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HomeMy WebLinkAbout0190 ROLLING HITCH ROAD .,; a Nt�p��.c�11 to � �,�:c�c��, ~� // 5k {1 +,. IY/ �+5; _. .. d � � .. i M1 '� .. .. ,. a +, +1 �� .. • �' '� .., .�� -.�� �. r • � �� v. � .. - s � _. _ c .. � Q .. m �1 - 0 , F e ¢ .. .. �: Q Rb r Town of Barnstable uilding "" �T:a rt i'sa%�sible�From';the:Street A Post This CardpSo h .., . ._ � ,, . roved Plans�Must bERe#arced on Jo'b an thisCard Musi;be'Kept •--anaxftrA63:B, ,���;� „� � ` �x ,`,, � pp�� ,cf ' �� ,mac, � x ;:� :� �� � ,� �M ,Posted Until-Final„Ins ecti'on HasyBeen Made � �s, �r '` ��;' �u �� Permit R Where a Certificate of>Occu an �s�Re�ured;suchaB.uildmgshal Not be Oecup�ed�urtt�l<aa>Finat Irispect�onahas..been made Permit No. B-18-3001 Applicant Name: Henry Cassidy Approvals Date Issued: 09/12/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/12/2019 Foundation: Location: 190 ROLLING HITCH ROAD,CENTERVILLEMap/Lot: 192 098 Zoning District: RC Sheathing: Owner on Record: CHANE, KATHLEEN M&DAVID E Contractor fume .HENRY E CASSIDY Framing: 1 190 ROLLING HITCH ROAD ContraetorWL CS icense Address: -;100988 m 2 CENTERVILLE, MA 02632 Est Project Cost: $1,045.00 Chimney: Description: Install a FSK air barrier to 1432 sq ft to designated area 4Pe�rm�t Fee: $85.00 Insulation: Fee Paid $85.00 Project Review Req: Basement ceiling area , Final: €r ®ate 9/12/2018- Plumbing/Gas Rough Plumbing: ��' ... ...._ _ Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed%y this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved appl catioWan- the approved construction docume SnAich,this permit has been granted. g All construction,alterations and changes of use of any building and structures shalh in compliance with the local zonmgI y laws-and codes. Final Gas: This permit shall be displayed in a location clearly visible from access s`treetzor d a roand shall be maintained open for$ublic rnspection for the entire duration of the work until the completion of the same. �J Electrical The Certificate of Occupancy will not be issued until all applicable signatures by th i Bwlding and Fire Off cials are prov ed on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work r 3 Rough: 1.Foundation or Footing N 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: - Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable � � .Building i Ie.From- he ree=-�A rovetl::Plans Must be;R,etamed on Jqb andrthis Card�.Must beFKept ;, Post This Card So Thai�t is,yis rr, Posted Until;-Final Ins ection'Has Been Mad - fh` k 4 r_ a _. Permit R uired swch-�Buld�n shall,Notftbe Occ red urit�l a,:Finai Ins ect�on has been made ,. �;�, a� W.here a�Cert�ficate of Occupancy,=�s eq, , , g � p y q P � � , .. . .. :.' �. ....� .7P'. ...yP ..�..,..ca...�.�..,,.._..... . ,,.;�.;<, u. ';� .u' ;:n: �-, s.�H., �4,,,,. ',:' u.-xt,., .e:.0.,�. .✓,,..:.� .r F: � �, ,_. ,.,� �..�ti ,�1s;:.�. x,.�.. ':.....�.c: Permit NO. B-18-1765 Applicant Name: RetroFit Insulation Approvals Current Use: Structure Date Issued: 09/12/2018 Permit Type: Building-Insulation-Residential Expiration Date: 03/12/2019 Foundation: Location: 190 ROLLING HITCH ROAD,CENTERVILLE Map/Lot: 192-098 Zoning District: RC Sheathing: Owner on Record: CRANE,KATHLEEN M&DAVID E y ContractoriName _•RETROFIT INSULATION, INC. Framing: 1 Y Address: 190 ROLLING HITCH ROAD K Cont actor License 160461 2 > w - CENTERVILLE, MA 02632 t e ° _ EstsP�rofect Cost: $1,716.00 Chimney: Description: Install 5" layer Cellulose open attic, Insulate all hatch 2 'Thermax Permit Fee: $85.00 board, Install insulated hose and roof mounted vent to bath fan,Air Insulation: Sealing Fee Paid: $85.00 g Final: u; Date 9/12/2018 111 Project Review Req: Signed installers certificate required to cl sep oermit `ter s (' Wa Llscrv� Plumbing/Gas �� . Rough Plumbing: ... . . Building Official Final Plumbing: Rough Gas: JJ This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents#or which.his permit has been granted. All construction,alterations and changes of use of any building and structures Shall be in compliance with the local zoning by laws pfi codes. �w � ��.. . � � �,� ,. