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HomeMy WebLinkAbout0077 OLD POST ROAD (CENT.) J 0 Town of Barnstable THE rp� Regulatory Services Thomas F. Geiler,Director * uxxsr�at.e, - XAS& Building Division .1639 .� g �rFo► 'r Tom Perry,Building Commissioner / �i2Jl�Ax 200 Mairi Street, Hyannis,MA 02601 www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623( PERMIT# 0 VlpCPFEE j�-- SHED REGISTRATION 120 square feet or less zoew � (' C VT6 Location of shed address) Village �`? `7 ( �`J n v tom. 0 �o r�c�-: 5"�� -6Z 3 7 Property owner's name Telephone number I � xl Size of Shed lv�ap/ arcel# 12-- 6 Signature Date Hyannis Main Street Waterfront Historic District?' Old Icing's;Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:004:30 &3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY:BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS, THIS FORM.MU.ST BE ACCOMPANIED BY A : PLOT PLAN Q-forms-shedreg REV:042506 . : • :9 9 ,,. to=:r► •, ; r .col 0 — � r t Q S� �K ' ��y ,ter• - '7 2 .7C? •lob 27.32 ' :dA72 pL .D PAST ibis is a mortgage loan inspection survey for mortgagE IIJCAT m: 77 old Post- Road , Centerville Ma. SCAIE' 1 inc DATE: July 10 , 1984 APPLICANT: Edward L . & Susan R. DEED I hereby certify that the existing structures Barnstab] shown on this plan are situated on the lot Creed Book and are in comliance with the pia„ Amk T®wn ®f Barnstable Permit,# �oaCo3D Expires 6 months from issue date Regulatory Services Fee rZ, Rv Thomas F.Geiler,lDirector, Building Division X-PRESS PERMIT Torn Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 MAY 1 8 2006 . www.town.barnstable.ma.us Office: 508-862-4038 TOWN OfeBA NAME EXPRESS PERMIT APPLICATION - RESIIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number7edentjaI � i?6 ttAddress ( d :os� —L Inl � I Value of Work ( �j- Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address � � �� . Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) T ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ 1261 the Homeowner (have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# �� 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 6pur ❑Re-roof(not stripping. Going over existing layers of roof) Videlacement 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: Property Owner must sign Property Owner Letter of Permission. H Imp e t Contractors License is required. SIGNATURE. Q:Forms:expmtrg Revise071405 The Commonwealth ofMassachusetts Department of Industrial Accidents V Office of Investigations 600 Washington Street Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l Please Print Legibly Name (Business/organizationadividual): i Address: Phone#: City/State/Zip: rfz� 1 Are yKamAla employer? Check the*appropriate bog; Type of project(required): 1, employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (fall and/or -time).* have hired the sub-co=actors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.# Remodeling ship and have no employees These sub-contractors bane 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. g, ❑ Building addition [No workers'c=ip.insurance• 5. ❑ We are a corporation and its required,] officers have exercised their 10.❑ Electrical repairs or additions 11. Plumbin repairs or additions ri t of exemption per MGL ❑ g 3.❑ I am a homeowner doing all work � ,� �P P � g myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ of repairs insurance required.] t . employees. [No workers' 115ZOther ( I)'j comp.insurance required.] *Any applicant that checks box#l must also fill out the section below showing their workers'compensation policyinfon=tioa.' t Homeowners who submit this affidavit indicating they are doing all work aadffien hire outside coatmctors must submit anew affidavit indicating such =Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp,policy infbsnoation. 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.Lie.#: � � Expiration Date: Job Site Address: r)0 PAt tom' City/State/Zip: f� 17�,f, '1631 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 a. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.90 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fare 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. 1 do hereby certi un a he p s d penalties of perjury that the information provided above is true and correct: Si a Date: Phone* Official use only. Do not fvrite in this area,to be completed by city or town official. City or Town- Permit/License# Issuing Authority (circle one): 1.Board of stealth 2.Building Department I City/Town own Clerk 4.Electrical inspector 5.Plnrr bing Inspector 6. Gther Contact Person: phone#: i-n.iorrnaza®n anu instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, . express or implied,.oral or written." An employer is defined as-"an individual,parmeiship, association, coipo lion or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal rep sentatives of a deceased employer, or the . receiver or trustee of an individual,partnership, association or other legal tity, employing employees. However the owner of a dwelling house h ' g not more than three apartments and who esides therein, or the occupant of the dwelling house of another w o employs persons to do maintenance, cons On or repair work on such dwelling house or on the grounds or building purtenant thereto shall not because of such mployment be deemed to be an employer." MGL chapter 152, §25C(6)also s es that"every state or local licensing envy shall vYitlihold the issuance or renewal of a license or permit too crate a business or to constrict bu dings in the commonwealth for any applicant who has not produced ace table evidence.of compliance the insurance coverage required." Additionally,MGL chapter 152, cc states"Neither the eommonwe th nor any of its political subdivisions shall enter into any contract for the perfomianc of public work until accep a evidence of compliance with the insurance regl�ements of this chapter have been pies ted to the contracting an 'ty", Appl icants Please fill out the workers'compensation affidavit mpletely,by c clog the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address ) and phone umbers) along with their certificate(s) of insurance. Limited Liability Companies.(LLC)or L' Liability artnerships(LLP)with no employees other than the members or partners, are not required to carry workers' mpensa ' n insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this a it may a submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be nre. sign and date the affidavit. The-affidavit should be returned to the city or town that the application for the p 't license is being requested;not the Department of . Industrial Accidents. Should you have any questions regardin law or if you are required to obtain a workers' compensation policy,please call the Department at the number below. Self-insured companies should Mer their self-insurance license number on-the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibJon The D artment has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of Iigations to contact you regarding the applicant - Please be sure to fill in the perr*11icense number which willsed as a r rence number. In addition,an applicant that mist submit multiple peimMicens a applications in any year,need y submit one affidavit indicating current policy information(if necessary)and under"Job.Site Address"the applicant sh d write"all locations in (city or town)."A copy of the affidavit that has been of5cially stamp d or marked by the 'ty or town may be provided to the applicant as proof that•a valid affidavit is on file for future p its or licenses. A n w affidavit must be filled out each ' year.Where a home owner or citizen is obtaining a license o permit notrelated to business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person ' NOT required to compl a this affidavit. The Office of Investigations would hike to thank you in ad ante for your cooperation should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. ` 617-727-4900 ext 406 os 1-o77-MASSAFE Fay#617-727-7749 Revised 5-26-05 Wd4 W.Mass.crov/dia °ftME T , Town of Barnstable Regulatory Services MASS Thomas F.Geller,Director TEo �9. Building]Division. A f Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barustable..ma.us office: 508-862-403 8 Fax: 508-790-6230 • Property Owner bust Complete and Sign This Section. If Using ABuilder I, FLA6JRe-A61,2L ,as Owner of the subject property hereby authorize _ ��{� to act on my behalf, in all matters relative to work authorized by this building permit application for: 41 -n rl k (Address of job) k G,■ 1��� Signature of Owner Dat Print flame Q:FORMS:oWNERPERMISSION I ' f • it 1 i 063-A-04 4 07-75 GH MC T Azgcn/Low E SC �..._� u�ndt�+a cea�id d� ® `ati th Grid 1-800-746-6686 RES 97 ENERGY PERFORMANCE RATINGS U-Factor(U.SJI-P) Solar Heat Gain Coefficient • 0 . 35 0 . 26 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 . 43 . 1ltrrdafa w ftubw dial mew ra ry moon to axombte URIC pmcmm thr derarmwN whole . Pin Prltxeuuree.NfiiC ratln4e are daterminad Ibr a triad eK at envhanmenbl carbMlarr and a . eperJlk Product etra.Careurt merwfac0aafe uteaDue for arherproduct perhrnwia Udormanon. www.nfre.arq I" EAEA6�'SERA uuit qualifies for Lnergp star Aegion(sI: Noctheco, Macth •' Central, South Central, 1., Southern f; 3ND: RUN CUCLASS D8/H-A25 DP: +2 5/-2 5 f._ t ze9c sise- 4e x 60 Order 0:3885118090001 50375 HS e ✓Ae ew.,n aeaaa o1,Awada%;,ll4 4 Burd of Building Re;ulrtiuns rud }TOME IMPROVEMENT CONTRACTCtr F. Registration 126893 I Exprratforr -�1312006 rvIT Supplement Card I .. THE Home Depot At,1400t,Sauve RICHARD FALLONE: - 3200 COBB GALL5KII 4KLIIY>•`20 . _p ALTANTA,GA 30339 �= MARS H—i �' r idbR Ff ATE �F INSURANCE' CERTIFICATE NUMBER _ :::.• ATL-00091 5 90 7-1 1 PROOUCER •�� « THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS MARSH USA,INC. , NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE ATTN:BRENDA BOOKER (404)995-2594 POLICY.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE MAYA MCCLURE(404)995-3206 OR AFFORDED BY THE POLICIES DESCRIBED HEREIN. TANII ROUSE(404)995-3430 FAX(404)760-5663 COMPANIES AFFORDING COVERAGE 3475 PIEDMONT ROAD,SUITE 1200 ATLANTA,GA 303135 COMPANY 10C492-IPUSA-GWA-03/04 A STEADF,',-S T INSURANCE COMPANY iNSUREJ CCMPANY - THD AT-HOME 6::?VICES INC. 8 ZURICH A,'vi=FICAN&;"�JRANCE Cf_'.MPA?,IY DBA THE HOME GE?CT AT-HCME SERVICES,INIC. — --- H04IE DEPOT US".. INC. ccn,l av 2455 PACES= „t.`.'ROAD N4l C NE'V1 'A4IFSHIPE INS ;CNIPANY BUILDING -3 --- — - - ATLANTA,GA 3C31./ i CCMF.�,r 0 --ANTE RICAN 1-101,riF ASSURANCE CO(..,PANY-------... - Ci0VER::.GES This`ceri, -atesupersp es and,�eplace&any pre�i:5usly pssued r;ificate` ,the p-licy period nc' d below 3 THIS :S TO CERTIFY THA7 CLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INS,RED NAME-' HEREIN FOR THE PCU Y PERIOD INDICATE NCT;V:THSTANDING ANY REE':.JIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE.MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN ISSUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDDIYY) DATE(MMIDDIYY) A GENERAL LIABILITY IPR 3757 608-01 03/01/06 03/01/07 GENERAL AGGREGATE $ 4,000,000 X COMMERCIAL GENERAL LIABILITY 'LIMITS OF POLICY ARE EXCESS' PRODUCTS-COMP/OP AGG $ 4.000,000 CLAIMS MADE a OCCUR 'OF SIR:$1,000,000 PER OCC PERSONAL&ADV INJURY $ 4,000,000 OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE $ 4,000,000 FIRE DAMAGE(Anyone fire) $ 1.000,000 MED EXP(Any one person) $ EXCLUDED B AUTOMOBILE LIABILITY BAP 2938863-03 AOS 03/01/06 03/01/07 COMBINED SINGLE LIMIT- $ 1,000,000 X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OW NED AUTOS ` X ELF-INSURED AUTO PROPERTY DAMAGE $ PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY sk• < ,L' EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ G WORKERS COMPENSATION AND 6610998(AZ,ID,MD,VA) WC STATU. 03/01/06 03/01/07 X TORY LIM TS ER s „, ti� -,; EMPLOYERS'LIABILITY C 6610995(ADS) 03/01/06 03/01/07 EL EACH ACCIDENT $ 1.000,000 G THE PROPRIETOR/ X INCL 6611326(OR) 03/01/06 03/01/07 EL DISEASE-POLICY LIMIT Is 1.000,000 PARTNERS/EXECUTIVE 6610999 NY,WI E OFFICERS ARE: EXCL ( ) 03/01/06 03/01/07 EL DISEASE-EACH EMPLOYEE $ 1,000.000 OTHER WORKERS E COMPENSATION CONTINUED 6610997(FL). 