Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0094 THOREAU DRIVE
�� ,_ - - H . - _ a y ,. ,,,. � P � � � � - a � o°' , . � y .: ;, n �� �' a �. ,. � e .. Y a „ O �. �. .. o _ r � :, r. - � �, c 4 . a u t .. .. .. � t �. :: .' ,. .. � � - 4 !. ��. a "� ��3 ,. ,u , � ._ .� - f v - Y � i ., .� = .. - .. p.. _ � - '. y9 a � o - ,^. � o - �i �. � - � e �. � o a _ �� .. �. x � v t, ,'�, .. � � _ ... ._ � ." � n � 9 _ , o a .. o �.. .� o ,., � _ ,. 0 .. 4 �. � 4'r� (_ � ..- u��:' u � .. ,�' .n �*1 .�'.. 4« v -a k - ? ... .. .f Hq'T - qf. _ v� vas. A s .. �e s i N , .. �� .. o _ .: o - - �. � ., �. e� - - � .� - _ .. �.. s° �. a C Town of Barnstable Building Pos#This Card•So That tt is.VisibleFrom.=the Street ;A roved'Plans Must be Retained on]obWandahis Card Must be Ke't , PPp, @� P �AUS.E..' Poste 'n;i .. ,#,:� ;�Y.. :Fi.��,{ '"t c+ `'-`•X«^ta`.� ,�• ':.:� .sue t S § '_?' ' •..�� • a63p d-U t l Final Inspect on H.aps'Been:Made y a s:. r m Where=a;Certificate�of Occu anc. ;�s•Re uiredswcfi Buldm shall Not:be Qccu red un#iI aF�nal ins ection has.been made >i Permit :a.:'•.� m_ _ 1p.,m,,....y:: q,.,F.ra" .'. ".,,i ..,, r..�. 3g•��:. ..z.•:,.?. ;; .. •.. .s,gyp u, .,, ..w.v«... .5;., pa,.t,. 5 .�.... ,. ,..�.,n...•. :_�.,... a= - Permit No. B-18-2609 • Applicant Name: MACPRES HOLDINGS INC DBA ALL CAPE ALUMINUM Approvals Date Issued: '08/13/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/13/2019 Foundation: Location: 94 THOREAU DRIVE,CENTERVILLE Map/Lot 191-188 Zoning District: RC Sheathing: Owner on Record: KUENZEL,ERIC A&ERICA L Contractor Name: ,.BEN W MCPHERSON Framing: 1 Address: 94 THOREAU DRIVE It Contractor License CSSL-099189 2 , CENTERVILLE,MA 02632 Est Protect Cost: $4,657.00 Chimney: Description: replace 12 window-all cape aluminum 's Permit Fee: $35.00 Insulation: Project Review Req: y. Fie Paid; $35.00 Date 8/13/2018 Final: Plumbing/Gas ` Rough Plumbing: y •,. Building Official Final.Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months:afterissuance. 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. All construction,alterations and changes of use of any building and structures shall'be in compliance with the local zoning by laws and codes. Final Gas: - This permit shall be displayed in a location clearly visible from access streetbrroad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. i Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building a id Fire Officials are provided on this'permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ' 1.Foundation or Footing x ` Rough: 2.Sheathing Inspection " 3.All Fireplaces must be inspected at the throat level before firest flue Irving 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 • Application number..... ......... Fee .............................................................................. EX, Building Inspectors Initials..MAM ............... AUG10 2018 Date Issued................................................................. TOWNO� BARNSTABLI Map/Parcel......... ........ ............................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDINGiWINDOWS/DOORS/TENTS/STOVES[WEATHERIZATION PROPERTY INFORMATION Address of Project: 61� _TKO rtet � c Prte-f'xi NUMBER STREET VILLAGE Owner's Name: f i V-00—vL-Le--L— Phone Number 50"C 777to 143-7 Email Address: kuyu-e-1-60ar A . Cell Phone Number Project cost$ 10 7. 19 Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize -A t l C--Pe to make application for a building p;xmit in ac ance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding [Windows (no header change) # Tnsulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than I layer of sh-ngle� Construction Debris will be going to laat A l um i n u CONTRACTOR'S INFORMATION Contractor's name C Home Improvement Contractor's Registration(if applicable)# 155 17 (attach copy) Construction Supervisor's License# C S L — 099 1 (attach copy) cwcasf. net Email of Contractor L Ll I 6CL, ecllomInv(18 Phone number SOT/775-qZtj ALL PROPERTIES THAT HAVES RUCTURES OVER 75 YEARS OLD OR IF THE SUBJECf PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT 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 APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. Office of Consumer Affairs.and Business Regulation One Ashburton Place - Suite 1301 'Boston, Mass��husetts 02108 Home Improvemtractor Registration Type: Corporation a 11 Registration: 135174 ' MACPRES HOLDINGS INCExpiration: 03/10/2020 D/B/A ALL CAPE ALUMINUM ALL CAPE ALUMINUM �`� 192 IYANNOUGH ROAD HYANNIS,MA 02601 r' f ~` Update Address and Return Card. 