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Service: The Certificate of occupancy will not be issued until all applicable signatures by the Bwldmg and Fire Officials are providedon this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Pe'Ysons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Town of Barnstable R� E4i�-r t3narisrAgt$; ,; ; 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-18-1765 Date Recieved: 6/1/2018 Job Location: 190 ROLLING HITCH ROAD,CENTERVILLE Permit For: Building-Insulation-Residential Contractor's Name: RETROFIT INSULATION, INC. State Lic. No: 160461 Address: 644 RODMAN ST, FALLRIVER, MA 02721 Applicant Phone: (508) 989-6436 (Home)Owner's Name: CHANE,KATHLEEN M&DAVID E Phone: (508)776-0562 (Home)Owner's Address: 190 ROLLING HITCH ROAD, CENTERVILLE,MA 02632 Work Description: Install 5" layer Cellulose open attic,Insulate attic hatch 2" Thermax board,Install insulated hose and roof mounted vent to bath fan,Air Sealing ZE y' I Total Value Of Work To Be Performed: $1,716.00 _ N Structure Size: 0.00 0.00 0.0a (Z) rn Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed_by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: RetroFit Insulation 6/1/2018 (508)989-6436 Applicant Date Telephone No. i Estimated Construction Costs/Permit Fees Total Project Cost : $1,716.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 6/1/2018 $35.00 ? C-Jam{-X3C- credit card 3296 Total Permit Fee Paid: $85.00 6n/2018 $50.00 ;XXXX-XXXX- XX{- Credit Card 329610 "Y i S PHIS I�r ® A PS r y Town of Barnstable Billldin g' P.ost;,This Card So That it is U�sible_From"'the Street Approved-Plans Must be'zRetamed on Job and this Card.Must be,Kept r tARNSPAB[.L. ':s' ...a wA•,:, }F t ✓r.s„` �r *+'d • MA&8. . Posted Until Final Inspection Has'Been Made fb39. ♦ ,.:«�' ,.� - ,:�r . w�'�' .,.�.. «e�A � 1.. ...a«:. p zG %ems ' Kr 4 n. ry a. er roiect Where a Certificate of,Oceupancy is Required,such Building shall No't be Occupied unt�I4a.Final Inspection has been made -" j llll� -a_- -— - iG..c�.,.aaa �:aa..w..5a.... .- Permit No. B-18-2235 Applicant Name: CAPE COD INSULATION, INC Approvals Date Issued: 07/17/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/17/2019 Foundation: Location: 190 ROLLING HITCH ROAD,CENTERVILLE Map/Lot: 192-098 Zoning District: RC Sheathing: Owner on Record: CHANE, KATHLEEN M&DAVID E 'efz Contractor Name,CAPE COD INSULATION,INC Framing: 1 Address: 190 ROLLING HITCH ROAD 7 Contractor License 153567 2 CENTERVILLE, MA 02632 r a.` Est Project Cost: $ 1,300.00 Chimney: Description: Weatherization3 Permrt Fee: $85.00 _ insulation: Project Review Req: # Fee $85.00 Date 7/17/2018 Final: s Plumbing/Gas Rough Plumbing: {Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months`after?issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. , - and_ � Final Gas: All construction,alterations and changes of use of any building and structuresshall`be in compliance with the local zoning by laws codes. This permit shall be displayed in a location clearly visible from access street or;road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same.' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation v�J Low Voltage Final: - 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 6qq Map Parcel ( i� Application #. Health Division � � ` Date Issued JUL Conservation Division TOVI 12 2®18 Application Fee Planning Dept. n B � Permit Fee - r 0, . r Date Definitive Plan Approved by Planning Board Historic - OKH — Preservation/ Hyannis Project Street Address Village Address �,4 apt e Telephone Permit Request Zfe s 1!:Z�// �r /7 �'/.