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0117 WARWICK WAY
i � 7 ova_ Town of Barnstable 11dirig x 8rA Post This Card So That it is Visible From the.Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAOM Posted Until Final Inspection Has Been Made. ernllt 16,19 Where a Certificate of Occupancy is Required,such Building shall Not be OccupiFed until a Final Inspection has been made.. 1 JllJll Permit NO. B-20-1389 Applicant Name: John Vreeland Approvals Date Issued: 06/03/2020 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 12/03/2020 Foundation: Location: 117 WARWICK WAY,CENTERVILLE Map/Lot: 148-052. Zoning District: RC Sheathing: Owner on Record: OCONNELL, ELLEN M Contractor Name. ,JOHN VREELAND Framing: 1 , Address: 117 WARWICK WAY Contractor License- CS-107947 2 CENTERVILLE, MA 02632 Est. Project Cost: $ 19,008.00 Chimney: Description: Roof mounted PV solar system. System consists of twenty,315 watt Permit Fee: $'146.94 I Insulation: modules connected with microinverters. Total system size is 6.3 kW Fee'Paid: $ 146.94 DC. ! Final: Date: 6/3/2020 Project Review Req: p Plumbing/Gas Rough Plumbing: I 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. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and 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 Final Gas: 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 th ,permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 3 wry-�� 2.Sheathing Inspection �._,.�_..�,�. _ _ ._ _ - .— - ' Rough: 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 0 IV t Applicatio umber.... ..... ...ao........ ..�� ..? 3-5 iA` Qa Fee ......... ....`- ........... ....................................... Building Inspectors Initials.. ..: ... .. ......................... !� Date Issued...�.?........./............................................ Map/Parcel.............�.:1.. . . .. ............ TOWN OF BARNSTABLE sj�^rr- EXPEDITED PERMIT APPLICATION: SCANW- ROOF/SIDING/W INDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ox 3a- NUMBER STRE T VILLAGE Owner's Name: F Phone Number 5�68 l a$g Email Address: Cell Phone Number Project cost$ 0 Check one Residential Commercial ' Btill own- OWNER'S AUTHORIZATION T. 2 6 2020 As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR RNSTABLE Owner Signature: Date: TYPE OF WORK 21"Siding Windows(no header change)# Q Insulation/Weatherization El 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 '50, CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# p /7 (attach copy) Email of Contract e&-ca ',t1t4'1 Phone number ALL PROPERTIES THAT HAVE STRUCTU ES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE 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 "��� J All permit applications are subject to a building official's approval prior to issuance. f rlTlnummrsw HOME IMPROVEMENTS PH. 508.328.1635 Exterior Relnode experts 8W, Web: www.thomashomeimprovements.net Fully Licensed 8t Insured P.O. Box 177 Construction Supervisor Lic #99913 Ceritzi viife,'P'iA'U2`632 . 30 .- v _ 1- ��x Thomas Home improvements LLC.Pr000ses'to perform the foiloartng.work Location of proposed work: Ellen O'Connell ' 117 Warwick Way Centerville, MA 02632 Date on which construction should begin: Winter 2020 The homeowner hereby acknowledges and`agrees that the scheduling dates are approximate and that such delays that cannot be avoided by contractor shall not be considered as a violation of this contract. The contractor agrees that when such delays become known to the.contractor,the contractor will advise the homeowner as soon as possible. The homeowner hereby acknowledges that in certain remodeling work,the demolition process may reveal defects in the existing structure which must be repaired,creating additional work which may need to be carried out in order to complete the work described in this contract. In such case the homeowner agrees that the duration of the work and the schedule date of completion may differ,and that such variation is not to be considered a violation of this contract. Cost for labor and matenals under his contract: Install Maibec A white cedar siding on gable end of the home $2,260.00 Install AZEK PVC trim on following areas discussed: -� Front bay window sill,entire back