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0140 PINE RIDGE ROAD
y RETROFIT INSULATION 1 Ricard Mccall 140 PINE RIDGE ROAD COTUIT, MA 02632 Date: September 25, 2020 RE : Permit#B-17-3963 140 PINE RIDGE ROAD COTUIT,.MA.02632 +v Dear Sir/Madam . y �,, I've received your message regarding an affidavit from rrie;Joseph RetIly, President of Retr iFitInsulation stating thestatus of the MassSave-weatherization measures thk,lwere to the above property All rrieasuce-were installed'and�cornplet d per the MassSave guidelines A final irisp ction was performed ,. 'by-RISE Engineering10 ensurecompliance with guidelines .Please don't hesitateao call me if you haue any questions regarding the work performed... k � erely J eilly RetroFit Insulation 13 .::.PO Box 105 �d Seekonk, MA 02771 508-989-6436 cell Town of Barnstable Building ..� HAWN LK IPost This U talyd So That it i �ibaeBeen IVIatlStreet-Approved Plans.Mustbe Retained on Job and thisrtCard Must be Kept i s ` Final Inspect o as e _ I Permit ° p y is Required,such Bwld�ng shall Not be Occupied until a Final Inspection has been made lwhere a Certificate of Occu anc .MN �, ilcli Permit No. B-20-1295 Applicant Name: kevin kuchova Approvals Date Issued: 06/03/2020 Current Use: Structure Permit Type: Building- Deck Expiration Date: 12/03/2020 Foundation: Location: 140 PINE RIDGE ROAD,COTUIT Map/Lot: 018-008 _ Zoning District: RF Sheathing: Owner on Record: KUCHOVA, KEVIN&KATHERINE M Contractor Nme. Framing: 1 Address: 8 LILAC LANE Contractor License: 2 PORT MURRAY, NJ 07865; Est. Project Cost: $7,350.00 Chimney: Description: Construct 15'-6" x 14'-0 deck on rear of home` Permit Fee: $ 110.00 Treated post, beam J g joists and ledger AJ i Insulation: Fee Paid:; $ 110.00 Composite decking and railing system s Date. 6/3/2020 Final: Project Review Req: t' l ( Plumbing/Gas ((( Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. 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 ofuse 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. f " Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspection_s Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection g Rou h: 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 Frameanspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 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. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department,,yt� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1r, Final: 47 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Q_—M -g_ Map Parcel Application #. Health Division kh S/OR ISTABLE Date Issued Conservation Division LF 0. � Application Fee Planning Dept. Permit Fee S 5' O 0 Date Definitive Plan Approved by Planning Board fi - Historic - OKH _ Preservation/ Hyannis " Project Street Address 140 Y- k ,Ne= (,>C'< (�_i) J,, `I "`� wL Village Owner J<eQ(i e r<_y(fJA o,J A Address c-y o t► NE' �� �� � - Telephone c Permit Request s' (� rvS yaf L 6 III I�SC;�,¢�� ��A� A Square feet: 1 st floor: existing proposed 2nd floor: existing proposed . Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ` Ov Construction Type 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 . ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1�� �(. �S•�\ '�l a� Telephone Number � d� ' �' Address P 0 x l (D s ' License # J 001 7 S V L'1ea,�,�e, �^� y ? I Home Improvement Contractor# y�' Email c 0 r orker's Compensation # V9 C e0 I d ALL ANSTRUCTIn DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE C'\ S DATE FOR OFFICIAL USE ONLY APPLICATION #, DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT; z ASSOCIATION PLAN NO. i { i , The Commonwealth of Massachusetts Department of Industrial Accidents s 1 Congress Street,Suite 100 Boston MA 02114-2017 l .. M 5� www mass.gov/dia. Workers'Compensation Insurance-Affidavit:Builders/Contractors/Electricians/Plumbers. ; TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/organization/Individual):Retro Fit Insulation PO Box 105 Address: City/State/Zip:Seekonk, MA 02771 -Phone#:508-989-6436 Are you an employer?Check the appropriate box: Type of project(required):. 1.Q✓ 1 am a employer with 10 employees(full and/or part-time).