�S-� / CCU' ��v/l''7�zr- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation /.3ea® , z. Construction Type U Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Or— Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes U I' o On Old King's Highway: ❑Yes kko Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new _ Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use _ -APPLICANT.INFORMATION. (BUILDER OR HOMEOWNER) Name Telephone Number Address ZE z et1 z i /2 License # , U c9 y'p6 i Home Improvement Contractor# Email vvl� i , j Worker's Compensation # CL✓®� l�%%, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY - APPLICATION # DATE ISSUED r MAP/ PARCEL NO. ADDRESS VILLAGE 1 ' OWNER t�. DATE OF INSPECTION: r FOUNDATION f ` FRAME .a INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING j DATE CLOSED OUT ASSOCIATION PLAN NO. of t,i� Tod Town of Barnstable Regulatory Services BARNYMBU, : Richard V. Scali,Director MASS. 0 9°0 1639. Building Division pTF6 M p.I R' Paul Roma Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section I, KATHLEEN M CHANE , as Owner of the subject property hereby authorize [ co to act on my behalf, in all matters relative to work authorized by this building permit application for: 190 Rolling Hitch Road Centerville, MA 02632 (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:\Users\decollik\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc 01/25/17 r The Commonwealth of uassaoltuwo t Department of Xndust�lalAooldettls 1 Congress street, suite 100 ,8"toni MA 02114.2017 wwwlmuss,gov/eta �1rotikersr Compensation Insurance AfAdavltt.�ullders/Coat.r�ctorsl�lectrlt;Ians/Pl.umbers, TO BIB FILDD WITH TES PitWI�`I I�,�3 At.11'HORITYAppli"InJIVI don Name (9uslnass/OrganlzalloMndlvidual)l Ca 6 Cod Insulation , Address, 18 Reardon Circle City/State/Zip; South Yarmouth,MA 02664 phone #; .506-77.6.1214 Art you tin employer?Mick the I�Ilmarmployarwlth appropriato bowl 4s , 7� Tv of proJeat (required); 2,C3 I ant 11011 proprietor or partnership and have no omployees working forme In �� ❑ New oonstruotion any oapaolty,(No workers'oomp, iruuranoe MvIrad,) 8, ❑ Remodel.ing r ),[]1 am a homeowner doing all work myself,- No workers'oomp,lmvnnoe r0qu1r0,)t 9, ❑ Demolition a[]I am I homaovmer and will ba hlr{ng oontreolors to oonduot all work on my property, l will 10 [� 8ulldlag addition eneure thtt UI ooncraotors elther have workers'oompensation lneurenoe or are sole proprielorswlth no employees, 1 LID Blo*loal rcpalrs or addltic S(]I un a general oont utor and 1 have>hired the sub,00ntraoton listed on the t+ttaohed sheet, 12,�plumbing ropalrs or addltic Nosubaonbaotors have employees enavo workers'oomp,d h Ineuranoe,t ' 13,[]Roof repay 6,[]we ue I oorporadon and N ot'tloen have exeroised their right olaxamp�on par MOt o, 1 a,��, IS2111(4)1 and we he,ve no omployees, NO workan'oomp, Insuranoorequlred,) �.1r Other Weatherization +Any eppl oanl lhal All aks box fl I mutt also sfil out a seol on below showing their worker,'oom ensatl t Homeownen who eubmfC�tle`1t ldavlt Indlaattng th are doing Q work and than hire outside oontraotors must eubmit a new affidavit lndloetin sue eeyy p on polioy lnformatJon lContraators tfut oheok thJs Dox mull attaohod an addldonai sheet showing We name of the sub•oontraato7sgnd stela wheWer or not►hoes entitle g amployeee, If the sub•conabaton hYva am 10 gas they must rovlde their workers'oom , llo number, s have !am art employer tact is provlaIng workers+ oomp¢vailore lrrsuranc¢far�,y anrplayets, Below is the ollc and lnfOrHtattOlt, p Y Job slle ., . , InsuraaoeCompanyName; Atlantic Charter Poll�y�orself•irrs, i�lo, t WCE00431902 r„ " '" BxplraHon Date 08/30/201q Job Vto Addresst��:ells Attaob'a co of the e J �l /S a pY vrorkers oonapensatloa policy declaration page (showjzlg tbetpol cy num a d ex Gatio da Failure to seoure ooverage as required under MOL o, p t cUor.one 152, §2SA Is a orlminal vlolatlon punishable by a tlne up to S1,S00,0 ate year Imprisonment, as well Us s olvll ponalties In the form of a STOP WORK ORDBR and a fine u day against the violator, A oopy of this stat.srnt nt may be forwarded to the Offloe of Inves of p to $250,0 ooverage veri>�oation, Hgatlons of the DIA for Insurano 1 do Ir¢reby oer un a pains and p¢nallles of penury that the inforrrt,atlon ravided ae p above is true and eorreq� �77 5 /f� { YI 111 +Ir�MVW1MNYVYWYYW�►Ny�y�WIM OfJlelai use only, Do not write In tills area, to be completed by clty or Town o,I 701a4 Cl or Tow 1 PermiVLloense # issuing Authority (clrols one)l 1, Board of gealth 2, Bullding Department 3, Clty�'own Clerk 4, Dieotrloal inspector Sr Plumb lhi inspector Contact Persons _. Phone 91 CAPECOD-27 AMAHLIER CERTIFICATE OF LIABILITY INSURANCE DATE 06105/2018 06/05/2018 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ileu of such endorsements. PRODUCER C NTACT 434 Rte&34ray Insurance Agency,Inc. A/C No E:t, A/c,No:(877)816-2156 South Dennis,MA 02660 - AIL ,mail@rogersgray.