door,entire back three season room window, =s1des • shed back rake member would be an additional $985.00 C bctAkrm Thank You for Giving Us the Opportunity to help'You hnprove Your Project In the event that while stripping the siding we find rot that needs to be replaced,the homeowner then has to agree and authorize any replacement or restoration. Then in addition to the above contract price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly rate of$65M.for a carpenter and$35.00 for a carpenter's laborer,plus the cost of materials. -Siding to be stripped and leaned of all old siding&debris -Home to be papered with Typar house wrap -Azek PVC trim to be feste led with Cortex &plugs as discussed -10 Yard dump trailer will be needed,on site,and wig be removed at completion of the job -Contractor will be responsible for allbuilding permits needed at the property With the agreement of the contract! �0: of estimate is due. Further payments under this contract are as follows: 1/2 of the estimate due at the start;and remainder due at completion of the job. Balance of all materials and labor shall be payable in full upon completion of work described in this contract. Payment as agreed upon shall be made when due. Any payments which are delayed shall be subject to a finance charge of 1.5%per month. The contractor warranties the work completed under'this contract fora period of one year from the date of completion. During the stated warranty period the contractor shall be responsible for the service of the repair or adjustment,but the contractor shall not be responsible for the normal maintenance,repair due to a6cise,misuse,aril or normal wear and tear,which shall be the responsibility of the homeowner Al warranties for the materials supplled by the contractor shall'be pastel directly to he homeowner. The homeowner may be required to register or mail in such warranty card or evidenceof ownership in:order to activate such warranties Homeowner failure shall not create arty respcsnslb lity for the contractor under the warranty provisions;the choice of repair of replacement shall beat the discretion of the contractor. The homeowner acknowledges that the form,content,and notices contained in this contract a_re intended to comply with the applicable portions of the Mass General Law Chapter 142A, and regu#atiorhs=Prorriutgated't#rer under li the exit yips n f ttc►n= ample ore,only such portion shall be invalid and the remainder of this oonhact shall be In full foroe effect. 1n addition,any such portion not in compliance shall be read and interpreted so as to have its intended meaning to the maximum extent allowed under such law and regulation. S'*gned as a seated instrument on this date: Date: Homeowner Contractor � � o .NCO d CEkWICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A OTTER OF d ►T"ONLY AND CONFERS NO RIGM UPON THE CERTIFICATE HOLDRI .7M CERTIFICATE DOES NOT 1"FaaniMy OR NEGATIVMY AAE M EXTEND OR'ALTER THE COVER0M AFFORDED BY THE.POLICIES BELOW. THIS CERTFICATE OF INSARANCE DOE$ NOT CONSTITUTE A cmamcT wTWEIDi THE issuHiG INSORER(S}, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE C,E110IVATE HOLDER.. IMPORTANT' If the cattillhWe adder an ADDITIONAL INKWj D.the poqKbo mwt han'ADMMNAL INUINED provisions or be endorsed. If SUBROGATION 8 WANED.subject 00 tEtttns and condom of the poncy.cwWn poOdes"*y raqul sh endorsement A stabmant on this cerdricalp does not confer ddft to Iw=dMcdo balder In dart of=x*a An t+aocuca cmmuy dell Mack Sylvia Irrst rmweAgency.LLC j t+on lift � 2#Zr r:att 508. 2781 404 Main Skeet t Centerville.MA OM 1 s l Fam lnsuraws . DOMED a ThonmHominpovenuffftuc c- PO Box 177 CentmNs,MA 02832 � e' COVERAGES TE tilAtl THIS ISM CERTIFY THAT THE POLICIES OF 01St CE LISTED BELOIN HAVE RPM TO THE SMAED ABOVE-FOR THE POLICY:PH2tOD INDICATED. NOTYUMSTANDING ANY RBC. R181NT TBMf!OR CONDITION OF ANY CONTRACT Ott O DOCUIllMT KM. T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PIlRTANI;THE DANCE AFFORD BY THE HEN IS SUBJECT TO ALL THE,t�S. EXCLUSIONS AND cONDRiONS OF Sty!P tYES LWTS SHOWN MAY HAVE BEEN RED BY PAID C)A11VAS a rt eestcY UWTS LTRTYPEOFQNIIMANCE X OWp�IAL OWSPALLKIWfY t;11M i 1,OtX1 D00 � 0cm i 11A000 lj7,16m txs 5.0w A 2WIX1416 5A112018 561=1 i LaAbva►aut+r s 1.OQ0000 GEftjh GFdMTE LWrAPP"pi3t E t ALAtIDREGATE :2 t}DO OOE} X POLICY a t ` PtiOQGCTB-tXlOPAGQ i '�. i s olpft s AUTOMOR E UARLM ANYAI711D BOD><.YWBiRY(ParPem$ i ( ttOD@.YiIIAiR1F(ParW�ddanQ i Y 1 i AtJT03 OraYmmolu U! LA LiAe Ij umoccumam s Oc ! omm LAa MWOMADE I ! GATE 41 s dtnafew IAlJtr You 1i0w 00 Q 41A N 200tVAM 5101QA19 5 112020 E.ir�us+AodoE►rr A NNltall oaawmz E.L.o -EA e�1 s in 1 a a..aa.