'A 1 0 20M-05117 - ✓� [�i>'re(rza�.ri�e�a�-f.�%Ow¢c,�zeuse%9 - // Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individa use only TYPE�Comoration before the expiration date.;lf found return to: Regy-.i�s�tiriiul Expiration Office of Consumer Affairs arfd Business Regulation T35 T_ 03/10/2020 . 10 Park Plaza-Suite 517.6 MACPRES HOL*b, 1 Boston,MA 02116 D/B/A ALL CAP�rA WAt,1W�--'W 7�. BEN W.MACPHEI3S ALL CAPE ALUMIfi < 192 IYANNOUGH ROAD UndersecretaryNot valid without signature HYANNIS,MA 02601 / H SETTS [)R1V, RCS / LICENSE III 5a Massachusetts Department of Public Safety Board of Building Regulations and Standards License. CSSL-099189 ' j 1QJr112a#6 � 74 Construction Supervisor Specialty BEN W MCPHERSON d 89 LEWIS BAY RD APT 415 Y a HYANNIS MA 02601 .. - ► � _{� ,. a i; jl i/ r/.////�( 1ssEX M 1sHGr5 1 ,"� � 1��®/��.. . Expiration:• Commissioner 11/20/2018 ,\L Alee CA�����i(� Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Masshchusetts 02108 rovem Home Im e8 p �'r3itractor Registration Type: Supplement Card v � Registration: 135174 MACPRES HOLDINGS INC � ! " � Expiration: 03/10/2020 D/B/A ALL CAPE ALUMINUM ice/ ALL CAPE ALUMINUM c 192 IYANNOUGH ROAD HYANNIS,MA 02601 7 defer Sy2 Update Address and Return Card. ;CA 1 0 20M-05/17 �7p �p //gyp pp._._........p_. .. ........... ....._..,..........._...__... .... ..........-...... Z.. _.-..........__...... ,... ..--------_ _,. .. ...... _ ..._.. C�aiYI✓/2o�uifellu/6 a�///l�a,JJlLc1U.c9e f� - Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE'/;—Awolement Card before the expiration date, if found return to: Registr`aYi'M' Expiration Office of Consumer Affairs and Business Regulation a 'ffl1 = 03/10/2020 10 Park Plaza-Suite 51,70 MACPRES HOLD `F`� Boston,MA 02116 .; DB/A ALL CAPE # JASON BROWN ALL CAPE ALUMII` M.. 192 IYANNOUGH ROAD- '"f Not valid without signature HYANNIS,MA 02601 Undersecretary ACC? CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) L,� 8/9/2018 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(ies) must 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 Karen Bernier NAME: Eastern Insurance Group LLC PHOAICNNo Ext: (508)997-6061 A/C. No): (508)990-2731 439 State Rd. E-MAIL kbernier@easterninsurance.com ADDRESS: P.O. BOX 79398 INSURER(S)AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURERA:Central Insurance Companies 20230 wsuREo INSURERB:All America Insurance Co. 20222 Macpres Holdings Inc DBA All Cape Aluminum INSURERC: 192 Iyannough Rd INSURER D: INSURER E: Hyannis MA 02601-2018 INSURERF: COVERAGES CERTIFICATE NUMBER:CL182904865 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X❑OCCUR DAMAGE TO RENTED 300,000 PREMISES Ea occurrence) $ CLP 7553703 1/8/2018 1/8/2019 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 a JPRO- POLICY LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY Ea BINocidEtSINGLE LIMIT $ 11000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OS X SCHEDULED gAp 9594949 1/10/2018 1/10/2019 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ included X Underinsured motorist Blsplit $ 250/500 UMBRELLA LAB OCCUR - EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN X STATUTE X ER ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT, � $ 1,000,000 A OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) WC 7553704 1/8/2018 1/8/2019 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - CERTIFICATE HOLDER CANCELLATION kunzelton@gmail.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Eric Kuenzel THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 94 Thoreau Dr ACCORDANCE WITH THE POLICY PROVISIONS. Centerville, MA 02632 AUTHORIZED REPRESENTATIVE Karen Bernier/KAB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) A11 Cape AIurl� nurl� � sti m to 192 lyannaugh Rd C'qT c'z�-&o l4vannis. MA 0260 1-20 1 8 � Date Estimate# 508475-4299/fax: 508-778-8999 (�122it g 4f 1120;1 Ii 1 2 179A Blame/Address Ship To ERIC KUENZEL 94 THOREAU DR CENTER'VILLE,MA 02632 Customer Phone P.O,No, Project 508 776 1437 Description Qty Cost Total -LIVING ROOM --PROVIA VINYL.WINDOW(S)-ASPECT SERIES,REPLACEMENT STYLE. 