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:West American Insurance Company 44393 INSURED INSURER B:SafetV Indemnity Insurance Company 33618 Cape Cod Insulation,Inc. INSURER C:Endurance American Specialty Insurance Company 41718 18 Reardon Circle INSURER D:Atlantic Charter Insurance Company 44326 South Yarmouth,MA 02664 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. ILTR NSR ADDLTYPE OF INSURANCE INSD SUER POLICY NUMBER P WVD OLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY nryyi EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FX]OCCUR BKW(19)63328281 04/01/2018 04/01/2019 DAMAGE TSESO RENTED 100,000 occurrence) $ MED EXP(Any oneperson) 51000 PERSONAL&ADV INJURY 1 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 2,000,000 X POLICY❑OTHER: PEST LOU PRODUCTS-COMP/OPAGG 2,000,000 X see holder descrip of operations B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 CF,accident,ANY AUTO 6232707 04/01/2018 04/01/2019 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS SSyVN p BODILY INJURY Per accident X AUTOS ONLY X AUOTOS ONLY PPe0aCc d nt AMAGE $ C UMBRELLA LIAB X IOCCUR EACH OCCURRENCE $ 2,000,00- X EXCESS LIAB CLAIMS-MADE EXC10006635003 04/01/2018 04/01/2019 AGGREGATE $ 2,000,000 DED I I RETENTION$ D WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY WCE00431903 06/30/2018 06/30/2019 ANY PROPRIETORIPARTNER/EXECUTIVE YIN 1,000,000 QFFICERM Mn rEXCLUDED? NIA E.L.EACHACCIDENT 1,000000 l andato NJFH1 E.L.DISEASE-EA EMPLOYEE Ues,describe under S RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. Excess Liability is follow form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. I' V Commonwealth of Massachusetts Division of Professional Licensure :Board of Building Regulations and Standards Cons!'90fO_Itb'Orvisor j� =s CS•100988 1" tow-.I. E lres; 11/11/2019 HENRY E CASSIDy,`°} 8 SHED ROW'--,,,. WEST YARMOGqi MA?0 Commissioner _ ��J 12P t(JGI/vi2�YL4/12�Lrl2t'�?i�i��'G Gl/ }�-' Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Ma�, ","" setts 02116 Home Improveme.::, AID tractor Registration Type: Corporation Cape Cod Insulation, Inc N Registration; 153587 18 Reardon-Circle a . .:'��f '' �� Expiration; 12/14/2018 So, Yarmouth, MA 02664 - 1 ;C✓J 0 20M.05/11 Update Address and return card. Mark reason for change, do�anunaovzrucrz��o�'C�/��aaorz�udetly r ym-srf,_Cl-A.o.�.,..art+.. office of Consumer Affairs&Business Regulation 151�' HOME IMPROVEMENT CONTRACTOR y ype; Corporation Registration th valid for Individual use only T-.:. before the expiration date, If foun urn to; • .;: 'M.. Office of Consumer Affairs and $f sa Regulation 12/14/2018 10 Park Plaza•§J614je 8170 P ry* . ;,�' Boston,MA. Ca e Cod Insulate`' +1 Henry Cassidy 18 Reardon CIrc� So.Yarmouth, Undersecretary t al hout sl atu ,. Town of Barnstable Building 3 , serhTIrri s Card Son-T�POePd h'•.•.at itr;i s,r,,U_..is;i�b',oWhs pxp.,;r=�ov,�e, fd,;.."'P lans,wM°u';+es�t,::"bWe`. Rre''ta"'�in. ebd1'on Job a�men�d t'e•hk`i s rC�a r.d,':�iM ust1w MAE& Permit i.:benKae p�t ^ z Permit No. B-18-267 Applicant Name: JAMES S PEACOCK Approvals Date Issued: 02/15/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/15/2018 Foundation: Residential Map/Lot: 192-098 Zoning District: RC Sheathing: Location: 190 ROLLING HITCH ROAD,CENTERVILLE Corit-rac �Name �iJAMESS PEACOCK Framing: 1 Owner on Record: CHANE KATHLEEN M&DAVID E t ` � 'se Contractor.License CS 094500 2 Address: 190 ROLLING HITCH ROAD Project Cost: $ 10,000.00 Chimney: CENTERVILLE, MA 02632 PermitFee: $ 101.00 Insulation: Description: RENOVATION-REFIT 