�.�aar a1. -Pollcvtriar s 10� 3 o>:aeasatestATlat��.wc+►Tnl�►v t �s•w�+�''a�•ars�.»na.,sae�.sr.owsvwr Carpentry Insurance coverage� tb rile lemts, ` dlla and andolsgnmrft Ndaft coroined in the cetff=ta of 4>suraaoa sbagbqdMnWtohMabrsd,w*vador6. dpriled the awmp provided by the per►P i CERTIRCA 1 TCANQ E 1 f Sea"MF OF THE ABOK DESCMM POUCM BE 0089SLUUMM ��/�BpEgF�ORE TIE .OMMIM DUE TtMEDF, NOtICE vaLL BE IN NOW Totwl of Bantsiable Bung - �M M IM POLICY PRCA 200 Main Skeet nib MA MM FCC EtTtBd: O tl tS ACM OORPORATKm Ad rtV=r mvs& ACORD 25(201WM i TM ACORD Hants wW Ingo.are ts0d=d m uft cfACORD '� /rd a nrvrra a!!i6 ffQFtas,rreh �k F� V,�VG V ���14i�a�I RegalatTon ,. ;HOtaE I?APR0VEM&T_Ci1NTRAC'TOR Ran valid for indh4dual use only TYPE„b4rporaiEon befoie the wq&adon data. If found return to: t r g 4r1 O[lice,of Goi m `Affes sand ess Regulation 1854 ' : 06/08/2D2a One Artod Place suite 1w1 TROY THOMAs HOB litilP tQV MENTS,INC. Boston,IYtA 021 TROY THdMAS . 499 NOTTINGHAM 6k . : CENTERVILLE,MA 02 2 - AIOt iio i lit lwgRahm . Cnvreait6 of PAassact►usefts Division of orofess�otlal Ls;ensure Board of ButidTg Re�qulat qns and SiaAdards sa C.SSL-0999.1 :>, � 31tos Q4t43l2Q20 1 ROY A T � > ••�� _ - t ;x� �.. CW)tR1IS1Sioner C/*a+ i i i t r .. 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 (Busincss/Organization/Individual): *MA_5 ljdwx t(�$lC.d+►^f S Address: fdla( City/State/Zip: ,,, OdO Phone#: ,� Are you an employer?Check the a ropriate box: Type of project(required): l. I am a employer with_ 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6-./ New construction 2. 1 am a sole proprietor or partner- listed on the attached sheet. 7" Remodeling ship and have no employees These sub-contractors have g_ Demolition working. for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.insurance comp.msurance.t 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. tContractors 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: yll ► a rvl 11 V_ Policy#or Self-ins.Lic.#: g&( /n/�� Expiration Date: S Job Site Address: City/State/Zip: a _ , 1 k i C1 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 coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct: S4mature: D VAS Date: Phone#: ), LM_ Official use only. Do not write in this area,to be completed by city or town ojficiaL 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—_ CAPE C - F INSULATION j " IIYIFY4Y 3[FMl[53 [PFr IOFM 1Y[P[NO[0 ' =Frts, - uutrres IN[Y[At10N C[IGINO[ .. ' 1-800-696-6611 w .1'own of Barnstable TIs f.t Regulatory Services Building Division 200 Main St I lyarini.s, MA 0260.1 Date: If 1�\ ZOO`� 77 Dear Building Insp' ector Please accept this Affidavit as documentation that Cape Cod Insuulation, Inc. performed & completed the insulation and weatherization work at the property'listed below. Cape Cod• Insulation did this in accordance to the specifications listed on the building.per.rnit application. All work,has been inspected by a certified Building Performance Institute .(BP•1) inspector. All work prefornied meets or exceeds Federal & State Requirements. Pro ert�Owiler Property Address, Village` tle,d C'CONNe,\1 Insulation Installed .Fiberglass" :Cellulose,-_R-Value Restricted' Uru•estricted Ceilings Slopes Moors Walls (X+) ( .) ' ( l Sincerely _ Fle ry L Cas. y Jr, President r r '(' e Cod�_tt ulation,ilnc. - . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i Map Parcel _ ` ' Application InDo Health Division ;; !.3 �.• Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 0 Date Definitive Plan Approved by Planning Board j Historic - OKH _ Preservation / Hyannis Project Str et Address Village Owner. Address Telephone '0 - Permit Request "7, 6 G f> 1tr° ,J Zt f-e?k- `� �i CCU. .0",_- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District /'Flood Plain Groundwater Overlay 0 " Project Valuation �� Construction Typo Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No 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 ❑ 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 4No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name a� Telephone Number Address License # i`1A 0 Home Improvement Contractor# Email Worker's Compensation # 1,6 q-3 l / ALL CONSTRUCTION DEBRIS RESULTING FM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I� FOR OFFICIAL USE ONLY APPLICATION# i DATE ISSUED l MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i- DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable Regulatory Services Richard Y.Scar4 Dfiredor:: Builffibg Division Tom Peirry,Building Commissioner 200 Mam Street;Hyan ik-MA.02601 www towmbarnstablema.us Office:.508462-4038 Fax: 508-790.-6230 Property Owner Must Complete.and Sign This Section If Usin ,ABuilder Y;. ,w ,, z�l.y� ,.as Qwn�er.Qf tl�e Ject progeny kebyauthoiizeC F CO �J co,acC an inp beialf, in all matters rk.autboiazed b}►this.building perm it:application for. AiMciress bf::off *"P'o01 fences and aiirms.are the res onsf the`a p hcant. Poo]s F Y oPP are-not to be filled o. . 'utilized before fence.is`mst led and a}1 final inspections am PeI rfornned and accepted of Owner =SignaQue of Applicant Print Nance Print Name Date Q XORMSIOWN gPi RNOSIOMWU 1 t, Massachusetts Department of Public Safety Board o'f Building Regulations and Standards ^�^�^• License: CS-100988 Construction Supervisor HENRY E CASSID-Y, t ; f 8 SHED _ ROW , WEST YARMOUTH Mlt1 2t " ' 0' Expiration: Commissioner 11111/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza Suite 5170 Boston, Massachusetts 02116 Home Improvement CO traetor Registration Reglstratlon: 153567 Type: Private Corporation -t ', Expiration:' 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 Update Address and return card, Mark reason for change, sCA1 a) 20WO511t (� Address Renewal [] Employment Lost Card �T .._. ..... ........ _...__. ..................,...... ....._..., Cam//ce�Pomr�raa�uuerr�C/a�C�/�rwdcro�ccde6t Ofnce of Consumer Affairs& Business Regulntlon License or registration valid for Individul use only OME IMPROVEMENT CONTRACTOR before the expiration date, If found return to: eglstratlon: 1.63567 Type, Office of Consumer Affairs and Business Regulation . j xplratlon ; •1;21:15120,:16 Private Corporation. 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSUIAGGU' N HENRY CASSIDY 18 REARDON CIRCLE'., S.O.YARMOUTH,MA 026$ Undersecretary ' qNva141dut sign e J • The Commonwealth of Massachusetts Department of Industrial Accidents :j Office of Investigations -- 600 Washington Street+ t,t`......_.(�' Boston, MA-02111 ww)v,mass,gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information' Please Print Legibly Name (Business/Organization/Individual): Address: /l"R1�� ✓ City/State/Zip::: IL W i t Phone Are you an employer? Check th appropriate box: T e of re uired 1, ,1 am a employer with 'il _ 4. 0.l am a general contractor and 1 YP project ( q �' , have hired the sub-contractors 6, New construction employees(full and/or part-time),^ rr` 2•❑ 1 am a sole proprietor or partner listed on the attached sheet. 7, [] Remodeling shipand have no employees These"sub-contractors have 8, [] Demolition working forme in any capacity, employees and have workers' -co insurance.$ 9, [] Building.addition" [No workers' comp, insurance � - P� • . required,) 5. [] We area corporation and its 10.0 Electrical repairs or additions officers have exercised their , 3.❑ 1 am a homeowner doing all work l },❑ 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' 13,5 Other comp, insurance required.] q ] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this aaMavit indicating they are.doing all work and then hire outside contractors must submit a new affidavit in such. Contractors that check this box must attaghed an additional sheet showing the name of the'sub-contractors and state whether or not those entities have employees, If the sub-contractors have empioyees,they must provide their workers'comp,policy number.: I am an employer that is providing workers' compensation lnsurance for my employees, Below is the policy'and jobsiie ,information, rt Insurance Company