2,/ ?.6AI 492XV, DOUBLE IIUN(.I(4501).EURO WHITE INTER IOR/EXTERiOR.CONSTANT FORCE R()I,I,.InR I•i1 1"l3AL.ANCE:SYSTEM.SINGI.,i.SWETP LOCK,COMFORTECH-DLA IN5LILATED CLASS,NO GRIDS.POLYFOAM WRAP. tit SCREEN(S),PROVIA WARRANTY*-ENERGY STAR RATED,U-FAC'TOR:.27 ---PROVIA VINYL WINDOW(S)-ASPECT SERIES.REPLACEMENT STYLE, I J 25161 2516IT PICTURE WINDOW(#509).FURO WHITE INTERIOR/EXTERIOR, CON-IF)RTECI-I-DLA INSULATED DOUBLE STRENGTH GLASS,NO GRIDS, POLYFOAM WRAP, PROVIA WARRANTY*-ENERGY STAR RATED,U-FACTOR: 2h -MASTER BEDROOM - PROVIA VINYL WINDOWS)-ASPECT SERIES.REPLACEMENT STYLE, 4 246 41 985,64'1" Do t,;3I_F fI11NG(0501).EURO WHITE INTERIOR/EXTERIOR,CONSTANT FORCE ROLLER TILT BALANCE SYSTEM,DOUBLE:SWEEP LOCKS.COMFOWI'wH-DL.A INSULATED CLASS,NO GRIDS.POLYFOAM WRAP, 112 SCRI:EN(S).PROVIA WARRANTY'-ENERGY STAR RATED.U-FACTOR:.27 CHILD'S ROOM - PROVIA VINYL WINDOW(S) ASPECT SERIES REPLACEMENT STYLE, )� 246.41 485.64L� DOUBLE fi1IN(:,(0501),EL)RO WHII E INI ERIOR(FXI'ERIOR CONSTANT FORCE: ROLL Tlt T BAL.ANCE.SYSI E M DOUBLE;SWEEP LOCKS.COMFORTECEI-DLA 1NSULAI'E13 GLASS,NO GRIDS.POLYFOAM WRAP, 112 SORE EN(S),PROVIA WARRANTY$-ENERGY STAR RATED. L!-FACTOR:.27 GARAGE t�ENIiFAC'T(,)RER:-, 'ARRANI'Y Subtotal Sales Tax (6.25%) Total Signature Page I , ' .-11 Gape Aluminum Estimate 192 Iyannough Rd Hyannis, MA 02601-2018 Date Estimate# 508-775-4299/fax: 508-778-8999 4/1/2018 12179A Name/Address Ship To ERIC KUENZEL 94 THOREAU DR CENTERVILLE, MA'02632 Customer Phone P.O. No. Project 508 776 1437 Description Qty Cost Total ---PROVIA VINYL WINDOW(S)-ASPECT SERIES,REPLACEMENT STYLE. 1 246.41 246.41T DOUBLE HUNG(#501),EURO WHITE INTERIOR/EXTERIOR,CONSTANT FORCE ROLLER TILT BALANCE SYSTEM, DOUBLE SWEEP LOCKS,COMFORTECH-DLA INSULATED GLASS.NO GRIDS,POLYFOAM WRAP, 1/2 SCREEN(S),PROVIA WARRANTY*-ENERGY STAR RATED,U-FACTOR: .27 ADDITIONAL MATERIALS --MISC. MATERIALS-INSULATION,ADHESIVES,FASTENERS,CAULKING, ETC. 45.00 45.00T PERMITS&DUMP FEES 50.00 50.00 SUBTOTAL 3.059.12 -INSTALLATION 1,320.00 1,320.00 ' - S ***ANY ADDITIONAL WORK TO BE DONE WILL BE BILLED OUT ON A TIME 0.00 0.00 PLUS MATERIALS BASIS*** SEE MANUFACTURER'S WARRANTY Subtotal $4,379.12 A 50% deposit is required to bind this estimate. Sales Tax ,(6.25%) $188.07 This estimate is valid for 30 days. - Custom orders are non-refundable. Total $4,567.19 Signature. - Page 2 Town of Barnstable y Building PostThis:Card So;That rt�s Visible;FromheStreet .A roved=Plans;Must;be Retained on J;ob an'd:°thisCard,Must be.Ke t -0- .: `: ,,. `"'a P p si T', ' S.. •* '� >, • PostedUnt�l Final Inspection Has=.Been Made ° Where a.Certificateof O,ccu anc s Re u�red 'sucfi Build�n shall Not beOceu ied;until a`F�nat ins ectron hasbeen made wl ill�t Permit NO. B-18-1963 Applicant Name: MDH CONSTRUCTION INC. Approvals Date Issued: 06/22/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 12/22/2018 Foundation: Location: 94 THOREAU DRIVE,CENTERVILLE Map/Lot 191 188 Zoning District:. RC Sheathing: Owner on Record: KUENZEL, ERICA&ERICA L £ Contractor Name MATTHEW D HARRIS Framing: 1 Address: 94 THOREAU DRIVE s Contra tc or License GCS 105679 2 CENTERVILLE,MA 02632 Est Protect Cost: $3,000.00 Chimney: Description: Insulation/Weatherization. .Permit Fee: $85.00 Mw Insulation: Fee-Paid Project Review Req: -z $85.00 • Date 6/22/2018 Final: S Plumbing/Gas 4 1.. Rough Plumbing: Building Official Final Plumbing: �t This permit shall be deemed abandoned and invalid unless the work authorized bythis permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the3approved construction documents'for which�this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zo in ngws by la and codes. Final Gas: 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. ; F 0 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Build ng 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 7.Final Inspection before Occupancy Low Voltage Final: 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 - ).8— Application numb�el . . I Date Issued..wZ."