03/01/06 03/01/07 D 6610996(CA) 03/01/06 03/01/07 DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLESISPECIAL ITEMS CERTIFICATE HQLpERr, ' z� t' i' CANCELLATI(1N . -H:;co:-�:, .,.z.....:_>....,.. .:..'�.r.4....,.aw-,ar.�..r,.•�._:k'r ac,.�,r.,.._i:,;r _:�...�...�M.ts&.. .cw.�..ter,. �.,.,,�.a�:.<..�..o,,..:��: .`i.�M,.u„_�sc�z,_.:� ..a..».<.."�r's,�a"��,.>`�.' -.�...__..t.u.4,s__:u�...�'�. .�.: SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. ' THE INSURER AFFORDING,COVERAGE WILL ENDEAVOR TO MAIL '1(1 DAYS WRITTEN NOTICE TO THE FOR INSURANCE PURPOSES ONLY • CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR • LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES,OR THE ' ISSUER OF THIS CERTIFICATE. MARSH USA INC. BY: Walter Gilstrap7 .. it . 44 r R MM1(3lC2� Y ;. ` ° VALID AS OF 02/27/06 M- a [� WINDOW SPECIFICATION SHEET - Spec.Sheet#: �r���� /10 Sheet: f 1 I,� Date: 1S b 1Iv Customer: Job#: 710 1- Consultant: r' Y CA a o i °) Existing Window New Window Measurements Grids Pattern' Pattern'.2 Pattern'•z_ Window Hinge Locations' N MISC. c c c &GIaSB Csmt,CPC,Bay,Bow, Rough Opening o c W 4 m Items � Q g Options Patio 6 Garden Doors 8 'I c Oder "Code" (from outside,Lt to Rt) Location Style Meta Style Series c � e g $ 'rC "c fV (Room/Floor) "Code" YIN "Cade" "Code" 0 Width Height UI p J 2 � ( p, I 5C 2 D i.v► Imo+ SoV 1J �� 3 PjNlnl(7- 4 f A 5C— Or 6,6 Ct T[T Color of Grid Pattern and Location MUST be indicated. Window/Door Wraps v�'f'l v� z r mulled windows require multiple grid patterns,indicate location and pattern in the additional spaces provided. _ If single window o Q a - as g �. r 3 For Csmts,CPC.Bay or Bow,use"U,"R",or-S"(Stationary).For Patio&Garden Doors,use"S"(Stationary)or'X"(Operating). (ti�T (,I L BAY/B_OW WINDOW GARDEN WINDOWSLJ Top of Window,to Soffit(inches) I WALL THICKNESS (inches) Projection Angle:(Bay:30`or 45') fV 0 SEATBOARD MATERIAL Bay Window Flankers-DH/Csmt. I Width of Overhang(inches) i o Seatboard Material-Birch or Oak If tied to Soffit,color of Soffit material Specify birch or Oak Veneer or White Pionite New Interior Casino(BavfBowlGarden/Patio Doors) Construct Roof,(Yes/No) � 'Additional charge for wall thickness of 6'or more. Clamshelf(CL)or Colonial(CC) 3 There is no guarantee that new shingles will match existing color. �----� I have reviewed and agree with all of the SPECIAL CONSIDERATIO T��e � job specifications described above. / •� Customer Signature Date 5-4-03 SFC-W ' �"E : The Town of Barnstable • BAFXffAl=MAM 1 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION 6LyD POST 23 C'GAl-7"CRVt(rC t_ Location of shed(address) Village F—D0o.,t9 krcotf&. ocNl�•2` '77,/ - �? 3 7 Property owner's name + Telephone number 10 x Cv '901 t.of Size of Shed Map/Parcel# Signature 4- W Date�`Lv G-`e R6 Hyannis Main Street Waterfront Historic District? �i O Old King's Highway Historic District Commission jurisdiction? (� Conservation Commission(signature required) r THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg �t I N - O 4 4 yti • \�, o � � ��y fir`• r ?T !fit i pL ,� SST Zhis is a mortgage loan inspection survey for mortgage p L CATICN: 77 Old Post Road ,- Centerville , Ma . SCAIE: 1 inch DATE: July 10 , 1984 APPLICANT: Edward L . & Susan R. P DEED AN I hereby certify that the existing structures Barnstable shown on this plan are situated on the lot ` Hook =, l fi des i with£°the ' ted and are in ccwpance' ` Plan Book The Town of Barnstable Department of Health, Safety and Environmental Services Building Division MAM 039.�A`0� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: Name: J 2 7-IY�a y, t—e �l�ev,^. Phone#: '&n—9 g S—u'7 7 v Address: Village: CV,71*r"//e 0 Z.63 L Type of Business: Map/Lot: Z-0 9 /A 1 INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: 6Q� Date: V 16 91 Homeoc.doc A/O 6-41ZEJ44,e c��2irC/1�E�Z Z?32 ' /Ao Lsc-�rrc 774AA� t/So _ 95 G)oL� S1Aerc/A44 A.t2o4 = /$D Ste" 74)T4Z IL 6A.I. .rr 06,::l PC> �3 t a TbT,GJ� �AiG Zott/ - 330 Z..PV EXp t ��f •` 2 A�•� `+ice.