Name: \ k NJAov Am ,, Policy # or Self-ins, Lia #; 'i (��i- Expiration Date: l 1 I , Job Site Address: htJ l(, City/State/Zip �L Attach a copy of the workers' compensation policy declaration paSe(showing the policy number and,expiratioIn 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 formi 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 insurapgLcoverage verification, I do hereby certify d the pal an penaltles ofperjury that the lnformatlon,provtded bove !s true and correct, S nature; e l _ Date; Phone#: 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 ('nntant PPYCnn' CAPECOD-27 ,BDELAWRENCE Acoizo� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `•—�' 6/30/2016 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 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: Rogers&Gray Insurance Agency,Inc. PHONE t ac No:(877)816.2156 434 Rte 134 EMAIL South Dennis,MA 02660 ADDRESS; INSURER(S)AFFORDING COVERAGE NAIC q wsURERA:Peerless Insurance Company•see LIBERTY MUTUAL INSURED INSURER B:ATLANTIC CHARTER INSURANCE GROUP .. Cape Cod Insulation,Inc. INSURER c 18 Reardon Circle INSURER o 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. ' INSR TYPE OF INSURANCE POLICY NUMBER ADDLSUBR MMIDDYrYEYYY MMIDD�YY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR- CBP8263063:. 0410112015 04101/2016 DAMAGE TO RENTE17- PREMISES Ea occurrence $ 100,000 MED EXP(Any one person)- $ 5,000 " PERSONAL&ADVINJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X .POLICY JEo LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY o ' COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident _ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH• AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE YINNiA WCE00431901 06/30/2615 06/30/2016 'E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLVOl (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ •1,000,000 If yes•describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES.( ACORD 101,Addltlonal Remarks Schedule,maybe attached If more space Is required) Workers Compensation includes Officers or Proprietors, , Additional Insured status is provided under the General Liability and Auto Liability when required by written contractor agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Cape Cod insulation,Ind THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 18 Reardon Circle ACCORDANCE WITH THE POLICY PROVISIONS, ' South Yarmouth,MA 02664 AUTHORIZED REPRESENTATIVE ©1988.2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD. R • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map Parcel Permit# Health Division (N ll - §1Z/uo "01C Date Issued �a { Conservation Division S 17,00 Fee y6 G 8'• 0 Tax Collector Treasurer BE Planning Dept. SEPTICED W INSTALLUST PLIANCE Date Definitive Plan Approved by Planning Board X $ ENVIRONMENTAL.CODE AND Historic-OKH Preservation/Hyannis t ; -TOWN REGULATIONS Project Street Address %J Gy rI't.;C, �� _ `�� L 7 lf- Village E r✓t`�✓`� e Owner ddress / 1`7 IAA+P IC �� , C�►�11�A'v �l� Telephone L.�av— Permit Request 3 '��1 SO►�sbU✓� ( �o 1 � Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total newcr— Estimated Project Cost w Zoning District Flood Plain Groundwater Overlay Construction Type W oo.!9 17—V1 4A`_-1 Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 3_. Two Family O. Multi-Family(#units) Age of Existing Structure �`(`S Historic House: 0 Yes O-P�� ' On Old King's Highway: ❑Yes ^ Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other 54x-o 7-6 �S 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 O Electric ❑Other /L 0 Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes O No Detached garage:0 existing ❑new size Pool:O existing Cl new size Barn:U existing ❑new size Attached garage:0 existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes O No. If yes,site plan review# ` Current Use Proposed Use A BUILDER INFORMATION Name 01 "r- P1 l"c O✓ Telephone Number 5 `6 a �i Address 3 ? 8Ptif:2 License# 0 S y 1 ____r�, ✓p ( ✓la to a b 3 Home Improvement Contractor# / 6 3 Worker's Compensation# t"v F,2 V761 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE L6 -FOR.OFFICIAL USE ONLY PERMIT NO.- DATE ISSUED MAP/PARCEL NO. .