� �..... . MAM Building Inspectors Initials.. . .......................... 89 Map/Parcel....gl........../ ........................... ® TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 7 —14 6Ir ea %/ Dr Lrn 4 NUMBER STREET VILLAGE Owner's Name:, C L'r; ,�,P Phone Number Email Address: Cell Phone Number Project cost $ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize s� �c e to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Y s 0 Siding 0 Windows (no header change)# L.ILI Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review 0 Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name /'7,0�� s f✓ �% Home.Improvement Contractors Registration(if applicable) # &O 7 (attach copy) Construction Supervisor's License# 105-6 7 % (attach copy) Email of ContractormJ4. C6V7SIr-4CAiwl Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT 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) f.� Dimensions of each Tent X X ' '•"X Additional tent dimensions can be attached on a separate piece`of paper. Check one: this event is a: for profit non-profit event' `rrsft 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 I ood is being served at our event lease obtain a Health"De Department approval between the hours .ff" g Y P P PP of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approvab *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 APPLIC, 'S SIGNATURE Signature r Date f / All permit applications are subject to,a building official's approval prior'to issuance. i a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia , Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): frJ C Off.;e, ✓,I Address: City/State/Zip: P e A,4 013{Z. Phone#: y Are yo:am, an employer?Check the appropriate box: Type of project(required): 1.[I a with employer 4. ❑ I am a general contractor and I � 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I 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.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑.Other. comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ✓� tJ 0 Policy#or Self-ins.Lic.#: V LIC /0 D 6 0 193 7 5 2 0f7 - Expiration Date: Job Site Address: y e v��✓ �� City/State/Zip:I�Pti+P�v�' /11' 6263Z Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance covers rification. s I do hereby certify e ai a p alti of perjury that the information provided ab ve is true and correct Signature: Date: /�/ Phone#: 7 C J — Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I • F 4 Information and 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,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of itspolitical subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and 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-, y Department of Industrial Accidents 4 Office of Investigations 600 Washington,Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.govidia DocuSign Envelope ID:FF1953A7-8745-4B5E-ABEA-FO63C95198C7 t1aE re Town of Barnstable Regulatory Services RA ABLE, Richard V.Scaly Director IMAM.. °0 1639. ®� Building Division 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 ERIC KUENZEL , as Owner of the subject property hereby authorize y to act on my behalf, in all matters relative to work authorized by this building permit application for: 94 Thoreau Drive Centerville, MA 02632 •' (Address of Job) C DocuSigned by: 5/5/2018 ,i 8:20 AM EDT r Signature of Owner Date t Erica kuenzel Print Name L 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 Office of Consumer Affairs and Business Regulation One Ashburton Place - Suite 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration, Type: Corporation Registration: 183807 MDH CONSTRUCTION INC. PO BOX 6413 Expiration: 11/15/2019 ; - - PLYMOUTH,MA 02362 •Update Address and Return Card. SCA 1 0 20W05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE;.;Corporation before the expiration date. If found return to: Realstration;1-. EW-1ration Office of Consumer Affairs and Business Regulation 183$07 " 11/15/2019 10 Park Plaza Suite 5170. MDH CONSTRUCTI.ORI ING: MATTHEiM HARRIS; — 98A EST R13 . . PLYMOUTH,MA 0236Q Undersecretary Not valid without signature , a Commonwealth of Massachusetts Division of Professicmai'Licenswe Board of Buitdinq Regulations and