* [ j 7. New construction 2.M I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9: ❑Demolition 3.M I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.[]l am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.E:]Plumbing repairs or additions � 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.F�We al 4 4.El Other Weatherization e a corporation and its officers have exercised their right of exemption per MGL c'.. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] t *An applicant that checks box#1 must also fill out the section below showing their workers'compensation olic information. Y PP g P policy t Homeowneis who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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:STAR Ins. V9WC802160 8-2-18 Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:140 Pine Ridge Rd,. ' City/State/Zip:Cotuit, MA 02635 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a:criminal violation punishable by 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.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 ns and penalties of perjury that the information provided above is true and correct. Signature: "Date: 11/07/17 Phone#:508-989-6436 Official use only. Do not write i s 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#: Town of Barnstable Regulatory Services ak'ANSYT ft� Richard V. Scali,Director Mx1SS� Building Division Paul Roma Building Commissioner _ 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 568-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section I, KEVIN KUCHOVA as Owner of the property J hereby authorize Retrofit Insulation to act on my behalf, in all matters relative to work authorizedby this building permit application for: 140 Pine Ridge Road Cotuit, MA 02635 (Address of Job) b Zu ( 1-1 Signature of Owner Date a Kr V I PN V oVc� Print Name If Property Owner is applying for permit,please complete the Homeowners{License Exemption Form. C:\Users\decollik\AppData\Local\Microsoft\Windows\lNetCache\Content.Outlook\L7U69LF2\EXPRESS(2).doc . 01/25/17 S �� 7 �y k *A �4'1� L�. � .��� � ! y+R:�� ,sa '8 xc�+s�n+j.r- � da d .fi t '� z , 1 rk w y SCE t emirs aau �� , ," '" i� y S yy .�. - 1 � Lk ° ° is r r ,. y { 5 z ��..� '� h. y f a 0, T P a , . ¢¢g§ 3 �y F I g ''� K d # �S ! ` �' k 'C ,E t t�ay. ,{� #Y 4r'.. `s?' rye �y _"' S + ## + ���}lrf gJ 1 !, I s . �b ti -1 R� Y ' ��+yy�pyy w Y 1 ' ' � ...S..f P [� " a "4".'P a'A 9e _"ro 4.. .: j .. , t ye 1 t r + �•- �" 61�19ti 11t # bbtL ��AM M"' � � lgtOE 1 p � � . . r , "1 y� x aL w , �„ 11 , {y"' }rsf- ''4a g� ;.� „� x r.,_` � t�� n r r 4''-w".'.� (kif : „#f t k F ., r ,. : .. �, �; e 3 .;5 ya a y r :n 4�; .CHI } , > a r- r d �, ' Y e a # . .. l Ale, f .� °. a a ar `;� a;k, ` A �' s 3 ' � a q `yS {� 4 u �'is t} st r;." .lw * a t•x.a a �Y, 1,� t yyp "':"�i�Y.i.1f, A9�7� {«fir i� *r i .� :: r lS �� ,ixr '?4k 4 R s�r, r t. .. uj 9 d ° fir{ f s J h SJ d II 2*``$k,: "` r �, 1 '' <f �, > 3 4.G�g z4's >x c S f > } e., , w'• .' ,irk` � + ¢ r B :c ' 4 k ,.0 �: s a 'z e F � a a R ` a s �. + ' k a. �, e r a 4 -x - S .�F'k r '' y. 3 x :. , K1 `f'.2 zrF r z - as _ Y 3 _ e`x ,� : t kt � rs a hd 0. i �' z :k'r,.'k 4 ' s � '� i.r ,,, ,'�' d- �: r a x , r , , a v g far o:; "°' n a^'i ., ,, gy .. - - �' l 3 r r { 'f , ggs 4" .._.. ., .. ..-... - .... ,. --. .... .. a" ,-a..," .. _...-...- P" ..._..,,. . _ - i -, � — 1,: I � . 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Fir ..L .f } `,' is�, ' , C I. , =` -. <, - _ - - dt > ^� r„" Y,� sC. < -y V, ,C A` ,4,' " .,, 3' yn ot'<� ",.^. 3 .ec -, `t� "�rfi ra-Y f .gx h f 1 =,Y ai �°° i a, <..y- , , --: r, „^r x », ,r �.< .. ..�„Ak.$.a, ... ;`.t.-rw,�,x'lAa`s., .., ...�>:,,,,. xa.. ..�i ... ad. , Ni �'F.. - ,a .... .. .-•^'� RETRINS-01 DCARVALHO 'DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07127/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License#1780862 CONTACT Diane Carvalho NAME: HUB International Now England PHONE FAX 222 Milliken Boulevard (A/C,No,Ext): (AIc,No): Fait River,MA 02721 E-MAIL diane.carvalho@hubinternational.com v INSURERS AFFORDING COVERAGE NAIC#- INSURER A:Selective Insurance Company of South Carolina 19259 INSURED , INSURER B:National Liabilft&Fire Insurance Company 20052 RetroFit Insulation,Inc. INSURER C: PO Box 105 INSURER D: Seekonk,MA 02771- • 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 ADDL SUBR POLICY.EFF POLICY EXP LTR TYPE OF INSURANCE INS D POLICY NUMBER. M D LIMITS - A X COMMERCIAL GENERAL LIABILITY - - EACH OCCURRENCE _ $. 