+ ADDRESS 3-4 ^- ,z r VILLAGE OWNER, " L DATE OF INSPECTION: - FOUNDATION FRAME t 4 I•NSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL ' ' - PLUMBING: ROUGH FINAL GAS: 'ROUGH FINAL FINAL BUILDING co P DATE CLOSED OUT ' ASSOCIATION PLAN NO.' ' ` g r ; W-u-, 600 Washington Sheet Boston,Mass. 02111 Workers, Co m ensation Insurance Affidavit name: . location' city C4 y y�l /�t d �° Z ,hone S6 ❑ I am a homeowner performing all work myself ; ❑ I am a sole proprietor and have no one working in any capacifty am an em loyer providing workers' compensation for my employees working on this job. com,anv name• ...... f ............ :?.: :. }. :. ....... ?::•. . :::.:::.:.:...:::::...:.:: address. f ;. ++ >•}:.;::::;::. ....:.. .. .:......;:'":i:;:>;::::�::;:::::;:;>;::;>>::::i:'::;i::;i-:::;:3S:i•:;?::;ri�:..:;�::;:;>�. 2i2s:ii>i<::ii:i::.;;::::;:;� -- citw ' — insurance co. :;:> . ....... .: ..: ::: .<:. .:.. . . oiicv# Fc� ❑ I am a sole proprietor,general contractor,or homeowner(ureic one)and have hired the contractors listed below who have the followingworkers' compensation polices: :,.,.........................................................................................,.:.:::.:::::,..,,,..:.- com anvnam addresi- ... ...................:.�...:..........:::.::::::::::::::::::::::.:::::::::::•::::::::•::::::::.:�::::::::::::•.�•::.:�.�.:.::::::r:a::..::......... . .... ............... ..................................................r. ............:.............. ..,...v.......................r.............:r((.:r. .....,r.........r.{.•x:...v:..nv,:............:..::: :v::::::::::..:w:::::v:::w::.�:vr:::.:::::::...:::•::::•.vn.......::..........................., ....:.::..... `�•h, city ................................... maaran :.:::::..:.....:: . ::...............::::::::::::::: :. .::::::. ...... c any name:.:<::::<::;>:<.:;;::?......??.::».....?.:::.:•::;;? ??:::,;,.::.: addres p ijOII :..•::•::.::::.....:::.�................. .. ...:.:.::�v.�::.::::::.: ............................................... nv:.v:::.:•: CV ...� :: : ::::::::nv::�::.xv::::::::::.v::nv:::• vw:.r•.w:•+}}:{?k{{?•}:{{:::{:•}:{•i:{:•:}:•:ii;:;v:. +}}y:•:•v::?{4::??L:•i}:-:i::•:i:•i}}:J:•}:•}:f < Fanore to secure coverage as required under Section 25A of MGL 152 can had to the imposition of criminal penaities of a fine np to S1,500.00 and/or one yam'imprisonment as weR as dva pendtles in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. I understand that s copy of this statement may be forwarded to the Once of Investicadons of the DIA for coverage verincation. I do hereby cerd the p dq r)=d penalties of perjury that the information provided above is true mid correct > name Uv signature Pr int name �— `e ✓� Phone it Sd 9—`��=7 �' oincW use only do not writs in this area to be completed by city or town official city or town. permli/llcense N ❑Building Department []Licensing Board ❑check if immediate response is required ❑Selectmen's Office . ❑Health Department contactpetaon: phone#; _ QOther�� 0evued 9/95 PIA) TabL.iS2.ib(condno") wig Ford Faris .. Prssaipttre Psslcs�es for dar ssad Tw�'��RssRidsndal Baitdla�8ssrsd MAXIMUM ( 1Y132Y>biIJM HOaagrCmu.=s Qls�g Ccs Ta I�va1 mw l f : Fr�a�e SlDI to 6300 Hnsi: Desses Q IZ!S ( 0.40 1 3E 13 19 t0 6 Norma R 1Z'S 1 03Z 1 30 19 19 10 1 6 Noses S 1Z!S 1 0,30 � 3E I3 19 10 6 LS AFUE T 13% 1 035 � 3E 13 2s WA � WA Normai U iSK 1 oA6 3E 19 19 10 6 Normai I: 23 arw moo: n AnM "r 0ARM W 13". ( OSZ 1 30 1 19 19 10 6 X Ir/. 1 43Z 3E 13 23 WA WA Norasai y IEY. i a42 1 3E I 19 1 23 WA WA Normsi Z IV% I 0.42 1 3E 13 1 19 10 1 6 90AF'ITc AA 1E'/. 1 wil 1 30 19 1 19 10 6 90AnM SS OF PROPERTY: 1. ADDRESS _ 2. SQUARE..OOTAGz OF ALL EXTERIOR WALLS: 352 5a F+ 3. SQUARE FOOTAGE OF ALL GLAZING: _ 4. %GLAZING AREA(#3 DIVIDED SY#2): 13 c U S. SELECT PAC., AGE(Q —AA-see chart above): NOTE: OTHER.'MORE INVOLVEDME'.LHODS OF DETERMINING ENERGY REQUIRE1ri�TTs ARE AVAILABLE- ASK US FOR THE INFORMATION. BUILDING INSPEOi'OR APPROVAL: YES: NO: �°p THE The Town of Barnstable MASS.BAMSTABLE Department of Health Safety and Environmental Services s639• �0 059 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to. such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 5-e-t450 0�,5 Estimated Cost 1 b,o uy,W Address of Work: 1'� l�✓ w v�� C Owner's Name: 11 e ti C) `!CGAA-C- L Date of Application: y [ /CU U T I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent a owner. h A& lo3g)� Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav EST/MATED PROJECT COST WORKSHEET _ - - Value LIVING SPACE (high end construction)=-= = square feet X$115/sq. foot= (above average construction)' square feet X$96/sq. foot (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet'X$20/sq. foot= DECK - - square feet X$15/sq. foot= OTHER square feet X$??