Standards• " . • Gr�nsTrda � 21 ,�Fi�c�r CS-1.06679 Expires: 11107/201.9 MATTHEW D:HARR1 +' 98 A ESTA ROAD � PLYMOUTH m -0236o `, • r�� psi 3� h� - • ' ' Commission r , c CERTIFICATE. OF LIABILITY INSURANCE101104J2018 TI 1SCERTIFICATE IS ISSUED AS.A MATTER OF INFORMATION ONLY AND COWERS NO RldkTS UPON THE CERTIFICATE HOWE&THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE.OF WSURAN CE DOES CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(SI,AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDM IMPORTANT- if the certificate holder is an ADDIT10N1kL INSURED,the policy(les)must be endorsed. It$UBROGAT 514 IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certify ate does not confer rights to the certificate holder in lieu of stxh endorsemenK-S). . .. CONTACT PRODUCER J Christopher Jordan Professional Insurance&Risk Brokerage.LLC t PRONE 781 826 74T5 ' s�z 791 828 7484 .. I7: � 31 Schoasett St Suite 309 r %e" c`ordan Irbinsurance.com Pembroke AAA 02359 itl 4Ishr FORD, .cavEaaf _. Nk?C#._...,_. u surtER ._.AtM 111UTUAL, 33768 - INSURED �I�siaR�r?p: The_ aln Street Arnc�r:ca Garoup _ .__._ _,_•. #4788 dADH Construction.Inc. c+5vlaFac Penn America In.Surance Co 32859 POox'6433 1yi � p Scottsdale Insurance Co _.., 41297 Plymouth MA 9236d COVERAGE$ CERTIFICATE NUMBER: REVISION NUMBER: THIS Ica TC,CERTIFFY THALT 7:}IE POL40ES Q]:fiNSURANICE UST ED BE et`*iAVE Q�E-E N ISSUED TO THE iNSv+c.E7 NMIAED tWI(E-10R TF-E PO Icy,P-t i2l� INDICATED. NOTWI HST 4,14D'ING ANY Rl l'1UIRE W1Et, . 1`I~WA OR CCNDr i 3(,'N OF ANY CONTRACT C R OTHER,t)i3(-,Utv4E.NT WITH RE-$PE,: 'TO`JVHIilr i(i%"ti CERTIRCATE�1AY SE ISSU D OR IMAM PL.f'iTiii!. THE w'SL`;ZANCE AFFORDED BY THE POLICIES DESCRIBED I-ifwf�EfN 15 Silly:E T T.ALL?i HE TERFRS. IrY,C'LL�JeCilel`"J A `,�tl;al@Tll�e`IS£..'" ..a.`'f ra°:sv$..{:'..cer?.If�;IT :es:3`,drwPY iri�tY f+A t�l• fl✓t` f ..............Irrty. ......._...�._� ,�<.__,..._...._._.„_..._._. .__�._ ._..,. ...w. .. .... .,.. INSR AE?Di$tIR _. P�JLiCY EFE Pf>Ll4 XP Y c TYPE OF INSURA iCF POLicy NUMBER rrYiM&Q1' )y Lili,YS C C t.R+t..:•=a qAi X X ISO FORM C00001 X X PAC12%72 05115/17- 05115M8 E�, r r nI -•,c six 5 fl00 f _.. X Contractual Liability It •CNL: � r'�'C.t.i s?t'.� r=�ldt,�wi,-..'7' t R' Si�L �.a-sZf ty s+�.rQQ�,l��!{I�®y .,.,1 V_Y ¢JG ..., - ga!1 s7»Au "A" ai OfIDrDt)0. ASITp64l'9E1,LELi�.s$3LtT'Y ,..::.,,.�3�.,fr;..,_.... .._._.,.. ...._..__.,..�....-:---...,�.�-,._:.__..._. ettrr g ir`f`. COME`P.t-t_ c If' X X M3F02t163� O6E18117 O6I181i8 "'s yip r?; w. X ISOCA0001 X UMfIREULA LIAO X t .:.;as r x:_?.{ t strf t�C . ... s,9;000,000. D Ear ss L s u . .'_„ X X XBS0076026 0511 17 05l1518 ;: ,i t,?r �1,009 Qllt X....`'i tir, :gin-10,000nVID -- i _ .a �. woRKERSCOWEr15At`IO Nth ti* AND EMPLOYERS LIASPOTY iA1 �l2 As Y[RvrRtr ;�,r Ariit C€trf.xK ...,"e+ YIN :s,a .X VWC1fl060193752017A 091fl4i1.7 09f04t18 ° " �{ ,500 00 A sfrCz!Y E ft -f diLG C narRc -c r E s5�11 QQIT C.L, ,500 000 _ 5. Comprehensive Ded Wo 8 Auto Physical l?alrlage M3F0206P 05,F1$e17 o6118118 -Collision Deductible SS00 ' DESCRIPTION Of oPfRATiON$:LOCAP ONS J rftii f:; t A{ORO;y11,Ash 3 tt tan€1L+; 3rr19!W&,tt".-ay be attachfad it a•wra space i.mgoies8i CERTIFICATE 140LDER CANCELLATION SHOULD ANY OF THE ABOVE OFSCRISED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TMEREOP, NOTICE WILL BE DELIVERED IN A.I TPORIZED REPRESENTATIVE D f , ,c 1.988.2014 ACORD CORPORATtOK Alt rights reserved. ' ACORD 26(2014101j . The ACORD name and logo are registered marks of ACORD r h PLOT PLAN SHOWING ILNOCATION OF BUILDING CENTERVILLE BAR N STABLE MASS. FOR ALA N E. SMALL INC. SCALE' 1 "= GOt DATE. AUG. 4) 11375 CHARLES 14. SAVERY INC REG. C.E. L.S. 712 MAIN 4T Hl*NNIS . MASS V DR I VE RSA 3 pr2M 3 A=51:99 " X K\ Nick pie\\\n9� 17'* M t e 22 2,3 s 15,123 5•F ^oa 17 34,00 24 I� herehy m ify th-it the huifding exists ('_4con the -ground as shown on this planand / is in accordance with the zoning ` ' A ror Iremporc cf the,Tawn of Barnstable. � -•� •. : ' ,�, • SAyJ 9l/oy�v Registered, Land Surveyor THIS,LOT IS NOT LOCATED IN A FEDERALLY DESIGNATED FLOOD PLAIN ZONE. 722 38 A •..-.rvr-+�1..r•✓`�vF�w/ti...ry,,,,rt•,�,,...,,,,,,,,,r�.,,�.d`t�y..r`/'�...�ti... ��.-.�+-r .�....�••-*w�+++..r�.+r...��-... �.