1,000,000 CLAIMS-MADE X]OCCUR S 2187653 08/15/2017 08115/2018 DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:. - GENERAL AGGREGATE $ 2,000,000 POLICY❑jE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ ' A AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT - 1,000,000 Ea accident $ ANY AUTO A 9100182 08/11/2017 08/11/2018 BODILY INJURY Perperson) $ OWNED . SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X AUTOS ONLY X AUOTOS ONLDY P OP.ER Y DAMAGE $ --- $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE S 2187653 0811512017 08/16/2018 AGGREGATE $ 1,000,000 DIED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE EERH 8 1,000,000 - 9WC802160 08/02/2017 08/02/201 ANY PROPRIETOR/PARTNER/EXECUTIVE Y - E.L.EACH ACCIDENT $ OIFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN N Sylvan Road ACCORDANCE WITH THE POLICY PROVISIONS. 02451 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD I � " Commonwealth of Massachusetts Sheet Metal Permit Map Parcel OU� Date: o� / Permit# •� I � � Estimated Job Cost: $ ?jam Permit Fee: $ Plans Submitted: YES NO Plans Reviewed: YES NO Business License# Applicant License# /� Business Information: Property Owner/Job Location Information: Name: T P o u A e Name: D,r kl� g Street: / DOA/ fnj(r3 0 C 1 y' Street: d City/Town: C—&dP/U t' City/Town: f,It, Telephone: 31 1336 .Telephone: Q0.2 — S 9 Photo I.D. required/Copy of Photo I.D. attached: YES NO staff Initial J-1/M-1-unrestricted license J-2/M-2-restricted to dwellings 3-storie8 or less and commercial up to 10,000 sq.'ft. /,2-stories or less, Residential: 1-2 family_ Multi-family Condo/Townhouses Othei � ' Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other 73 Square Footage: under 10,000 sq. ft. _2L over 10,000 sq. ft. Number of Stories, • ? Sheet metalwork to be completed: New Work:_ Renovation: 5, Ln ` HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents ZC_ Air Balancing Provide detailed description of work to be done: e V 4' , it VSURANCE COVERAGE: have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes❑ No.❑ you have checked YM, indicate the type of coverage by checking.the appropriate box below: liability insurance policy Other type of indemnity ❑ Bond ❑ WNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the assachusetts G eral Laws,and that signature on this permit application waives this requirement Check One Only Owner ❑ Agent ❑ ig u e of Owner or Owner's Agent - r checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and curate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments s Final Inspection Date Comments I I Type of License: Master 5 ❑ Master-Restricted ,/Town ❑Joumeyperson Signature of Licensee mit# ❑Journeyperson-Restricted License Number: Check at www.mass.gov/dol )ector Signature of Permit Approval Tke Commonwealth o Massachusetts Department oflndustrial Accidents Office oflnvestigations 600 Washinoon Street _. Boston,AM 02111 www.mass gov/dia ' Workers' Compensation InsurAnce Affidavit:Builders/Contractors[FIectiicians/Plumbers Applicant Information Please Print Legibly Name(Busness%orgMizatiMAX1ividu4: AV .�p /�f�Pr f Address:— 13 S� rs�,e�A !l' ►v ('&At ho//r//1 City/State/Zip: Phone.#: o ! 6 F[MKI4am employer?Check the appropriate box: employer with 4• ❑ I am a general contractor and I Type of project(required)::yees(frill and/or part fime). have hired the gub-contractors 6. ❑New contraction'sole proprietor or partner- listed on the-attached sheet, 7. ®Remodeling d have no employees These sub-contractors have Demoliiion g for me m any capacity, employees and have workers' orkers'comp.insuia,ce comp.insurance.$ 9. ❑Buildmg addition d.] 5, [I We are a corporation and its . ME]Electrical repairs or additions 3.❑ I am a homeowner doing ill-work officers have exercised their 11.