/sq.foot= _ Total Estimated Project Cost /.5-U L/ IAHFO 1/3/00 a !G'•4T/4pA/: cEA/TE V cnL Bak. 3 6 _ •�+«�eY ca�r�s�Y rN.gr 'e evit.aw. CW-"" OA./ TWAS OL.q/t/ vt Rs �rA,r�pwA✓ sif.eec:w .ra.va: .,,�gr tT .�i' f ,�..,�. ,fir �cti Y;,g e OUTN C -e c f o �. K = 44 X a, P 4 r . �a J ! 1 � r s� O �lp r � 1 0 � o L a Go 17 41 - �` -72. �omwanonuiea �✓�avoaclu�ae�Gi OEPARTNENT OF PUBLIC SAFETY :CONSTRUC H\SUPERVISOR LICENSE Expires: es wed 00 �. _31 Al ' CENTERVILLE, MA 02632 • - _ 7MfYceS.:�d�4�-.cTr*-T^•cam . ..P;',�±-s.T,,; ;tit .•r as i:._.. .r._ �. HOME IMPROVEMENT CONTRACTOR Registration: 103218 Expiration: 01/06/2002 Type: OBA ` APPLETON CONSTRUCTION D ter Appleton ADMINISTRATOR J/ BairE Way {I Centerville NA 02632 - .FROM - .. '. - " -TOWN 4F BARNSTABL E BUILDING DEPARTMENT' Mr. Francis L,ahte�;ne � �� 4 Town Clerk W? MAIN STREET HYANNIS, MA OM Phone:, ns-1120 SUBJECT: ~ .FOLD HERE - - ... DATE Jame 13>• 1984 MESSAGE � Work-has beeiI. comple'bed under Buiiding Permit #25364 (Coolidge Samos) ,& f Perzui;t #26106 (Coolidge Homes). Please•release. Bohd.. . SIGNED f DATE REPLY , 3 SIGNED N87•RMI RECIPIENT:-RETAIN WHITE COPY,RETURN PINK COPY = • - ' - PRINTED IN U.S.A. - SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. ' s N a TOWN OF BARNSTABLE Permit No. _____261-06__._ »>z� Building Inspector ! cash r � rug a r-•. .. ,- . OCCUPANCY PERMIT, Bond - --------------X-------______- Issued to C!Oolidcre BaMS Address ` I i.li, 11.7 Rmvici'Way. Cn t,-- a l le Wiring Ins ector Inspection date Plumbing Inspector/.� /4_, ,L Inspection date Gas Inspector Inspection date x7 p Engineering Department � - � i Inspection date 6-Il — Board of Health f, � r Inspection date �/�7 4- THIS PERMIT WILLL NOT BE�/VAL AID, ND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED"BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector a " Assessor's map,and lot number ........... ...,. �- (..... a pFT"ETo � .Sewage Permit- number ...................................(.•41.'?�;�. ...... Z BARNSTA►DLE, i House number j MAO& .... ...!............... 9 0 �p 1639. 90 TOWN OF, BARN_STABLE BUILDING INSPECTOR . r APPLICATION FOR PERMIT TO ........... .... ...j. /.l�.r'� I� ,y...; ../.. .......F ....... ........�........�................... TYPE• OF CONSTRUCTION ........V4�20�.. ... Mr..d.A.� ,........................................... ......... .... .................... ....................19. .y TO THE INSPECTOR OF BUILDINGS: The undersigned h reby applies for a permit according yyt�o the�followi g information: i!c. ... /`f ✓�. ✓...��..11f'..... . .... ... ..................... . Location ... ...�........ . ... ...... .. .h.... .. ........ r r �� l 1 DW4 l/�Pro osed Use ..... i !.'' G !.[../..� id�l.e, . eap ./... t ... . . , W. .................. ................ ... .. ............. PZoning District ... ....G.......:...... .................Fire District ... ..., , /. ....,...... __.. a.... Name of Owner ... .. �1!`�!........... .t �<`P ...Address .. 1 .. .. .... ,�!,� ` ...... K.l.! t^ t ! S Name of Builder ......,....�1./...........�911 ... ......................Address Name of Architect ..... .. \.:...+.......\..... ...............................Address ......I....\..............I i ............. .......................`........... Number of Rooms ........./•.'? �..............................................Foundation ..: ... .�J.. ' .l..... r!.� ?1��............ 1 l ` _Exterior .�?!1..,../.. M_....!.�?.. .�,✓�..... ......... ,o Roofing ........ ..��/!..// .1.. l , .. ..................... , �Floors ...... ............... ............. ......... . ... .... ....................Intenor .....!�;.... ...... ...: Heating r , g: , s ..... +� . _ ..�. _ ..v,., Fireplace .................... � .,�/ /�.