- .�..�.......,.w,�..�,_.,,,,�. Asses,3or's map and lot 'number SEPTIC ' �. INSTALUED IN- Sewage Permit number vZ .. �, WI7H `�'° ... . .. Sf�Ff ITS�tl' G:aJE P':y TOWN FTHE'T��yO TOWN OF. BARN�STA�BLE ii • i MUMBLE, i "b 9 .e� OULDING INSPECTOR APPLICATIONFOR' PERMIT TO ........... ................................................................................................................. TYPE OF CONSTRUCTION .........: ...... . . ....... .. ................. TO THE INSPECTOR OF BUILDINGS: The undersignod��reby applies for a per it according to the Alloing information: :: n..l..Location .... ............................ .... ... . .. .... .. . . ........................................................................ ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District ....... .............. ............ .. ................................... Nameof Owner ..... ...............................................................Address ......... ... / r Nameof Builder ....................................................................Address .................................................................................... Nameof Architect .........`.........................................................Address ............................. . ............................................. Number of Rooms ......... ..... ..... ....... ...............................................Foundation . . ...........................................Exterior ....... ::.....................................................Roofing ................ . ..............................Interior ......... Floors ......����`�..".`:.............:................ � .....C.i�,rZ°�••••!••••............................... Heating ..................................................................................Plumbing ...........:y.............................................................. 3- 15 .....................Approximate Cost ............. ... .........................................vv Fireplace . Definitive Plan Approved by Planning Board ________________________________19--------. Area ....../.. ... .. ................ Diagram of Lot and Building with Dimensions Fee.. SUBJECT TO APPROVAL OF BOARD OF HEALTH l --�..®. I hereby agree to conform to all the Rules and Regulations of the Town of Ba table regarding the above construction. r" Name ! .................................................................. 256 ' ` \ No 17870—.. Ppimhfor — ............... � ............................... ��.�, Lot g��q eao Qr. Location ---.—..��.�---r----.�----- ' .............. =------------- ` � / Owner ..............Alart..���`ll_______..__. . Type of Construction ...�hood.JFraoom.----. ' - - -----.--~.----------------.. ' Plot .....191—_---. Lot ........... ...................... > � Permit GrantedAugu-s-t6. —lV 75 . - ! Dote of'Inspection Dote Completed ------lg ' / . � , � PERMIT REFUSED � ' -------.-----..-------. lA � � --------------------------. / --~----^`^—^-----^----------' | � t ._._,_________ ........................................ / ` > -------^--'--'—'—^^----^—'---'^' > � / ` | Approved ................................................ 19 � ^ � ---------------~--------~—. � � � ...................`.................................................... ^ � Assessor's map and lot number .!.....^ f J Sewage Permit number .. THE T TOWN OF BARNSTABLE i MARNSTA MILE. i "b 9 BUILDING INSPECTOR O �0 E MP'( APPLICATION FOR PERMIT TO -`�-'GY ............................................................................................................................. TYPE OF CONSTRUCTION ......... --?!;.' `'! .; ..:...................................... ............................................. .......6�..................191.).. TO THE INSPECTOR OF BUILDINGS: The undersigned herebbya. applies for a pe�rmiit}according to the following information: Location ` • !/Lt3 '.t./........... J .11 " •�'......................................................... ProposedUse ............................................................................................................................................................................. Zoning District Fire District el Name of Owner ems%.....