2 BATHROOMS, NO AREA CHANGE DEMO Fee Paid $ 101.00 SHEETROCK WALLS AND CEILING ` i Date 2/15/2018 Final: Project Review Req: �� f Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized bytFis permit is commenced within sumo the after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and�theapproved construction document for wh�cfi this permit has been granted. All construction,alterations and changes of use of any building and structures shall ei in compliance with the local zoning ng by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road nd shall be maintained open for public inspection for the entire duration of the work until the completion of the same. n e kk Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Hre®fficials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work. 1.Foundation or Footing �w _�� Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Appficadon Number.. .......OtherFce........................ ILAss �► "`J"'�' ��G Total FaPaid-.16019 .................................................................... TOWN OF B U AR] ; PB\'� Perm Approval by........ ............On.... �.��..�.`.�....... BUILDING PE APPLICAVON MV...........ftz.............�...... .��:.. �.. ....... _.. Section 1 — Owners Information and Project Location Project Address 0 I l t1 1 In R&. Pillage �'�r y 1 I l Owners Name rr�� Owners Legal Address Iq V --Ro 1 l.,'l Yi City "4 i V State ki As' = Zip ®Q.(3 3 Owners Cell#- SC9 --f-X0 -0 S( ;L E-mail KG,—an -QQaC Drn c0-s+, n t+' Section 2—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3-Type of Permit ❑ New Construction ❑ •Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire sti ud=) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar 53 Renovation ❑ Pool ❑ Insataiion Other-Specify. Section 4—Detail Cost of Proposed Construction D ODD Square Footage of Project 2-U0 � Age of Structure �b f - Dig Safe Number #Of Bedrooms Existing 3 Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last update&I M2017 Section 5 -Work Description Section 6—Project Specifics . a ❑ Wiring [] Oil Tank Storage . ❑ Smoke Detectors . ❑ Plumbing 0-0as ❑ Fire Suppression ❑.Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply L`7 Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane C Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this o had relief from the Zoning Board m the past? ❑ Yes 0 No property Last upddut I M2017 ty Section 9—Construction Supervisor Ij. Name S C-0 a Telephone Number 50 9,-�— Lf a 9-�7 (p D Q Address(P 0, 3 0 u. 1� i Cityoa;it rv�l l e, state Jq A- zip (3 License Number CS -094SD 5 License Type Expiration Date �- ContudorsEmail 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 ation re d by 780 CMR and Town of Barnstable.Attach a copy of your license. Signature ?� Date Section 10-Home Improvement Contractor Name as a b©V e—, Telephone Number Address City State Zip Registration Number �S( g S 3 Expiration Date I understand my responsibilities under the runes and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedures,specific inspections and documentation re " d by 780 CMR the Town of Barnstable.Attach a copy of your ILLC... signaftre Date 1 -2 6 _ % F r' Section 11—Home Owners License Exemption k Home Owners Name: Telephone Number Cell or Work Number I understand responsibilities under the rules and my resp regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Brnldmg Code. I understand the construction inspection procedures,specific inspectians and N documentation required by 780 CMR and the Town of Banzstable. Signature Date APPLICANT SIGNATURE Signature '° Date Print Name , �Cv=1�f-Q�eA�� Telephone Number r E-mail permit to: S C+-+ VV'1'.GY1{ YJ Last updated:11/72017 Section 12—Department Sign-Offs Y Health Department ❑ Zoning Board(if required) ❑ Hi storic District ❑ Site Plan Review(if required) ❑ 1 Fire Department ❑ Conservation ❑ i For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization set-prop I, , as Owner of the subject erty here y authorize to.act on my behalf, in all matters relative to work authorized.by