCTION SUPERVISOR LICENSE. Birthdate: 10/20/1959 Number: CS 026325 Expires: 10/20/2003 Restricted To: 0.0 PAULJ CAZEAULT 1535 MAIN ST — OSTERVILLE, MA 02655- r Tr. no: 7310 Keep top for receipt and cl range of address notification. Property Owner Must Complete and Sign This Section If Using A Builder lid?. u /ER Z/N4—f , as Owner of the subject property hereby authol7.ze Oil Z e AU L f '2v® Ct tom. to act on my behalf, in all matters relative to work authorized by this bAding permit application for (address of job) i ignature of Owner Date TUPE-s7 o , b4 S f e��L, t)L= Print Name �r TOWN OF BARNSTABLE Permit No. Building Inspector BAMSTAU Cash � ma 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 Davl_di. 11r11st: Address a . 4 Wiring Inspector '"� jf +� Inspection date Plumbing Inspector z 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. ` i ...............................1 19...... ^.......:............ ..:................................_._ Building Inspector Assepsor's_ map and lot :number.. Sewa a Permit number'`C�o�. + �. g .. .. ........... EP SY"T E MUS p� °�q g µkg COMP �- R /p r�.p. AHB9TAD •« `« INS ALLEDIN.'4sO1?�0♦�6�:95a0�P : B LE House .number. ..�........ :.. ........ rb a ... ............ ........ W 9 ./� Vv'�T� TO��.� � -ENVIRONMENTAL CODE AN TO W N*. OF 8 XR N �� A� a��� f s [OUIMING I�HSPECTOR y APPLICATION FOR PERMIT TO Construe#! single family residental ........ wood frame TYPE OF CONSTRUCTION ......... .... ..............:............................................................................................ _ f F.,wbruax ...25 152... TO•THETFNSPECTOR OF BUILDINGS:' The undersigned'hereby applies for a,,permit according to the following information:. Location ..... Lot 1*3 Meredith Way "Crossridge" Centerville Proposed -Use '...........................................single family residental. . .f . Zoning District :..:,s .f.r.. Fire District -Centerville — Ostervil.le David Trust P.O. Box 426, Centerville Name of Owner ...................................:. ...Address ......... ....................................................................... Name of Builder- same Address :Name of Architect .................................................................. Address,.......................................... ................................ : . Number of Rooms six poured concrete Foundation ........ ..... cedar shingles asphalt shingles Exterior ................................................... Roofing .. . . ... ..... .... ... Floors ......• . hardwood Interior , drywall ... .................. g f h.w by oil g P.V.C. .................. Heafm ....... ..Plumbin ....... A Approximate Fireplace ..:....brick & block . pp mate Cost $A4 .!.000. .•.... ..... .... ........ ....... ........ .... . .. . 125ousU Definitive Plan Approved by Planning Board ___________-___________19________. Areo .................................. Diagrani;of Lot and Building with Dimensions Fee 288 garage SUBJ'EC:T 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 . ... .... . . .. .............................. DAVID TRUST 23832 One Story No ..16.............. Permit for .................................... s Single. Family Dwelling R Location „Lot #13. 41 Meredith play Centerville ............................................................................... _ Owner .....David Trust.............................................. + 71 'f Type of Construction .....Frame....................... . r�. y ........... ............................................................ Plot ..`.......................... Lot : . ........................... Permit Granted February 25, 19 82 - T. Date of Inspection .............................I........19 Date Complet d 2,,..-1.9 a 0 F tt>�t.� t=a,Mtl..�! - 3�5r~se�oM s . . , . . , _,,,�i pis f � � • «� Ir tOw tic) V..3 33o .p PDSAL PIT uSE Moo 'GAS. ...,...... zs ALL fin + A �(�lV �EA L 1� ��, t5o sir.. rt 2.S • .f 3�S G .P.U. ,.� i �' t t' ! Y.� r• r . � ,1 om SO�t�t `Aett=ll. 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