`.......................................Address ..............11�,.. .. /`x-1.................. . ............................ Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ......................................:.......:..................................... r 11 Number of Rooms ......................Foundations r: f .. ............................................ C Exlerior .' '�'`� ' Roofing ............ ........................................................... Floors �A r. 1 l•* .........................................................................Interior . ,•ate Heating ........f............f........................................................Plumbing ..........................r`7.................................................. Fireplace .......:.... '.? 'r;'"'�` .......................................Approximate Cost J�1. :i.. .......`................................ Definitive Plan Approved by Planning Board ________________________________19________. Area .......!.. ." ............ Diagram of Lot and Building with Dimensions. Fee?V `5 �................. ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH c y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ..............;l........................................................ 256 ' 17870 ' No ................. Permit for DRMll^ ................... --------------~------~^'---' - Locution .....�«X...U..%}xxreao.J0r...................... Centerville --------'------`-----------' � Owner ......Alan-Small..................................... � Type ofConstruction —. ............... � -----^--.—.----------------' � Plot .1�1..................... Lot --.. ------ ' � � � Permit �ronua6 lg � ----''�e��oa���6--'' 75 � Doteof |nxpachon ------------lA Date Completed PERMIT REFUSED lA -------------' ------------' ................................ .. --------------' � —.----.--'�--- —...~--...—~----.. ^ —''--~-----^^---------^—^^—~—' Approved .-/--------------.. )V � ^ ` -------'-------^^^----'~^^''--^ -----------.---------..~--..,` | | ' — Assessor's map and lot, number .... .. ...V...4.:L........ �` ` -4/— 7 7 7 �'c ' SEPTIC' SYSTEM MUST BE Sewage Permit number .... rr�GL.., ... . .. . t �IN57' <L _D IP! COMPLIOICE WITHf�"Ti` !_E 5..P E -gANIIT !.RY OnDE.A'.t,R TOWN ofT"Er° TOWN . OF �BARN�S,I �MLE i ZAMST"LE, "AS` BUILDING INSPECTOR '' �fp IiPY OrY _ rP ' APPLICATION FOR PERMIT TO ....................................................................................... ................... _ ........ n TYPE OF CONSTRUCTION ....................... � n .. . ......... n t �' w ........................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Ile— Location ... ..... .D .C- ..U.....v.R.l.�.. .............C e/V' � (V/?�...��i.. -................................ 9 ProposedUse ................................................ ...........................................................................:...................I........................ , Zoning District . .............................Fire District Name of Owner /��. �•`u y� .Y..c .l> 7. . �/� /a/s d�dress ...... 6 7' 'r // Name of Builder .................Address ..///..., �t...ot'/Y/✓j- Name of Architect k /V�~ / Address ...............................:........:............................1. Number of Rooms G61151..A, ...!...Q.�,.(... ......:......Foundation ....... ......&:4....................................................... y r. / Exterior ..., e.C. .. .. `G.:..... .. ..(....1� . � .��.�J..............Roofing ..� ..�CiGi/`� .....7... .......... Floors . Cf ..L . ....5...................:................................Interior ....... �...GV.1`:4! ..... :...1�1... ' �S ................ �..+r...:. / Heating .................l...:.J.. � ......................................Plumbing ........................ ._............................... Fireplace .��. ..lt/:.' ........................................Approximate Cost .........../.... .:.: ..�.....: ." . .. .. G•. Definitive Plan Approved b Plarinin 'Board ________________________________19________ Area. l . PP Y g ...... ... . .. .. . Diagram of Lot and Building with Dimensions Fee � '.