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HomeMy WebLinkAbout0754 PUTNAM AVENUE . . .. .�� � � .� n f Town of Barnstable *Permit#al 6555 f F-rpires 6 months from issue date • a�wvareatE. • Regulatory Services Fee ,41 d HAM $ Thomas F.Geiler,Director •63P ��" Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p Not Valid without Red X-Press Imprint Map/parcel Number 03-(—Q /r�9 (Bm K/'0q<_ C/1587) Property Address �r-54 f L' j\7A" A l ena-'C Cp4 l i 1 t i A COC Residential Value of Work { . 6-0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address i a1 IT heas any 44 W.,W'R , MaA(XrO, M A o.t I , Contractor's Name SELI Telephone Number jU g —.4 35- 017+ Home Improvement Contractor License#(if applicable) P LA Construction Supervisor's License#(if applicable) N I� ❑Workman's Compensation Insurance og Check one: PERMIT ❑ I am a sole proprietor 21 am the Homeowner S E P - 4 2007 ❑ I have Worker's Compensation Insurance [TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) n Q Re-side .Cf ;l�l Cb C, Gt f S O Y1 �1r � ko-v.. C2 v v p�� J�Q � �%�ZaItQD�Z. ❑ Replacement Windows. U-Value (maximum.44) J 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permiss o�on."-- Alf Home Improvement Contractors License is required. - i SIGNATURE: Q:Fonm:expmtrg Revise071405 �� �,, The Commotiwealth.of Massachusetts `.. Department,.of Industrial Accidents Office of Investigations i ~ 600 Washington Street Boston,.MA 02111 ' ww v.»tass Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A licant Information 4 Please Print Le 'bl Name(Business/Organization/Individual): 0L&_kl� rob , P `�'Yl �Ven u' , t4k 020 rra Address: y u Cx � c)Tllrl �12r 1?he��SCc v�� { /ll Gam(, City/State/Zip: Ste P p ,0,�. Phone#: rQ 495—I0'7q- Are you an employer?Check the appropriate box:` _ Type of project(required): 1.❑ I am a employer with 4.'El am a general contractor and 1' � 6. ❑New construction , employees(full and/or part-time).* ;' have Hired the sub-contractors 2.❑ 1 am a sole proprietor or partner t listed'on the attached sheet. . ❑Remodeling ship and have no employees These sub-contractors have 8..❑Demolition workingfor me in an capacity. workers'comp.insurance. Y p h'• ` 9. ❑Building addition . [No workers'comp.insurance.. %. 5. ❑ We are a corporation and its quired.].: offices have exercised their. 10.❑Electrical repairs or additions 3.[�Ieam a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions' myself.[No workers'comp.' c. 152;§1(4),and we have no 12.❑Roof repairs insurance required.]t - employees. [No workers' comp:,insurance required.] 13.[�ther 3 4 I . 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 3 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.. `S —$Contractors that check this box must attached an additional sheet showing the name of the'sub-contractors and their workers'..comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site ' information. Insurance Company Name: Policy#or Self-ins.Lic.#: ► Expiration Date • s Job Site Address: .S '� 'City/State/Zip: , 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 rti under the pains penalties o perjury that the information provided boy is true and correct Si ature: Date: Phone#: 50 ��- 1 o4 YOfficial use only. Do not write in this,area,to be completed by city or town ofjrciaL _ City or Town: PermitlLicense#. 