❑Plumbing repairs or additions n#sel£ [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' . 13.0 Other comp.insurance required.] Any applicant that checks box#1 mast 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 hue outside contractors must submit anew affidavit indicating uch s$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have crnployees. If the sub-contracture have eaPloyees,they unrstprovidt their workers,comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy rind job site information. Insurance Company Name: Policy#or Self-ins,Lic.# Expiration Date: " Job Site Address: City/State/Zip: Attach a copy of the workers' compensafionpoIicy declaration page'(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A ofMGL c. 1.52 can lead to the impos flue ition of caminal penalties of a ne 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 OfS.ce of Investigations of the DIA r insurance co era cre verification I do hereby certify u e.pain an enables of perjury drat the information provided above is true and correct. Si afore: . Date: /o` Phone Official use only. Do not write in this area,lb 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 S.7Plumbing Inspector 6..Other Contact Person: Phone#: Apr 02 12 08:10p Scott 908-366-7822 p.1 04I8212612 15:56 5087750574 HOME NECHMICAL PAGE 81 f A' -may ` - •' 1 Town of Barnstable Regpdfttory Services ism F.Ear,Dk"r nuff(IWg DIvWo11- To=Pe ,BmIdivag Ciamd8siomer 211 Main Street ems,MA 02601. www tu"Inwbbkjmw Of= S09462- 9 508-790-6230 Propel Owner Hurst Complete and Sign This Section RrmV, • de _ ---- ,as rJw=of the subject pxopezly hereby xuffioxizc-_ �/� 0 act on my behak 2ll nm;tt=zclztiire to w'ark autbxo=e.d by k i#.di gperm=t . (Addy *Pool fences and slams 2M thetcspOjDsjbiRty arc:tot-to be Ued before few is it tailedand of tlxe app caywc, Pours utilized imtil iu finest ins 1 pools are not to be p�ctions are owned ai'd accept id. Si&aturc of Owner of Appnc=t pfjc- I�af�e 6 e Q U�C� prig - Datc - a� ootrs I r COMMON:WEALTH OF MASSACHUSETTS • • • -• eWWI ;• .• • j MR ' AS A MASTER UNRESYRICTED ISSUES:THE,ABOVE LICENSE TO { ' GRE:GORY' J HOUDE Al 4; CENTERVIUE MA 02632-2704 ' 210' 08%28%13 33398 =. Iy M`R 0 Assessor's map and lot number ..... .... ..8..�..�...:: ....... �� ; Pee SEPTIC SYSTEM MUST B OF "E TOE Sewage Permit number �'�y MTALED IN COMPLIA WITH TITLE 5 : 3 ........ !. () ..... ENVIRONMENTAL CODE 9T4nLE, . House number .. ....... ,sue 63 TOWN REGULATIONS �'EDNA,(, TOWN OF BARNSTAELE �E BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... !...� :........ ..N... .C..tS.............................................................. TYPE OF CONSTRUCTION ...... .................................................................................. �ViV 7 19... 5 .................. I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...�. .�.... 1.I!� .....1.\.1�1.4�`e.. 4�........ ................................................................................. ProposedUse ......... VI1/ �C.. .............................................................................................................. ................... ZoningDistrict " . .... ............................................Fire District .Q.. v ...................... ......... `.................................................... Name of Owner ..!!�..!. .'.. L..I.!...................................Address ....... .......................................................... Name of Builder ...... ..........Address ......I...S...7........ 1� ..............�. Nameof Architect ..................................................................Address ....................................................................I................ Number of Rooms ..................................................................Foundation S C -rl/ ` / Exlerior . DINY �'" 1 ../ ...Roofing ......��SP.A.4. ............................................... ...... T ,c K I Floors ...�.,�. .........+,�... ...........N.<?................................Interior .................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate. Cost ........J.