Loading...
HomeMy WebLinkAbout0028 THREE PONDS DRIVE Y � JA 4i im 41 AL k ."M.:� f.+ xY..l'�Y,,y.'C: ,' ,v. .� � -.• V pF. ,;I.n .. ... :: i .1 d.l- M ,�,�.. ,•� Aa.'�:.,#� .:.� ',- �.b„b.i ., i.. ., �•', .;:'. .. �. :. �b ; •k, _ `,+ ��. tea# ^a 0 , • , .. _ a ,: - w, a .,, _. .- • ,. � J - n c , ' e , • r a , r , n 0 n u , , p 'o , r , Y , u X ` i s ,.' *. C Now Y 'THE r, Application numbery 'f..... -�J�& .......... snawsrn P Date Issued.......... BM ...... !.................................... nvaM SEP 0 6 20•18 Building Inspectors Initials.. ......................... FO WN 0� bAHNS(ABb Map/Parcel........ .......F 3` ............................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY FORMATION Address of Project: L T re �„�S �P-V l/e NUMBER STREET VILLAGE Owner's Name: 4 rv,e ✓ea c�, Phone Number S rfr- Email Address: Cell Phone Number Project cost$ _ 2 IC1 (oj Check one Residential Commercial ®GAG 1VJL1'RIS AUTHORIZATION HOR.8ZATIO As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: S e ck\J Oa,-�&4 Date: TlPE OF WORK O iding. Windows (no header change)# Insulation/Weatherization u Doors (no header change)# Commercial Doors require an inspector's review g ) .—� q P v Roof(not applying more than 1 layer of shingles) Construction Debris will be going to 14J.1s46-Irla Ja�Pn'IP/1-1 - . col s t / L COl`7JLRL'ACTOWSINFORMATION Contractor's name Ida an `��n�,'so✓� - So+����r. 4/ � F,51eva kf,'1)c(oW S Home Improvement Contractors Registration(if applicable)# 17 ,3 LK 5 (attach copy) Construction Supervisor's License# yJ S-7 07 (attach copy) Email of Contractor a-Su)ed 4 Q5 �@ 2"(1' c-oR'1 Phone number q01- z 2 R -9 1a) O _ ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IIV A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUER. t. 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. 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 food is being sewed 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.Five Department appvovaL *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 any responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 C1VIR 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 1?LICANT9S SIGNATURE Signature o Date All permit applications are subject to a building official's approval prior to issuance. ew 4 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England Anne Veach AIA.M..� Legal Name:Southern New England Windows,LLC 28 Three Ponds or RI#36079,MA#173245,CT#0634555, Lead Firm #1237 Centerville,MA 02632 WINDOW 10 Reservoir Rd I Smithfield,.Rl 02917 H:(508)428-0717 Phone:866-563-2235 1 Fax:401-633-6602 1 sales@renewalsne.com Buyer(s)Name: Anne Veach Contract Date: 08/22/18 Buyer(s)Street Address: 28 Three Ponds Dr, Centerville, MA 02632 Primary Telephone Number: (508)428-0717 Secondary Telephone Number: Primary Email: Secondary Email. Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $2,919 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $972 Balance Due: $1,947 Estimated Start: Estimated Completion: Amount Financed: $0 8-10 weeks 8-10 weeks Method of Payment: Credit Card We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date.Rain and extreme weather are the most common causes for delay. Notes: Taxes in Barnstable Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing-or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s)and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER,MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 08/25/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC r dba:Renewl By Andersen of Southern New England Buyers) Signature of Sales Person Signature Signature jim passanisi - Anne Veach Print Name of Sales Person Print Name Print Name UPDATED: 08/22/18 Page 2 / 9 ' Commonwealth of Massachusetts t~ Division of Professional Licensure Board of Building Regulations and Standards Constrq&i& 1§6-pe.rvisor CS-095707 _ ires: 09/08/2020 W BRIAN D DENNISON 8 BLACKWE'. DRIVE ` CHARLTON MAi01507 `" Commtssioner C;L Otfiee of Consamer Affairs and Business Reg lation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registratiork Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2 018 BRIAN DENNISON 26 ALBION RD :.. LINCOLN, RI 02665 Update Address and return card.Mark reason for change. Address = Renewal 7 Empioymeut _ Lost Card -Office of Consumer Affairs 8 business Regulation Registration valid for individual use only before the HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: Office of Consumer Affairs and]Business Regulation Registration: 17?245 Type: IlQ Park Plaza-Suite 5Il70 Expirations: 9,,19,,201 8 Supplement Card Boston.NIA 02116 IUTHERN NEW ENGLAND WINDOWS LLC. :NEWAL BY ANDERSON JAN DENNISON ; y� JCOLN, RI 02865 --t;ndersecretar; Not valid without signature L.