this building permit application for: , (Address of job) Signature of Owner date 'l Print Name i 1 I .I r� Last updaInd 1 l/72017 e Corrs_worrsveaUh gfMassachuseza Deparftnent rrf bdus Accidents Oywel ofiives4adons 600#3'avhingfm&-reef Bostoq Mi a2.J wmv.rnas&govfdia Workers' Compensation InsuranceAf'fdavit:BniTders/ContractarsMertricianstMumbers Applicant Information Please Print,Legibly Name(13nsroe�a/Orgauizatioorinai�idnal):Sc�1�`f' }��t ear� iC �v i')d;►r1c `�' �2e vl�rz�F,l i L, Address: R 0, ?)bjC l 7 I ►G i(� C� i Y,l .S LIi Imo. cityfSt.,,t,jzip-0S}ervi ))l✓ A, 0a(PSZ Phone 9 5_0?,-,�--Lf Are you an employer?Check the appropriate boxy Tie of paoect(required):l. I am a employer with 4- ❑I am a general contractor and I employees{full and(orpart-time).* Have hired.the sub-conicactors 6_ ❑New . 2_❑ I am a sole proprietor orpartner- listed on the attached sheet_ 7_A Remodeling s and have no employees , These�-oflII�ctars�`e � � Y S_ ❑Demolition: working for me m any capacity employees and have workers' 9 ❑Building addition [No workers' comp_insurance. comp.tusurance-- required-] 5_❑ We are a corporation:and its 10-0 Ele;ctrical repairs or additions 3-❑ 1 am a homeoum-cer doing all work officers have exercised their 11-0 Plumbing repairs or additions myself [No wcwkers'ooII'P_ right of exemption per MGL insurance required-]F c-152,§1(j%and we bK,.,e no. 12�Roof repairs employees_[Na workers' 13-0 Other comp-Msuranw rtquires9,J "Any appUcx9 emt chedcs box M must also fill out the sectionbd ow showing di&wodcen;'compensadoupolicyinfvnmatiom- ' t Homeowners who subtait t#us sffluln 2 indi;catiRg they are doing all uu&andthea hire outside contactors must submit anew afdavk mdirating mcb- Contmcmrs that check this bone must attad[ed au additional sheet showing the name of f m st#aomx sUacs and state whether ocnnt ff ose en hies Have Employees If the suh-coniractors have employees,they nest provide that workers'comp-policy ntmmber lam an etnpIoyer illat is prm idbzg rtrork-e s'conTeawiion inrurauce for my anWrbyees Bdatr is Ste pohi and}ob site informatian - Insurance CompanyName: � 0Q- -C# Policy 9 or Self-ins-Lao_''_ _, `J .�1 —' �5 Y(o q_ Expiration Date_ Dr��} Jab Sites Addtesr ►e a i%1 h n(A 00-Cti RA City'staterzip_ Ce-v)-Ier v i I I,e. M—o a&3� rktt3C,k a-copy of the zsorkers'comI_jpensation policy dedaration page(shoving the policy number and eacpiiration date). Failure to secure caverage as required under Section 25A o€MGL c_ 152 can lead to the imposition of criminal penalties of a fine up to$1,500-00 andlor one-year imprisonment,as well as ciril penalties in the foffi of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator- Be advised that a copy of this statement maybe forwarded to the Office of Im estigations of fhe DIA for insurance coverage verification_ I do hereby fy der the s andpenaWas ofpedwy dtat$ie injormatian prm2ded abin c Es.trua and correct Sitmature. Date- Phone 9: ------- --pff-rctul-iise any?t 17a rtot svri�irr�tzs stet,fa-bs coutptetetd-Fry-�ar-btsmiu�---- -- --._..-- --- City or Town:- PermidUcense# Issuing Authority(arrle one): 1.Board of Health ?.Building Department I CitylTown Clerk 4.Electrical fnspector S.Plumbing Inspector 6.Other Contact Person: Phone 9_ 6 LJt3G LV 1/ V°I.VVP MUL111VU1I d11U UdVIU - QUO-1!U-LLRJ P.I �'"F Town of Barnstable • Regulatory Services . - Richard V.Scali,Director M� Building Division Tom Perry,Building Commissioner 1-00 Again Street,Hyannis,MA 02601 www.town.barnsta b le.ma.as Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section ILU-AWg A Builder as Owner of the subject property herebF authorize .ice r GQLC.r1-r�� to act on my behalf in all matters relative to work authorised by this building pen-nit application for: 190 Rolling Hitch Road,Centerville (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner atvre of_applicant C Print-Name Print Name Date i Ac C>RV® CERTIFICATE OF LIABILITY IN SURANCE o7/1orzo17 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT . NAME Germani Insurance Agency PHDNE _ (508)428-9194 908 Main