�...........................Approximate. Cost ........ . d. g�� Definitive Plan Approved by Planning Board __________----------------------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - n.�4 Name .�twQ.... ... ../. Cons?ruction upervisor's. License G1�f a,.!/ 6j- ............ r, COOLIDGE HOMES A=148-52 I 26106 Vn 'Story No ..............r.. Permit for .....�............ Single Family Dwelling F Location ..... ot..18. 117 Warwick Way Centerville................:.............:.... y Owner ....1 o 51e Homes ! Type of Construction .........Fr ....................... - ............. ........................................... i Plot ............................ Lot ............................. • ary Permit Granted ........................................19 84 Date of Inspection ....................................19 Date Completed ......19 i J r I l Assestor's map{and lot number O// 179 `� _ PiCYw ftp' F7HE rod C� y Sewage Permit:number I v �'aL� l= x ( P ?IIJ Z W- 4, BJHH9TADLE, i House number ................ r.....:.......... .................... ,63 0 YAY a�9 TOWN - OF BARNSTABLE UILDING ' INSPECTOR' R C . ' APPLICATION FOR PERMIT TO .�:. :.:.. . . ..1f ....: gin.: : .. /TYPE OF CONSTRUCTION ......... rC.:. :..... ......................................... ., ................ ..............7. . ...1....................19AY TO THE.INSPECTOR OF BUILDINGS: The undersig ed reby. applies for a permit according to; the follows infairmation: Location ... . ... .......... ............... .................................... ..................... . . .. ...Vl. ./..... .. .. ................... Proposed Use .., /.:h ./'... . 1.� "` .f'j. ...................' ....... ..........�......... "... !. r • / Zoning District ' ...... .... .....�... ....'.:.. .::...:.......Fire District •... ...,1. . ./. . ..�...... V� . Name of Owner .. f�...l. ... ...... Aciclress�.'.`2.1�.................... �� . . !. ....� (15 Name of Builder; .:`... .W�5..... /��.. ..Address l ' ` ....... ...................................... Name of Architect .....t.. ..............�....`...............................Address ......1...�........'.:.:...�:.1. ................: ....... Number of Ro ms .:..�/. .............Foundation e1 f .. .(... . :.�,�......... . Exterior "`' . . ...I ....L. li1?/........,; f./.L �? v..1 .........Roofing ...:.::: ...�.. ../ ../..... E y.. .......J t Interior .. o�.......... ... .. .. Floors .. .... ................... �... ............................... .. ..... .. .. ..... .. Heating ....... ...... . .........:...........:........................Plumbing ... �J . ............................ Fireplace .. .. . ��s � .. .. .. .. ............rApproximate Cost ..... .v .... ................... ............. Definitive Plan Approved by Planning Bodrd _________________ `!.. �f r ,... ---- - 19 - - Area 1.... Diagram of Lot an d Buildingwith Dimensions Fee .............................L�..�....:.../ SUBJECT TO APPROVAL OF BOARD OF HEALTH �`✓ 'OCCUPANCY, PERMITS REQUIRED FOR NEW DWELLINGS s I hereby agree.to conform to all the Rules-and Regulations of the Town of Barnktlearding the above' construction. Name .....i� ..................................... y . Construction upervisor's License... ... f__C 1,IDGE HOMES 26106 Permit fqr One Story .. ............ Single Family Dwelling . ....... ... ................4...................................... Location Lot..18.'.....117 Narwick Way ,w Centerville :........................................... .......... Owner .. Coolidge Homes...................:........: TYPe of Construction .Frame............................. _ .�, ='ram rr �, .•�- ................................................... .............................. - Plot ....................... Lot ..................... �Permit'Grantecl ..........F?l?47 a.3Y..24.,. .f9 84 Date,of Inspection ...............................:t-9 l Date Complete .�...... ....1'9 • 4 - �. ..,�-� ,-� � r � � - -- ,_._,._ ,.,�� fir:� � - . - , • 71 r �.r iE V G,.L15:0- - �G�L Z 0C!r' GACTiop TFIAgT SA O.a! TttYl'� PL li+V /S :4.00 qTE a: dam/.7F'i/G�•. totrvt� 3 .SMpw. / N !CBGuc'/ .Ula N7wg9" fT y; 9µj . ,e / � OOrA.• rlc3 �d*llvtQi.V/�ll.Cr �,.Flit/:f �- 'fiC/�'�...� �•�`.�; �f'7 G , �. :'�.�-�'� �, t