-fAAI) �G '.`�j H. ,e 1 ra; fort � � in• LOAN /,O f PiPE /Cf7 �' Se�FKoi[. 9Z•o e�Ql. lW� /N✓. ��G 47 /,V✓ LuN 92.2s� saprk. 94?y 950 90.-o TErr 7;4 A/K �p WPrT f1 �/ Sfi7MF l SA a Bc3TTOd� ,54: 8G ez.a C E Z T I I=I EU no -c©l LaCATlot-.i /r_N1L2�✓1LLC- -ci't > Sri= 40 �A�r� -7 CERTIP-Y T"Ar TNT qv&izw4TtoQ 1514cwQ1 PtQ.�t. R�F'clZc►.1C. _- 4-i Eai�1 CCWkPL'-(S W ITN TWG St�� LI►�� ���� 5C-T�3ACtG 'EQU1QE�tit�+-ITS aF 't'�-+ i-'� 'Zo W U o�= - i�FrGtS n=1��� L.-Al�lp Suev�YoiZS IS Q ur A&.i k t 4,57re ji AA c--i,.iT 5vszve=Y j T1•IG-- oP—v: ,ITS ;IAccwlr-> Al�t�t_t C-A'""r- t-�r ECG- U,->C-a ru bt-TCeMieli=• L >-r LlWeS I Assessor's map and lot nu�_r .1. 1 l 4�'1.. � l ` � r � � 7 SEPTIC SYSTEM MUST BE L�,/ INSTAL J Sewa e. Permit number .F 7............................ _� 9 IN COMPLIANCE µr gT, WITH ARTICLE 11 STATE Dr D TOW" TOWN OF BARNST A� � n 2"13TdDb i 39. BU'I,LDIHG : INSPECTOR APPLICATION FOR PERMIT_J-0 ....... ........................................................... TYPE OF CONSTRUCTION .........:: ...... ...................l .Co.. ............................................... ...... .l�...... ...............19�.'.. TO THE INSPECTOR OF BUILDINGS: - -_ "'`-The unders1Wd-hereby-' applies for a permit according t he foil o i►�gg information: v c9�� Location ............. -.....:..............:......:............................................................................ Proposed Use .......... ........ ......................... ZoningDistrict .... ........ .......... ......................Fire District ................................... ........................................ Name of Owner .........................................:........Address ...( . .�.�.. .... ... V km �1 _L Name of Builder . ! - .. .. .. ,• Address .3 ............................. .......... Nameof Architect ..................................................................Address ..................................................................................... lbCf Number of Rooms .. j' ........................................... ....Foundation Exterior .4 �� ...1e .. ... . ............................................................Roofing .. ....... ................... ................:................................... Floors ....e !....` ...... Interior.......... .... ................................. Heating Plumbing ..... .....:........................... Fireplace ........ ........................................................ .........Approximate Cost ZY..... 41... .�........ p Definitive Plan Approved by Planning Board -----------__ :------19---� . Area ............. Diagram of Lot and Building with Dimensions Fee 9s. s....... SUBJECT TO APPROVAL OF BOARD OF HEALTH t-a M /Jv 33 2LF `f /.3 q S FS I hereby agree to conform to all the Rules and Regulations of the Tow a Barnsta# regarding the above construction. Name.................... ................................... ................... Coletti, Guy 19419 -- one story Na ..... .FPermii.for. .. ................................ ` single "family dwelling _2 ..................... �: t Old µPostA ad.... ...... �. .......... ,: x " , Location Centerville U .... .... .. ......... ....................i.................... Owner Guy..Coletti......... frame. Type of Construction r Yp �. F . ................................... t Plot ................� .... Lot ......... 2....:........ . - July 22 Permit Granted ......... .. .........................19 77 a, f Date:of Inspection v/p/� !... 7.1... .....:19 x Date Completed ...`I✓.� 7J...... .....19 r R_PERMIT :REFUSED ........................................t~ ..:....... 19 - . ........................ ... ....... ................................ ............................`........ ........... ................. - ' i .......................................................... .............. .i Approved .......................................... ..... 19 .......... . ............................................ .............