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#: "`� Q� z4211 07 f�Town of Barnstable Fiscal Year 2007 PRELIlVIINARY Real Estate Tag Bill 4f ot j Bill No. :3129 TAX RATE PER S1000 Tag Collector:, Maureen J.McPhee Real Estate Tag $1,201.11 RES. PERS. COM. DID. ( Class Code: 1010 District(COTUIT) $353.03 Parcel M 039-079 CPA $36.03 Area 20038 Sq Ft This prel®inary tax bill is due. Special Assessments $0.00 Book/Page C/1537 226ate Please Grote chat no Abatement/Exem lion' $0.00 tax rates,valuations or` P Deed Date 08/15/1990 assessments appear on this bill., Total Tax/Special Assessments $1,590.17 Tax Paid ($1,060.11) Location:754 PUTNAM AVENUE Interest. _ so.00 BLACKSTONE,MARYANN Pay This Amount by 2/26/07 $530.06 %COLOMBO,MARYANN - Voluntary Scholarship Payment: 121 PHEASANT HILL RD MARLBORO MA 01752-3488 -,Voluntary Elderly/Disabled Payment: Total Amount Paid: III��11��IIL��I,I�I�r�1�I��IIt�I �II��L6�Lr�LI�ttIILl��I 3rd Quarter Preliminary-Taxpayer Copy '02082082007300003129400000530063 Please put your Bill Number on your check. To obtain a receiped bill,enelose`a Payments• self-addressed, stamped' envelope and both sections of the bill with your• Please return the top portion of this- payment. If no receipt is desired,please DETACH TOP SECTION and forward bill and make checks payable to with remittance.�If not paid when due,your tax amount is subject to penalties of Town of Barnstable'and mail to: , interest,demand,and fees. Town of Barnstable, • Collector of Taxes Interest at 14 percent per annum will be charged from the delinquent due ro Box 1360 Tc date to the date payment was received in the Tag Collector's Office. Hyannis,MA 02601-1360 Office Hours -- Payments as of 1/16/07. T "8:30 AM to 4:30 PM Monday through Friday 367 Main Street- Hyannis, o- Hyannis,MA 508-862-4054 *Visit our Town Website at http://www.town.barnstable.ma.us This form approved by the DOR: SEE REVERSE SIDE OF BILL FOR EWPORTANT INFORMATION 7687=18 ...v.v.ww wu vvnu a•rvuv III Va•I IVI0I AIM./I w IV UVA VI 1111G II VI Ia VI We WIA U111. I I lei I dUU ale dll lUUllt winrlDUIeG 10 ine tax rll ip. Fnrincp nnp-rhprk fnr the Pntirp.amnl lnt navahiP to the TAWn of RnmstahlP WP;arP_amwino and vour SIGNATURE/NAME AFFIDAVIT THIS IS TO CERTIFY THAT MY LEGAL SIGNATURE IS AS WRITTEN AND TYPED BELOW: Maryann Colombo OSi*gna I AM ALSO KNOWN AS: f Maryann-Blackstone Sign t re I AM ALSO KNOWN AS: e Maryann Oskirko Signat 4� And that Maryann Colombo, Maryann Blackstone and Maryann Oskirko are one and the same „" person. COMMONWEALTH OF MASSACHUSETTS County of Middlesex Ma qhh 610WiLjO 44 Subscribed, sworn to and acknowledged before me by the said OQki this 281h day of August, 2007. vvv_ Notary Public ti My Commission Expires: MARYJO HART Commonwealth Of Massachusetts My Commission Expires January 23,2009 Assessor's Office 1st floor Ma Q C Lot I V Permit# Conservation Office(4th floor) ' k"-\ Date Issued Board of Health 3rd floor ® �ou Engineering Dept. (3rd floor) House# �/ �_ � Planning Dept. (1st floor/School Admin.Bldg.): HAMSTeeM Definitive Plan Approved b Plannin Board 19 ` ®�+�a�� '.Y+.• Zs 6r� (AvOications 8:30-9:30 a.m. & 1:00-2:00 .m. TOWN OF BARNSTABLE�' ;>, Building Permit Application Pro*ect re ress < Village Fire Distric ✓U D�3 1 f (hvncr %t t YLA Address � l c✓ Telephone Permit Request: Nev a° �✓f .Zoning District Flood Plain Water Protection Lot Size Grandfathered o i Zoning Board of Anneals Authorization Recorded Current Use Propgsed Use Construction T / Eaistinp-Information Dwelling Type: Single Famfly Two family Multi-family Age of structure > Basement bN Historic House Finished 1Je Old Kings Highway b Unfinished Number of Baths