�..I,DO............................ ........... ..: Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area .................. ....................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLYNGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. `, 1 Name (/l.l ... .. ....................... Construction Supervisor's License o0a..1. .s........ 1 BELL, W. J. A=18-8 No .................28108 Permit for addition...to........... . .... . . ...... ......s.i.n g 1 e...f.am.i.l.v..dw.e.1 l.ina........................ Locatio'n• 140 Pine Ridge Road ............................................................... Cotuit ............................................................................... W. J. Bell Owner ... .................................................:........... Type of Construction. .......frame......................... . .................I................................................................ Plot ............................ Lot ................................ Permit Granted ......................June...2.......19 85 ........ 7 719 Date of Inspection ........................... Date Completed ..... ...... ..............ri 9 Q) in W > Al 0 M tv — X rn < :xSvM0 7v Assessor's map and lot number ......14 .......lJ... ...:......... . 7NEj0� GE T'ry L E£LN piT, R o Sewage Permit number ......:..........................:......... ............ d .w s i BIS�^98Ta LE. HOUS2 number ........ . .... . 1...� M ................ 9� 639- 00 L 'EO MPY A" TO OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO,......h.✓..►...��....... :........................................................ TYPE OF CONSTRUCTION ......�.00.Z.....�A?AM. L............................... ................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ! Location ... .. 1./U . ..t.1.1 � ` ../.1. ........ U./.. ............................. . ......... ......................... ProposedUse ..- n • ... V1?/�L?C.!4 ........................................................................................................................... ....... t ZoningDistrict ...................!...:................................................Fire District ........�.C?. .V...,.................................................... Name of, Owner V.!.. l ..'...!-'��..!..�...................................Address ....... .. ................................... ....................... Name of Builder ...... ..........Address ....../.. .7.........?.V4.Av ;>...�_.1.✓...: ..Ji ....yam .wls Nameof Architect ..................................................................Address .................................................................................... -Number of Rooms ...Foundation S �ti .. ................................... `Exterior /I!�`� ../....1�{ q. . � ......................................... �...........^ ! .........................................Roofing .....�.l . ...... ........... Floors ... ........................Interior ....................................... Heating . ........Plumbing ..:............ ........................................... Fireplace ppVOO :....................................................Approximate Cost ............... t� . Definitive Plan Approved by Planning Board ________________________________19________. Area .................. :..,........ ....'.. f Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t OCCUPANCY PERMITS REQUIRED FOR NEW DWELL GS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name1 r M.... .. .................................. Construction Supervisor's License Ona... .7. ......... BELL W. J. - A=18-8 ~~, No Permit for —,�dit.i»o..t.u-- ' __...aizzgle.. .dwell _______. ' Location l�0 Pine RoadLocation ...--...................................................... ' Cotuit ' --------'-----------------'' | W. J. Bell - ' Owner --------.�---_----�—........ . r- frame -' - Type of Construction -------------- ^ ~ ---.-----.--------^--------' . ^ / Plot ----__ ........ Lot —.--------- . ' - Ju�a 27 85 Permit Granted -------------]q Date of |n --------.'--.�lg ' Date Completed ------------'1P ' . ' � ^ ' ^ � _ - . . ' - / � � ^ |` ' |