�� . f SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to-conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ................. Carlson, Harold & Esther No 19094 = enclos/ck Permi%for .... ................. .......,- , .. ,Location_........ 94 . u Drive ' Centerville....... t Harold & Esther. Carlson Owner g frame Type of Construction f� ................................................................................ • .. tt a -. - I . Plot .... Lot ................................ Permit Granted ....................................ri1 .....19 �� _ , Date of Inspection ...........://...............:...�....19 T Date Completed G.� �! .. .... i .�:19 ? w PERMIT REFUSED .......................} ...................................... 19 :•�. ........................ ........... ........................ .. .;.. .................... .......... ?•;i �♦ a 1. ......... ..................................................................... ........................................................................ •. r�� ,.,♦f-�,. .. � fir• �. Approved ...........19 a ...................................... A, .- , _ _. - _. � ._ .. � ., ... �. y- .. ,.,r.r .r')" .o`•K ey+Ne a . „�.,,.,.d. '.:Aw.rciN'..�'=.ri:<...Js•.e.:�:,,.�..�..�,•L.,.,.�..W....r�.yev,.n Assessor's map and lot number ... ......... �QC/,�i 7 7 7 Sewage Permit number .... • ' y°f'THE r TOWN OF BARNSTABLE �. Z EABH$TAIILE,ABIL M6 9 e�� .° BUILDING , INSPECTOR 'E�MPY APPLICATION FOR PERMIT TO TYPEOF CONSTRUCTION� ` .................. ....................' ` ............... .......................................... .19.-! TO THE INSPECTOR OF BUILDINGS: ,,The undersigned`hereby applies for a permit according to the following information: Il Location .................................................... ......................................,:...........................:...................................................... ProposedUse ... .............................................................................................................. .. .........................,......................... Zoning District ...........................................Fire District .. �� Name of Owner Name of Builder /� - ' .r n. �.................Address k1(l -9— - Nameof Architect ....................... ........................................Address .................................................................................... V. /v C1/ gar Number of Rooms .........................................trr } � f(� 1��/�/� .........................Foundation .......,...................................................................... h ff� lr.. ..!�!.:..... .1?..�../!�.�... (J ...........Roofing ...r �S' ! .....t ......................................... Exterior7. ............... Floors � ........................ Interior ....... Z4 Heating ,................�.......I.....`✓. � ...............Plumbing ...................... ......................................................... Fireplace .................... ... R......................................................Approximate Cost ........... ... .1 - .......:......... .... .... ........1......... Definitive Plan Approved by Planning Board --------------------------------19--------, Area ...................... .............. `.r...,r„v t_ Diagram of Lot and`Building with Dimensions Fee ' ..........� SUBJECT TO APPROVAL OF BOARD OF HEALTH ; 1 w Y:. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. W ��Name .................... !..�a�fi��'�'�................. Caisou Harold � Do�ber ' /lgl~l88 ' No J�u9* eoclmse/de ................................................ — 94 Thoreau . Location— -----------t�^--------' Centerville _—.-----------.---.—..—.-----.' Harold & Dotbmr Carlson Owner ---------------------... ^ frama Type of Construction -------------- ' . . . ---------'----------------'- . . . Plot . . Permit Granted . ^ Date of Inspection ...................................19 � ^ uo/e Completed - . . . .^ . PERMIT RE)IUSED .-----_----. , ........................... ' ...................................... ...................................... . . .......................................... ............ � . Approved ....................... 19 ` . . ' ----------------------~.--.. . . , -----------.------.—...---.... . . . . ^ . � |