No.of Bedrooms Total Room Count(not including baths) h First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds rc; Other Builder Information Nam iC� ✓ / G/ 'Tele hone number —2 S 3 70 Address Id S QS'4 O License# V 1.e�V,Ile & 6 3 Home Improvement Contractor# !l g 7 r Worker's Compensation # —76(3p S' 34.2 pz. NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO !l G �� Pro'ect Co a 40C Fee c o0 SIGNA DATE !l l Zfr BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) " BPERM T fy �x e'OJ tt: y FOR OFFICE USE ONLY ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FOUNDATION FRAME - � �� `� �,• '; _ ..� INSULATION E FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL V GAS: 'ROUGH FINAL ` FINAL BUILDING: DATE CLOSED OUT.-, ASSOCIATE PLAN NO- t •1 • z _ • . F. K , • �ITO s MAY 4 - „ . , . /Z3® ..x � . ... ,: ., •ar �' n _ •ads._ l.y a y t� i Jr C NIAN PL TE 12.> ti x Y 55 T Zo w4j.:: ' F Ogg r,: y p i � ! , - r � • 4 I � T � l a pay Ex n/�U f5 i f �.:. N 5p AA —E s i, _ T - N � t N�•� �c n : e �•a� r { V - . 111.,, rig, ,. , ,•.:, s: r .; a r • _ , • - x m , y, �^j - T I � HIM 3 3 . , - r : Y s- y ;+Ux 'st.*�wa"'°r"""•S' °-=wr,4^'.' '_, -w .. "- '-...�r+ ., :"W. - •": ""'t-5r""' i .'�'"y.-,,�,{+ +�r'u.+' �M."'y` "t"`�•w�..• �'"',�'�i. *me,µ x,�'.°i .te. s. i,. - . y � T• '.� r-.w> • ,3i'.1t.. 'a a.. +1-"•^,ay*.s.`- ": 8. :. � ..A,. n�,:!fI'�•7R,'. .r., �, �s�(,t-s .+5i., �'' �-� t+�;' a �;,'7n .1�:-t§ •.� �• ..: t; �s.• ��ba,- $An4 i.�J �irt..y"F, .. .: .. �. ,..'A. •,r�' ��na,x' �Y� ��� - dPw7twr�'��"'�'��1e..r�r�"�'ts � rw Y .. '.k � .•+. r;Y' .� rn '� a�T f`"''f �"�•,+. tom^.j � _ ... " - ..1.. - -+ � t — { -:... IDPE.D. TOG E_f � NCLEyS .'PANtt ax, Y' Ac( Ef5 PaNEL �9 ,1, T -Q p2'AWE¢°/ J x 1 i h 3� r 4 S �iy.•i�"4 ii Y..' i,,. 2 * ,'�d N 1� � -— �- +1 � - � � - � 4 _ / {�J/ ' _` � � s' ++. 1..0 FT. �,r i.'y *•� n� i'^ -�.�+ .. of�'X(v.. �.�t'it�/L M � i V ," J/ .. I OQ 3 i w r y 141 lat It J �Mp .t ^� a r .fi .. iy'I` � I •� n PC ' n � 5^:�,1 � �a •fit,: ��o�� S _69 sY3SDoc , :_� . , `�' .�' .,:• - max; t �E�oNn FLDOF, LAhi ;-_— : wy„ 'fi..�� R `.' �jlp7binfY/,g €�G(fp54 ,g a Y�• • �E '�'ti3 d '' �a t K���YF' '��'+*u�^X�,� kt f�"# . 3 Rau MPROV ME Ap f� �flNTRACi OR r is EKplatkon 3 4, ���� ly, �}}11 ,q���S��x{�{� AUMIt,ISTRATbR ✓"'1�5�)f���f�'7�� �.��� �vz�'. a �: IV+l .Pi yy, p AM -•y r aa-r'^�..+ � ,y�!�iFQiaa.: COMP40NWEALTFp OF MASSA DEPARCUUST PUBLIC -- ETT BO TON R®RTON LACE SAP�TY EXPIRATION PATE 'MA 02908 o"tto'g, real LZ cof�® svjvj� RESTRICTIONS I:'' j ®f>IAos A®r ®� DATE EFFECTIVE CAUTION � :. LIC-NO c+, OR PROTECTION PRO TEC TION A BPT RI THUMPRI TIN P OR►ATEPHOTO(BLASTING BOXpNLCN FEE: LASTING OPERA? HEIG Noiv !.' N/UST INCLUDE PHOTO. HT ALID UNTIL SIGNED 8Y LICENSEE qNp OFFICIALLY i' � HOTO. Doe STAMPED.OR SIGNATURE { OF THE COMMISSIONER THIS CARRIpCUMENT MUST 8E - OTHERS RIGHT THE ON THE PEEN NOF xJ - S tT iHUMB PRINT HOLDER WH EN GAGED IN iHI OCCUP ATION. TURF OF ..7 {. LICENSEE d SIGN NAME IN FUII ABOVE SIG .A - ONER - NATURE LINE f r The Commonwealth of 111assachusctts Department of Industrial Accidents OfJ 9011MOSI&at/ons 600 il<•asltin„ton Street '�\ Boston,A1ass. 02111 Workers' Compensation Insurance Affidavit i�arit nfnrmatinne — �" Please PRINT'Ieb1 ily � �M+-"-' �Y' name: L!conivanv phone# a homeowner performing all wort.myself. a sole proprietor and have no one working in any capacity *'+' *'c-.-__..L,... ,v_an employer providing workers' compensation for my employees working on this job.na /(�Y( A 2—!�� `S PJ/ia . ci E'y y r 1-P phone th 7 U insurance co, l y'->l. �� �/1 i 2 policy# ,F, _ ..< < �.. .,.... ,... „-:»?+d� - ,.;t.,.s.+„�...aw, t.....wnt,-x.r.'•'-'4x-��7T.,,w�°�^�R�',..w_�s�ws ,.v.,,..:,. Imam a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name-, address: 61y: phone#: insurance co. policy# ._-,..' v yY•Fitii: ..:.H'R!9"fi'-�y,'`s"Ts Tt•-;r,2 �'7.-!{x.L ?C}�':?I7.'i`nN�'.. �`^'"'•'�'Pir,q�.nr 'f,pw company name: address: city: phone#• insurance co policy.# :Attach addJhonal'shcet tf necessa_ry ` . �.t-rr. v.' .w,.r- 1:3'F•�t,+�4 ;.e r: a:i' •v: r-xs.. oc.. •s"it. � +,ds�'� y U.�frM..� . riii�'�.'-wfL�,itC,il.4Tc Failure to secure coverage as required under Section 25A of NIGL 1.52 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as-well as civil penalties in the form of a STOP NVORI:ORDER and it tine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of investigations of the D1A for coverage verification. I do herehr certify unrler the pains and penaltie perjure'th t the information provided above is true and correct. Signature / Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# 7rlBuilding Departmentnsing Board check if immediate response is required Oeectmen's Office S. 011calth Department contact person: phone#; nOther (revised 3194 PJA) The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Stream Hyannis MA 02601 Office SOSMO.6227 Ralph Crossca Fes 588-775 3344 - Building Commissior For office use only Permit no. Date AFFMAVIT HOME 1WROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"tzoonstruction,alterations,renovation,repaw,modernization,conversion, itnprvvetneent,.Rmo%al, demolition, or construction of an addition to any pm-adsting owner occupied building containing at least one but not more than four dwelling units or to structures which are ad}acent to such residence or building be done by mgmcred contractors,with certain c=pdons, along with other Type of Wank: / �/ Est Cost a d= Address of Work-- O%Mcr.Namr- Date of Permit Application: / ) I hereby certify that: Registration is not required for the following rrason(s):: Work excluded by law Job under SLOW Building not owner-occupied pulling.own permit j Notice is hereby gh=that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTffitED CONTRACTORS FOR APPLICABLE HONE 34PROVEMIENI' 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 gent.of the owner.' ` jazz D to Contrictornarac Re ' on No. OR ,l ch ffis natne . y to-do _ i' .fir >. J.J . / Ap Ek'g'M .. PLOT PLAN L©0ATION G.Q't U S. . . . . E SCALE - /'dl ,4 PLAN REFfERCNC1E . ��0'�%.. .�7: I • era'", ; i , �,��"� � . " 4 ,£3L'J.0 , 4"iD.l=ti JP 0-a .pf{J�.�J�•g. Y.A.kF•iC7Lt;Fir !kYA a`a. It1•fin.Q I CERTIFY THAT THE . FOUT.1 ATTON SHOWN • ON THIS PLAN IS LOCATED ON THE OR'OJND Wa"E,D.Re3alty Trust _ AS SHOWN HE[3EON AND THAT IT CONFORMS TO ' 41i11itrR Ed© 1)4iC(3y il'1''U3'l;(?0 , TNE, �'OP11,NI(�"^�,rta�2l,S OF-'THE TOWN C?f -�j��0 West [virgin Street c3�1.1.{Ivr.sllffLLtt'',J,.r.. l+SatFi;l,G?iiferfFTI;CTt lye nnis 4 Mla,,l ,achurOttS DATE PETITIONER : REG. LAND Su9vEyo� �A.���'�.�'�v"r.'.s�s".. •-fit._"+Y"'�,;.�.ji w,�w�..-.-.�. �- v r-: _ �'�„t,.,... �-t.....r�:_ �... .s ,s+�: ;.... _.,.. ,.:.�.«.. ...;--... .. h _ `_�) � 7 5— As�essor's map and lot number .... �.r.�../.................. Sewage Permit number ..... ... r../..........-................. °`T"Er°�° TOWN OF BARNSTABLE i BARNST"LL i 1 16 9 BUILDING -INSPECTOR APPLICATION FOR PERMIT TO .( .......................................................................................................... :�.. J�--:�$It.?-OQ ......... `. . .1.1��:P... ....................................... TYPE OF CONSTRUCTION TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit acc�orddin"g' to the following information: / Location ..... l( - .....:<...... ...... Q .� .��...... � d............ ....................... +.........................: ....... ProposedUse �..!�........!..J. !.. ' 1 .. ............................................. ZoningDistrict .....;. ..........<.........................y.......................Fire District ` 2....:.... ...... .......................^......................... �� �� . MCA Name of Owner ,.-.�.,.l..l. . ...,,,�.rt..................... .r.:L.Address ...... ........ ...� ................!.,....�... i Name of Builder t ...Address 'I Name of Architect r 'I .f....Address 1( ...........`..'. ' .............................................................. ..................... ................................................. Number of Rooms ..........1 ....................................................Foundation ....!......... ......................... Exierior .... ..............................Roofing .......... ..'.rr....................................................... Floors l i/.� ! ...........................Interior .......... . n Heatin ' 1"; ......... cx-`--...................Plumbing .................................................................................. Fireplace ............11.....................................................................Approximate Cost ......... :J.a... L�.......................... 'r'....... Definitive Plan Approved by Planning Board ------t 9 Area ...... ' . - ......r......... .... ............ ..........Diagram of Lot and Building with Dimensions Fee ti- *.-4" '" `............ ...... .. . SUBJECT TO APPROVAL OF BOARD OF HEALTH ( �, , I hereby agree ree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ;" i / .. . r'.::... /... ......... Dacey, William E. Jr. 3 - 7 '- 17566 one story, Na ................. Permit for .................................... single family dwelling ................................................ ... . ............ Location Cotuit Pines Cotuit ............................................... .............................. Owner William E Dacey, Jr. ......................... Type of Construction .. ......frame . ............................ Plot ...................... ..... Lot ...........4A................ �I Permit Granted ......January..27...........19 75 Date of Inspection ....................................19 Date Completed ...................... ...............19 PERMIT R FUSED ................................... ........................ 19 .................................... .......................................... ........................... ................................................... Approved ............................................. 19 ..............................................................(................. i "<� .tit tM ... '� -M/��c.��• - I .. . . .. ,� ��✓ i � fib.. 2 r Ss 41 r o �\ CERTME® PLOT PLAN stif' LOCATION v0Il1 SCALE .� it J�): DATE . .� ��./'�' PLAN REFERENCE Lot �1-4 Lind CQ.urt .laja y c c : + ti✓„fan•4 CERTIFY THAT THE : FOjjn.(, ATION -SHOWN 'ON THIS PLAN IS 'LOCATED ON THE GROUND ^i.E'.D.Realty Trust - AS SHOWN HEREON AND THAT IT CONFORMS TO ' t,iilliam E Dacey Tru5�'('G THE N!Ijd�•C� �,A', 9. OF/THE TOWN OF 1 570 �'J t.,,Inain Street r� N,CONSTRUCTED; 1 annis I a3 achusetts 1 •.� 4. r DATE . . cf i� P E*riTiOtVER : - REG'. �L6lNO SURivC�YOR C9 10G/111A— l a-I/- Asse'ssor's map and lot number .... ..�..�.. ..................` ?T4C 6Y T ' �E .]USTALLED IN 'ON Sewage Permit number � SANITARY �.; yofT"E!°�� TOWN OF BARSTAE �Q N o B9SB9TAHLE, i ., "6 9.,.•� BUILDING INSPECTOR 0 YPY a' APPLICATION FOR PERMIT TO .. .. .. .... . .......... .... ....... ............... .........i.... .L{; ............................ pp oo TYPEOF CONSTRUCTION .....t. =! ........ .............................................................. 9 TO THE INSPECTOR OF BUILDINGS: The undersigned he eby applies fora yermit accord' g to the following info,. atio Location ...... . :.... ........ ........ .... .. ... �..... . Proposed Use .. ....... ..4�.... ....... .......... ......... .C.. ... .. ................................................ Zoning District .....t,. ..... .:.................................................Fire District ...... .. ....................:.^....................:..:. Name of Owner (.rL..�. C<(itdAe-0...Omw ....Address .�.1..' ..4 ...✓...!.! ... t cE Nameof Builder .........�.�...................f............. .............. .....Address .............'..`.........................................;......................... Nameof Architect t....................................................:.............Address .................................................................................... Q t, Numberof Rooms ..............................................................Foundation ... ............ ........ ....... ................... Exierior ...` ". ...` !^ .....................:........Roofing .........��J :... .. . ..... .....:..................................:..:...... 1 t- Floors ....6.4"6 .........Interior ...... I..... .............................. ........ . .................. .................... ... . ..................................... Heating ...1.......�.1 ..... ......��....................Plumbing ........L.........................................................:.............. Fireplace ...........1............................................... .....................Approximate Cost ........ V.a.. ........................ Definitive Plan Approved by Planning Board ______ 1______19_3_1. Area s.......................................... .9b Diagram of Lot and Building with Dimensions Fee ........ �Q....�............... SUBJECT TO APPROVAL OF BOARD OF HEALTH z y 4df I hereby agree to conform to all the Rules and Regulations of the Town of Parnstable g r ing the above. construction. Name ..... . .. ...... .... . ... ............. .. .... . .... ........... Dacey, William E. Jr. ^'- - ... Permit— ^ for ^------`'^'--- v _ ' �.�' -^ rL' x ���� / ' Location ' � ' � --''`^==---=—.--..--.. --.. - - ` Cmtoit ' ----------.---------------- . Owner ---Wi .E�.. x..Jr�___. � � ' ~ � . Type of Construction ----���R!�.------ � * -----^---r----------------' | Plot ............................ Lot .............. ---' _ . � . ^ ' � 37 75 ~ � Permit Granted --.�~~~~^� ' ' lg ' Date �V^ � . . , / Dote Completed .!.I?�..x���.�������~��� ~ , PERMIT REFUSED � '--------------------- 19 ^ ~ ` .---------~---------------... ~ ~~ . ^—'---...---------..—.—...---~--. ` ' —.--,-----------.. ............ .----.,.- ^ .* , -----------...---..—~—.—.--.—.. ' � Approved .................................... lg � � ' ^ � --.----.------.,~--'.,--.—.---. ................... . � �