-S.TL. Irk. y: \e�v.:fitly�.0 Cc; .,.w tii iG+: BRAN D DENNISON LAM,3S FOND CIRCLE -"ARLTON VIA 01607 The Commonwealth ofMassachusetts Department of IftdustrialAccidents o I Congress,Street,Suite 100 T Boston,M,q 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. Applicant ormation TO BE-FILED yVIT11 THE PERmrrnNG AUTHORITY. Inf ' Name (Business/Organization/Individual): ` e .� Please - Print Legibmly awl Address: City/State/Zip: p Phone : Are you an employer?Cbeck the appropriate box: 1.X1 am R em lover with ZO Type of project(required): P employeer.(ful]and/or part-time).* 2.❑I am a sole proprietor or partnership and have no employees working 7,eq,,,r 7' New construction any capacity.[No workers'comp..insurance rea,u ed.] 8• D Remodeling I .❑1 am a homeowner doing all work myself[No workers'comp.insuranrequired-] 9• ❑Demolition 4.�I am a homeowner and will be hiring contractors to conduct all work o10 a Building addition ensure that a1 contractors either have workers-compensation insuranc proprietors witb no employees. I I.❑Electrical repairs or additions 5.7 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet lc- Plumbing repairs or additions These sub-contractors have employees and have worker'comp.insurance.", 13.❑R of repairs / I 6. We are a corporation and its officers have exercised their right of exemption per MGi c. 14. Other n f r'N of Ot2l 152 6](4),and we have no employees.[No workers'comp.utsruartce required.' `/�/4 C�,yt f o �- 'Am applicant that checks box it1 must also fill out the section beiow showing their workers'compensation policy informatior, I Homeowners who subunit this affidavit indicating they are doing aP work and then lire outside contactors must submit a new affidavit utdicadrii such !Contractors that check this box must attached an additions sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they mast provide their workers'comp.policy number- 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: `irf PIL,/) S j Policy#or Self-ins.Lic. : �(� Z l — Z.O Expiration Date: Job Site Address Z V (12'r e e ` �n S j7�- City/State./Zip: ( Attach a copy of the workers'compensation policy declaration page(showing the policy number and exp- 2-t date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation puaiishable by a fine up to$1,500.00 and/or one-year imprisonment as well as civil penalties in the form of a STOP WORE ORDER and a fine of up to$250.00 a day against the violator-A copy ofthis statement may be forwarded to the Office of Investigations ofthe DIA for insurance coverage verification- 1 do hereby certify under th aims and penalties of perjury that the information provided above is true and correci. Si ature: D2te: Phone#: Fonly. Do not write in this area,to be completed by city or town official n: Per=A/License W ority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone : CERTIFICATE DATE(MMIDDIYYYY `.� OF LIABILITY INSURANCE ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEICATE HOLDER.RTIF 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). IRODUCER CoBiz Insurance, Inc.-CO NAME 1401 Lawrence St,Ste. 1200 P"oNE 303-988-0446 Denver CO 80202 C-MAIL ac Ne:303-988-0804 D COMail c�,Jnance.Com INSURORDING COVERAGE NAIC 0 1"suRER A:Acadia Insom an 31325 NSURED ESLERCO-01 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA,D.C. P1784 dba Renewal by Andersen of Southern New England INSURER c:Homeland Insurance Company of New York 34.452 10 Reservior Rd Smithfield RI 02917 INSURER D: INSURER E: INSURER F: OVERAGES CERTIFICATE NUMBER:1252851165 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. - R T TYPE OF INSURANCE AODL SUBR �MOL�ICDY EFF .iOOLI D FXP \ POLICY NUMBER A X COMMERCIAL GENERAL LIABILITY YYYI LIMITS 1112018 1/72015 EACH OCCURRENCE S 1,OOD,D00 CLAIMS-MADE X OCCUR PREMIPREMI 7 RENTED SES occurrence, S30C,OOC MED EXP(Any one person) S 1D,DD0 PERSONAL&ADVINJURY ff1,00D,D00 I�GEN'L AGGREGATE LIMB APPLIES PER; GENERAL AGGREGATE $2.000,000 POLICY LJ JC LOC PRODUCTS-COMP/OP AG6 g 2.000,000 OTHER: A AUTOMOBILE LIABILITY N CPA3158726 111201E I 1112015 COMBINED SINGLE LIMrT X ANY AUTO Ea accident 5-ODD OOO ALL OWNED SCHEDULED BODILY INJURY(Per person) 3 AUTOS BODILY INJURY(Per accident) 8 X HIRED AUTOS X NON-OWNED AUTOS PROPERTY DAMAGE S Per accident A X UMBRELLA LIAR X OCCUR CPA315872E I ff 111201E 111201E EACH OCCURRENCE S 10.0D0.000 EXCESS LU1B CLAIMS-MADEI AGGREGATE $10,000.000 DED I X I RETENTION S S WORK]ERS COMPENSATION - WCA3158729-20 I V12018 1/1201E X PER OTI+ g AND EMPLOVERS LIABILITY ANY PROPRIETORMARTNEWEXECUT1VE YIN- STATUTE ER OFFICER/MEMBER EXCLUDED? ❑N/A EL EACH ACCIDENT ff 1.000.00D Wandatnry in NH) N yas describe under EL DISEASE-EA EMPLOY 51.000.000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UMrr S 1.000.000 C Pollution liablBty 7WO073340000 1112018 111201E Each Occurrence $1,000,000 Claims-Made Policy Retroactive Date 052012013 Dea=e 5 10 0.0m IESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks schedule,may be attached if more space Is required) .'ERTIFICATE 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. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. 4CORD 25(2014/01) The ACORD name and logo are registered marks of ACORD YV . RQ A010 \ i It Lp qoOF R - _ 31 1 1977 No. 34 Q _ Dsu r "AS BUILT PLOT PLAN TO . THE BEST OF MY INFORMATION V1L MASS. KNOWLEDGE, AND BELIEF THE o FOL�i�ID,4TioN SHOWN . ON THIS R. J. O'HEARN, INC., RLS, RS PLAN HAS BEEN LOCATED ON THE 1348 ROUTE 134 GROUND `'AS ) D EAST DENNIS , MASS. ATE : a��8� SCALE f JOB N0. 6 - 12149 CLIENT: WLj9j9AY, .. .Q E REGISTERED LAND SURVEY® r DR. BY I SHEET. LL. OF �L_. Assessor's map and lot number IN E Sewage Permit;: number © .. ... ....... J 0 °4 ISTA `s-ED 9a y C`0 r St • Wilk*TITLE House number:.......................... .....................Z .......... 9 E TOWN REGIJ�T� TOWN OF --BARN'STABLE BUILDING;= WSPECTOR' APPLICATION FOR PERMIT TO . '................................................................... v TYPE OF CONSTRUCTION ............ �YU..Sf ......., ...... . . ...........�ILL:.d.C1 ................................... . :.. .K................19lei TO THE INSPECTOR OF BUILDINGS: .The undersigned hereby applies for a permit according to the following information:. ��. ....9.. ........ � . . .. .::,dicwe Location .... \.:.....e.......... ProposedUse ........ . ................. ............................................ ....................................................... Zoning District ........ . ' 'Fire District .......C. ....Q..........:........................................... Name of,Owner .....Q. .... `.Address .... ,. .4.0.. Name of Builder .�.>o.�.:.. ddress . T . t Name of ArchitectR/ '!,>� ..:e. . i . ......Address ).,;.. .:.., .. .. .. Number of Rooms .............. ....:......................................Foundation' .. ... .:. p ............... Iry .... ..Exterior .... .. .. /!. ...... .�.�. ... r!I/. offing �.r �� t...� Floors .............. ..... ..... .� .. ...................................Interior .... 4r1I ....:.......... ✓' . Heating ......... ..........:......................Plumbing .....0L. .. .... ............................................... Fireplace ......... 0. . . .............................:`.............. .Approximate Cost ...... D >�.�il.III .................................... Definitive Plan Approved by Planning Board ---------------______---------19 Area ,,,�.......................�— S� ..� .. Dia ram of Lot and Building with Dimensions i�r // y g g ` Fee .:........ �.�.............. ........... SUBJECT .TO APPROVAL OF, BOARD. OF •HFALTH' 2 a OCCUPANCY PERMITS'REQUIRED FOR NEW DWELLINGS hereby agree to conform'to all;the Rules and 'Regulations of the Town of Barnstable regordirfg'the above construction. ' Name .. ................................ • Construction Supervisor's License ....a..�...4g-3-7 e 'f ✓ OODCREST REALTY CORP. 25303, One Story o .................__P rmit for .................................... ^ Sin le Famil Dwellin r - Locationt Lot 46 ......28 Tli..e... .N .P.....n..d........Drive `f ' ',�.6� ..'t'� „may. . •' ............................................................nr. ........:.......... . t A Owner ..Woodcrest...Realty....Corp.;f...... t� _ ;. � • � ,��' � ��, � s ; Type of Construction ....Frame........................ ; Plot ..... Lot . .............................. Permit Granted July 12, 19 83 ..� o-•f� f t Date of Inspect i ....< !iir ... .1 /4•,J�. .19 .--` '. -• � »R ♦. a ,.> � k' _ ;, r ,.., Date Completed �:7—.Z.k_.. ... A....'.:19 1 y - _ mo _ ; Assessor's map and lot number ... ................... THE 42) Sewage Permit number ...... .............. 3DA"STAMLE: House number .............................It? MAGL ............................................ t639. TOWN OT. BARNSTABLE , BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......... ..... ................................................................... TYPE OF CONSTRUCTION...........q f. ....... ... ........ . ............ ................................... PA.A ....:: ..............19. TO THE INSPECTOR OF BUILDINGS-` The undersigned hereby applies for apermit according to the following information- A Location ..... ........:r tte....... ...... .... ................ ........................................... ProposedUse ........... S,...... 7^..................................................................... ................................ .......................... Zoning District ........cr��' ...... 3 .....L.Fire District ........K,..Z-At ...................................................... Name of Owner .......Address .... a . Name a ...... f Builder ..... dclress,..M.!