Street eo ds@gerrnaniinsurance.com No: (508)428-3068 AIESs: ce @germaniinsurance.com INSURERS AFFORDING COVERAGE NAIC R Osterville MA 02655 INSURER A: SAFETY INS CO INSURED 39454 INSURER B: Granite state-AIU Holdings 000000 Scott Peacock Building&Remodeling,Inc. INSURER c: P.O.BOX 171 INSURERD: INSURER E: Osterville MA 02655 INSURERF: 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 DOCU CERTIFICATE MENT WITH RESPECT TO WHICH THIS MAY 8E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCEwsn Yvun POLICY NUMBER PIO�ILIID EFF �DYYY) °P LIMITS X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 CLAIMS MADE ®OCCUR DAMAGE TO RER70-- PREMISES Ea commence S MED EXP(Any one person) S A BMA0022118 07/0512017 07105/2018 PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000.000 POLICY1:1 JECT 0LOC PRODUCTS-COMP/OPAGG S OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S OWNEDED SCHEDULED ANY BODILY INJURY(Per person) S AUTOS ONLY AUTOS BODILY INJURY(Peraccident) S ' HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident S S UMBRELLA LIAR OCCUR - EACH OCCURRENCE S EXCEH tSS LIAR CLAIMS-MADE AGGREGATE S DED 1 RETENTION S S WORKERS COMPENSATION PER OTH AND EMPLOYERS'LIABILITY YIN STATUTE pt ANY PROPRIETORIPARTNER/EXECUTNE EL EACH ACCIDENT S SOO,000 B OFFICERIMEMBER EXCLUDED? NIA WC 005-81-5464 06/22/2017 065P2=018 (Mandatoryfyes,d be and EL DISEASE-EA EMPLOYE S 500,000 ft yes,describe under ,DESCRIPTION OF OPERATIONS b Jvx EL o)sEASE-POLICY UMrr S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101.Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Scott Peacock Building&Remodeling Inc ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 171 Osterville,MA 02655 AUTHORIZED REPRESENTATIVE Fax: Email: ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-094500 Construction Supervisor JAMES S PEACOCK r PO BOX 171 ,:;:;=s+ OSTERVELLE MA Expiration: Commissioner 07/22/2018 _ Office of Consumer Affairs&Business Regulation License or registration valid for individual use only 'j am HOME lMPF.OVErUIENT CONTRACTOR before the expiration date. If found return to: i 'a'Registration:istration: 151853 Type: Office of Consumer Affairs and Business Regulation _ F' _N"��� expiration:.=:7r1201.8 Private Corporation 10 Park Plaza-Suite 5170 ' Boston,IVU 02116 SCO 1 f PEACOCK BUILDING&'REMODELING INC JAMES PEACOCK 1 1046 MAIN STREET SUITE 7 OSTERVILLE,MA 02655 .. Undersecretary JNot valid bvithout signature i' . �Al a c �\ ti r xtt' _ a . � r f L . y X-PRESS PERMIT Town of Barnstable *Permit# JU N — 2007 ExpiresY6'no rths from issue date Regulatory Services Fee (� TOWN OF BARNSTABLE Thomas F.Geiler,Director Building Division / �^ Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �f Not Valid without Red X-Press Imprint Map/parcel Number l D / Property Address Q a) 4atyio 4 � 0 1c �VIJ t [2/Residential Value of Work ,(C30 04 0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 6haAV_ 00 F_aL4lNc Ht'22M I?N 7-PR l/I L a.;L6 3c�— Contractor's Name ,Q • p e •- A 55 oC 1,4 mS Telephone Number 50V Home Improvement Contractor License#(if applicable) // �'y Construction Supervisor's License#(if applicable) d 7 Z/ 7 7 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 211 have Worker's Compensation Insurance Insurance Company Name �Q2�+e�1 S V/LLB �dJ O�eP$ � l}J &0 e Workman's Comp.Policy# ill U,OO,2-df.5 A147`90Q: 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 ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side (Replacement Windows. U-Value e 33 (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: &HoInmipr7ovet sign Prop ty Owner Letter of Permission. Contract o License is required. SIGNATURE: Q:Forms:dxpmtrg Revise071405 J ptIKE Town of Barnstable Regulatory Services ' Thomas F.Geiler,Director z639 •� Building Division. FpMAr� Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 62601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I,�A tte-,N CAW ,as Owner of the subject property hereby authorize TA FCp 4 A5e,)DC I Ares to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) �-�-o 17 S' nature of Owner Date Print Name III r a - c j LOT 9 38 LOT 3 6 ; "LET EXIST) NG Ln J o� 55 44 t5004 ROLLING H ITCH RSA PL. O 7, PZ_ A-// aR1r,N s .4 Ic L. �.�.H % CEJ�LIER�CI L ._ .L�IA5S. � IN PLAN -BOOK 9-3.6 sIVr 1-:146£ /,a GEORG Low: IR OIST � �� 7i%�N 4,ve-'_-QQC5 -CON,FJ�'/`� TiIZ N� r^v'vv vF ELA. 00 UA 1 533 c.���z� ; 7-1 By G�;��.J.✓.:.�T Y4i�.a.f�7ti7�/fOk.'T Mq P* o`TM` TOWN OF `BARNSTABLE" Permit No. 21198 y - `{ Building Inspector Cash NAM OCCUPANCY PERMIT Bond X_ II/gr/9 `-`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." Sandra Jj mays dlb/a Issued to �, ai , He, Address lot 037 190 Rolling Hitch Road, Centerville . f Wiring Inspector �� Inspection date Plumbing Inspector ' _-rA Inspection date Cras Inspector N \ �` Inspection date -/'Engineering Department �ei`Inspection date l 77 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. /f Building Inspector Ass sor's map and lot numb -r Bpi THE Sewage Permit number .......... � MUST House number IS M AHB9TADLE, . �1 MABa .................... ....... ... ........................... WJM1'ITr,E 5 ,,�,ie39•a�e� 4). &MR CooE AWD TOWN OF BA*RNSr T,ojVS BUILDING INSPECTOR APPLICATION FOR., PERMIT TO ! � ....c5!if/6L r�.... � /..�. .. K� gI.wo............. ............................. TYPE OF CONSTRUCTION .`V.002....AX/t ...:.....................................................:.................................. q .................... /`a`Sr...........I9.z/.. TO THE INSPECTOR OF 'BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location ... 1/..�p� 5 .....A'�C`30�.................................. ProposedUse ............................................................................................................................................................................. ZoningDistrict ................................................................../..�...,....Fir�/e D trict .............................................................................. Name of Owner !�.° 2A.. :.. !d, s..........4/ ..... ��Oldress ..S`.. . 4y...` :. ...yA.41 fi .......... Name of Builder ..... ...41!".''.4!:C.......................Address �� .. 1 � ..... :.C-. iL1t`eurl��... .�c.�at�D . sS Name of Architect ...................................... Address . . .................f............................................................ Number of Rooms ..�A ..........Foundation lU9. . ....... ATE ............................... Exterior ..............................................Roofing .... L. .................................................... Floors 17�!e/? .......................................................... .. !e�IEJA.. ............. .......................................................................... G S Heating .t..��ca......�y .................................:......Plumbing ...................................................................:.............. Fireplace 110*CA...................................................................Approximate Cost 4!1 ............................ . Definitive Plan Approved by Planning Board ---------------_---------------19________. Area ........................... o............. Diagram of Lot and Building with Dimensions Fee �— SUBJECT TO APPROVAL OF BOARD OF HEALTH 33OD 1 �IV /g77, .v I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ............. ............ ` Sandra J. Hays d/b/a Creat` Hormss -----� ` f � A_192-98 . k - ` 2l39� l ----._. P�x�hfor .~.. .duwall.in* � / _,___,,___.___.^,~____,~__,.__. ` � Location .......1»V. 3J..... �90. .���a��'B�, � _ / ----- }}�--'----------.. Owner ���Cb�� .�. l{�o� ^ '--' ' '—'—^---------'' ` Type of Construction —��xJd'---------' � ' 1 1 _----..---..------^---------- v � ` 4 / ^ � Plot --...................... Lot ................................ .. Permit Granted ..--^TUne..25................lA 79 - / Date of Inspection --lq Dote Completed � ^ � � � ' ERMIT REFUSED ` � . . /m [--' | ' �m JI ---- ^ � ��.��. ' Cv ' Approve ��__.��___--------. lQ . - ^ --'-----'------------------' . ------------------.---. , .�^�' , L�^^_, ' � �