� ........................... rXV ;e, 1-M1 A .... •...fi Name of Architect .........Ll­P .......Address .......... ... ........ ................ . ..... ........ ................................................Foundation. J.....Oz. .................... ..............................Number of Rooms ................ J ? T,14 ; — � I ......./Ekerior ..... , ....A./ -T... ..01ARv offing ....z ......... ...................................... ­4 Floors.,......... ...................................Interior .....A....... .................................... h ___H,eciting—,r............ ................................................Plumbing ... ........................ ...................... Fireplace i . ................ .............................................................Approximate Cost ......!t.... .... .. .....d............................... Definitive Plan Approved by Planning Board __________________________------19--------- Area ............ Diagram of.Lot and Building with Dimensions Fee ............ ................... ........... SUBJECT TO APPROVAL OF BOARD OF HEALTH Al- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above J construction. Name ........ . .................................................................... Construction Supervisor's License .... .....r's WOODCREST REALTY CORP. =193-'183 2530.3 One Story No ................. Permit for .................................... Single Family.,Dwelling .............. ..................................... ..... Location ..Lo.t...4.65........2.8...Thre-P...F�qAds. Di .................C PM.t ex.v i.11 e................................ Owner .....Waoidr-r.eat...Re.FtI.-ty..Corp....... Type of Construction .................Frame......................... ................................................................................. Plot ............................ Lot ................................ Permit Granted ............�Tu1y...12,.......19 83 Date of Inspection ....................................19 Date Completed ......................................19 e6 TOP HAT SERVICES OF CAPE COD Chimney Cleaning - Relining - Waterproofing Replacement Dampers - Chimney Caps STOVE INSTALLATIONS PROFESSIONAL FIREFIGHTER LICENSED CONST. SUPVR. #024272 HOME IMPROVEMENT LIC. #100147 CERTIFIED SWEEP #2719 FULLY INSURED - CLEAN & NEAT DEXTER T. BLISS - owner 428-1444 rk --� �e,ZG4 J 35/ Co/vim'•� a�y Q s 'vOf7N2 q TOWN OF BARNSTABLE / d DAH34TAHL i 'o,, 6 9. MASSACHUSETTS — 113 'Fa N ?/_ 7 /* !t/ u -,�. Solid Fuel Stove Permit DATE OF APPLICATION ...............� ... ...... 1A49=P4P*. ISSUING PERMIT .`® ... � /W` NAME ( ) ..sty............................. NAME (Installer) owner .�... Nile........ 4 . . . �� .. ....�4f......�.�:..V...!..�.�.5.... ADDRESS .Q.......7-4Z'e,.E....R6A di...��'t..V.. ................. ADDRESS .,,,,....26..OL?.....t-r2.L.�x.s q fir; its � STOVE TYPE ....................(........{..-.....................................................r............................ CHIMNEY: NEW ..........:............. EXISTING ........................ Manufacturer ....... `'.c9...1..!t�!J.........�aA9•!=......00.6r.-f.4'.. CHIMNEY: Masonry ............ .................................................................. Mass. Approval .. ................................:............................................................. CHIMNEY: Metal ................................................................................................... This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with tbe' y�.,W ...�/��� ........ �.. ���$ Department, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. IssuedBy: ..........: ...... ............. e .. �.�......................................................Title ......L�G/�........... Date................... �,�....... Permit to install expires 60 days after issue date StoveV............J.0,...t:....u....I.................W.4R e.d....................................................................................................................,................................................................................... StoveClearance D..........................................................................................................................................:........................................................................................................................................ Floor ...................b.EGGY•,�I L" W A-L-L- SmokePipe ............................... CAY........................................................................................................................................................................................................................................ SmokePipe Clearance ........................ ...................................................................................................................................................................................................................... Chimney ......�.....�.'U...r. ....................................................................................................................................................................................................... SmokeDetector ................................ ............................................................................................................................................................................................................................................... The undersigned hereby certifi s/that the installation of solid fuel burning stove and equipment made under au- thority of permit dated ........y �l .................. has been made in accordance with provisions gfe;e.7 lth of Massachusetts State Building Code now currently in effect and pertaining thereto ........ !..... ............. Installer INSTALLATION APPROVED ...f` `,,�............. By• /L�.. / �>��--- :/..... ............................ I idle: A- date Z(/ WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT ice... .""�.k°��'F",7'.'�krd"x,tt`.� 3r-�.�fe.�,,..'+n�Gn ,�'^���-�/fw.'R}'y,�,+'P'°,M'Wb'"""r�•,,�'"rj�.,'�-�.y�-=ir^��"'",�'°'`-a�0"�+�.t^F"'n"'�-tv'.�...w:i+b . TOWN OF BARNSTABLE t Z 86HISTABL i r 0 9. �,� MASSACHUSETT S k �3 6, 7 Solid Fuel Stove Permit f DATE OF APPLICATION .. 7 � FIRE DEPT. ISSUING PERMIT .�� .................... : ........... ............................. y NAME (owner) �-` /�tVl'1✓L A1.�• ,..... C:....... NAME (Installer) 0 AfA ADDRESS ... �` >r .......22r�� /a,n r � l�r'i,!/��.........�..... ADDRESS ' I/, r ; ,1 f� 1;'.r �� tn• !item.................. ... ^�^ .......... ................... ..................... �} ° .- STOVE TYPE .................... .................................................................................... CHIMNEY: NEW ........................ EXISTING ........................ Manufacturer ........ .: . t1,0 Co rr. _.r s CHIMNEY: Masonry............ ............................................. . . . .......c r k C1 Mass: Approval ...:. .: CHIMNEY:r Metal .c.......................................... ........ . installer has permission to install a solid fuel burning' appliance at the listed This is to certify that the above nsta er s p ss on pp � address in'-accordance with an application on file with the - 1�R! t�:"144�r�. F Department,. ..... : !: ....................and subject to- the provisions 4 the Commonwealth of, Massachusetts:-,State Building Code- and regulations made under the authority thereof. t A Issued By: .... Title Date ... � Permit to install expires 60 days after issue date 4 Stove . .. - . � !a c-..... ........... ............. ................................... ........................................................................................................................... StoveClearance ...........................................................:...................................................................................................................................................................................................................... Floor ..................................C 6a C Y" --E e, ............................................................................................................................................................................................................................................................................ 7 Smoke Pipe . . �. lt1�' Smoke Pipe Clearance .........................4 p _ .. ......................... ......................�........................ �....................... Chimney f.................. ............................................................................................................................................................................... .. SmokeDetector .............................. ........................... s ...... f ......... ....... .................... The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated .. �� has been made in accordance with provisions of £he--Commonwealth ....... ...................... of Massachusetts State Building Code now currently in effect and pertaining thereto : !... I................................. - : ` 0, Installer INSTALLATION APPROVED 1111V1W........ By a'' / �'-'' ''...:.... Title .............................................. ..........y.........�......... .. .. date I f., � "�/ WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT