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HomeMy WebLinkAbout0082 GLENEAGLE DRIVE ., �. � � "'.n .. Q .. �. '� 6 � .. � � - �, {� o 6 i., S 83462 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ICA, Parcel .' Application # 1 Health Division Date Issued ( 1 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 82 Gleneagle Drive Village Centerville ` Owner Nelson,Cook Address Gana Telephone 50R-771-4492 Permit Request Air sealing, r-10 rigid fiberglass insulation to kneewall , r-tlq_i=s latien to attic INsulate bulkhead door, R-19 insulation to asement reiling Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2698-60 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: Number of Baths: Full: existing new Half: existing cro neu� >" CD Number of Bedrooms: existing —new ► Total Room Count (not including baths): existing new First Floor Roorl Count-o Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑ Other N tin P-- Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stoves ❑`ice ❑ 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 RISE Engineering Telephone Number 401-784-3700 EXT 161 Address 1341 Elmwood Ave, Cranston RI 02910 License #. lno459 Home Improvement Contractor# 120979 Worker's Compensation # 3730961-01 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource cov r A SIGNATURE DATE A, Erik Nerstheimer for RISE Engineering F f� 7 y FOR OFFICIAL USE ONLY APPLICATION# y ..DATE ISSUED r _ MAP_/PARCEL NO. ,r ADDRESS VILLAGE s OWNER DATE OF INSPECTION: 'v FOUNDATION!"JI '. FRAME _INSULATION ( _si 2 tl l t FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ? -4GA& G'T:" ROUGH ;97,jl-: .. .,. FINAL S �iNFINAL BUILDING a K 1—DATES CLOSED OUT a ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 60O.Washington Street Boston,Mass., 02111. www.mass.g ov/dia Workers' Compensation Insurance Affidavit: Builders/C6n tractors/Elect>ricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual) °,RISE Engineering a division of Thiel ch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, :RI 02910 Phone# (401)784-3700 'or 1-800-422-5365 Are you an employer?Check the appropriate b6ie: Type of project(required): 1. 0 I am an employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors :p Remodeling 2. ❑ 1 am a sole proprietor or partner-- listed on the attached sheet. ship and have no employees`- These sub-contractors have- 8. ❑Demolition working for me in any capacity. , employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. $ required] 5.0 We are acorporation and its 10. ❑Electricalrepairs_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 perm MGL - insurance required] t c. 152, § 1(4)'and we have no 12. ❑Roof repairs employees. [no workers' 13. N Other Insulate comp.insurance required.], *Ally applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. IContactors that check this box must attach 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: The Preston Agency Policy#or Self-ins.Lie.# 3730961-01 Expiration Date: 1/.1/12 Job Site Address: 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 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 $250.00 a.day against violator.Be.advised that a copy of this`statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certi and the ins enalties of perjury that the information provided above is true and.correct. Si nature: r Date: Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1-800-422- 365 _�_xt 13 3 Official use only Do not write in this area to be completed by dty or town official City or Town: Permit/license#: , Issuing Authority(circle one): 1.Board of Heath 2. Building Department 3.-City/Town Clerk 4.Electrical Inspector 5..Plumbing .Inspector 6.Other Contact person: Phone#: �1 OP ID: 31 -AL.c 0" CERTIFICATE OF LIAB.ILITY•INSURANCE, DATE(MMIDD/YYYY) 12/30/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. - PRODUCER 401-886-8000 CONTACT NAME: The Preston Agency,Inc. 401-885-1700, PHONE FAX 1360 Division Rd Suite 303 A/c No Ext: A/C No): :E-MAIL- - PO BOX 810 ADDRESS: Duc East Greenwich,RI02818-0810 cuooTomERloa:THIEL-1 INSURER(S)AFFORDING COVERAGE - NAIC if INSURED Thielsch Engineering,Inc INSURER A:Zurich-American ins Co. Thielsch Group Inc. Z. -INSURERS:American Guarantee&Liability , Hi Tech Realty Inc. 195 Frances Avenue INSURER c:North American Capacity Cranston,RI 02910 INSURER D:Hartford Insurance Company • - INIURER 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 SUBRI - PO ICY EFF. POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER - MMIDDlYYYY MM/DD/YYYY LIMITS. GENERAL LIABILITY • EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY 3730962-01 01/01/11 01/01/12 PREMISES Eaocaurence $ 300,00 CLAIMS-MADE a OCCUR r MED EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ •1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY X JEC Loc Emp Ben: $ 1,000,00 AUTOMOBILE LIABILITY - _ - - -COMBINED SINGLE LIMIT - $ - 2,000,00 A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Ea accident) ALL OWNED AUTOS BODILY INJURY(Per person) $ " BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON OVMED AUTOS $ UMBRELLA LIAB X OCCUR • EACH OCCURRENCE $ 10,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,00 B... AUC:1857188-00 01/01/11 01/01/12 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONI WC AND EMPLO ERS'LIABILITY Y/N.; - n XITOR Y fM U 0 R• ' -A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 - '01101111, 01/01/12 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER(EXCLUDED? ❑ NIA (Mandatory In NH)es,If E.L.DISEASE-,EAEMPLOYE $ 1,000,00 y describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000.00 C Professional Liab DVL000026800 04/01/10 04/01/11 Prof Llab 2,000,000 D Leased/Rented Eqp 02UUNTD5678 01/01/11 1 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) + CERTIFICATE HOLDER CANCELLATION t TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN a, ACCORDANCE WITH THE POLICY PROVISIONS: :AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION_. All rights reserved. !"ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD I - 1 I J NOTEPAD THIEF-1 : PAGE 2 QQ.4 INSURED'S NAME Thielsch Engineering;Inc OP ID:31 DATE 12/30/10 MREr:. nggineeri3 ,a division of Thielsch En ineerin9,Inc. GG kell Associat9es a diwsio cif Thiels h Wn ineen g,Inc. B LLa oratory,a ivlsion o Tnielsch n In,,:, ,Ir1c. qE� O oretorv,a rvieign o Thiglsch'Fn meennT Inc. W Engmeehnq a ddrvision off TThmglsch ggmee ir��,Inc.: ater a ageme Services,a division of lelsch Engineering,Inc. t J 91te O nus nesse onice o onsumer 10 Park Plaza Suite 5170 _ Boston,&ssachus ect1s021,1 Home Improveto ontrr Registration — Registration: 120979' Type: Supplement Card - i w , Expiration- 3/25)2012,- THIELSCH ENGINEERING ERIK NERSTHEIMER M 1341 ELMWOOD AVE. CRANSTON, RI 02910 -yam h�.;f .- •. y,y Sv y" Update Address and return card.Mark reason for change. Address Renewal Employment Lost Card DPS-CA1.0 50M-04/04-G101216 �1te C7G✓7tY�t6�ti�sEai oy✓I�LaQdaC�tLt6el2`6 r + Office of Consumer Affairs&Bu iness Regulation License or registration valid for individul use only OM IMPROVEMENT CONTRACTOR before the expiration date. If found return to: e C Office of Consumer Affairs and Business Regulation . -Registration 979 Type: 10 Park Plaza-Suite 5170 - Expira —.12 Supplement Card Boston,MA 02116 THIELSCH ENO _ ERIK NERSTH _ �W 1341 ELMWOODY CRANSTON; R1 029 fl'�..:r1 Undersecretary Not valid without signature f Licensee Details Pagel of l 4 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety s Department of Public Safety Licensee Complaints License Type Construction Supervisor. License# 100459 Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search AI http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSL 100459 1/7/2011 . C �r E lPffA N-AT-24531 1 I- 1 r f Control No: 34244 THE COMMONWEALTH-OF MASSACHUSETTS DEPARTMENT OF LABOR ' DIVISION OF OCCUPATIONAL SAFETY 19 STAMFORD STREET,BOSTON;,MASSACHIJSETTS 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910, WAIVER: LW000672 EXPIRES: April 15,2015 IN ACCORDANCE WITH M.G.L. C. 111, § 197(B)(b)AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST_ BE MAINTAINED BY.THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 19713(b)AND.454 CMR 22.04 WHEN PERFORMING LEAD-SAFE , _ RENOVATION WORK. HEATHER E. ROWE,ACTING COMMISSIONER Printed on Recycled gaper - - RISE ENGINEERING Federal ID#05-0405629 RI Contractor Registration No 8186 A division of Thicisch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R102910 00NTRACT M ' (401)784-3700 FAX(401)'784-3710 Page 1 . THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS E NG IN E E I UNE DESCRIBED BELOW CUSTOMER - PHONE 'DATE _ - Client# Nelson Cook (508)771-4492 04/29/2011 083462 SERVICE STREET BILLING STREET 82 Gleneagle Drive 82 Gleneagle Drive SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP ' Centerville,MA 02632 Centerville,MA 02632 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This measure is available for 100%rebate from the Cape Light Compact. $792.00 RISE Engineering will provide labor and materials to,install a—6"layer of R-19 Class I Cellulose added to 102 square feet of attic kneewall floores space. y $102.00 RISE Engineering will provide labor and materials to install 2.25"R-10 semi-rigid fiberglass board insulation to 255 square feet of kneewall area. $688.50 RISE Engineering will provide labor and materials to install a 14"layer of R-49 Class I Cellulose added to 714 square feet of open attic space. $999.60 RISE Engineering will provide labor and materials to insulate the back of the basement bulkhead door with 2"rigid fiberglass board and seal the door edge with weatherstripping to restrict air leakage. $100.00 RISE Engineering will provide labor and materials to install 15 square feet of missing R-19 faced fiberglass insulation to the basement ceiling in the laundry room. $16.50 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Two Thousand Six Hundred Ninety-Eight&601100 Dollars $2,698.60 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF t%WILL BE CHARGED MONTHLY ON ANY - UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AUTHORIZED SIGNATURE-RISE ENGINEERING CUSTOMER ACCEPTANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN. DATE OF ACCEPTANCE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK- DAYS. - - AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE Jun 03 11 10:54a Owner 5087785624 p.1 4t5/U3•/'L'UL1 Lt:u4 rJLA •►UL Iv-- .. _� -•-- FedMI ID 0 OS414a5629 ME ENGINEERING Rl Contractor RegistraWn No 9106 MA Cortractor Registration No 120976 A division of Tbielseh Engineering CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,1U 02910 CONTRACT. (401)784-3700 FAX 1401)784.3710 , Page 4 �.TWSCONTRACT t9 ENTERED WTO SETWEEH RISE . 04CWWZMILO AND TIE CUSTOMER FOR WORK AS DENCRISEDBELOW EMGINlEt2NG , GATE - Gieal 1 0429r201 i 093462 Nelson Cook (SOS)771�492 BaLNO STREET - SERVICe STREET - - 82 Gleneagle Drive 82 Gleneagie Drive O WNG CITY.sTAM ZIP . - B6RV[CE.CITY.STAM ZIP Centerville,MA 0263� Cetterville,MA 02632 JOB DESCRIPTION RLSE Engineering will provide labor and materials to seal asm of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special toots and diagnostic tests to assure that your home will be left with a healthful level of air to be used to seal your home can include caulks,foams,weatberstripping and other products. exchange and indoor air quality.Materials not generally addressed) Primary arm for sealing include air leakage to attics,basements other unheated trees(windows are d) This measure is available for 100%rebate from the Cape Light Compact. S792.00 RISE Engineering will provide labor and materials to install 11--6"layerof R-19 Class 1 Cellulose added to 102 square feat of attic knexwall lloorcs space. $102.00 stall 2.25"R-10 semi-rigid fiberglass board insulation to 255 square feet of kneewall RISE Engineering will provide labor and materials to in area. S688.50 RISE Engineering will provide labor and materials to install a 14"layer of R-49 Class 1 Cellulose added to 714 square feet of open laic space. $999.60 RISE Engineering will provide labor and materials to insulate the back of the basement bulkhead doorwith2".rigid fiberglass board and seal the door edge with weatherstripping to restrict air leakage. $100.00 RISE Engineering will provide labor and materials to insta0 75 square foot of missing R-19 faced fiberglass insulation to the basement ceiting in the laundry room. $16.50 WE AGREE HEREEIYTOFURNMHSEIRIACIES-CoMpLE EWACCORDANCEWTMAISOVESPECIFICATIOWS-FORTHESUFAOF � Two Thousand Six Hundred Ninety-Eight&601100i Dotlars $2,698.60 UPON FINAL INSPECnCII AM APPROVAL 6Y RISE ENGINEERING.CLISTOM91 AGREES TO It EMI T ANKRINT dII FULL OF1%NILL CNARGtDAEGISTRIONTHLV TI ANY UIPUO°�'� AFTER 7T DAYS.SEE REVERSE FOk IMPORT0WrrrFORnATtON ON GUARANTEn.RIGN'K CF UUNO.AROCONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTFtACT W THERE ARE SPACES � ce AUTHORQm AIGNATURIE RmaE EWU19ER*W ACCEPTANCE, - NOTE:TH .CONTRACT m1AY BE FRTMRAWN KY US IF MOT EXECUTEOTIITHIN DATE OF.ACCEPTANCE ACCEPTANCE OF COMTRAOT- ABOVE S.SPECIFICATIONS AND COMOn10NS ARE SATISFACTORY TO us AM ARE REBV PTEo-YOv ARE Aun4m E0 TD Do THE WORK DAV& AS SF ECIRFlL►AYME MW VrR.L MADE A OUTLINED A69I t 06/0342011 FRI 11:08 [TX/RX NO 54731 Q 001 . Town of Barnstable p114E Tp� do Regulatory Services Thomas F.Geiler,Director BMWSrnsi.e, 9 MAW• �� Building Division 1 . �prFD MAC A, Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERMIT# ,L CL 1 '7 FEE: $ OZ� SHED REGISTRATION 120 square feet or less Location of shed(address) Village. S, C © 6 k v�^,�,�r^ 4 2 �-1 IJOf} J. S-C. oolL Property owner's name Telephone number � � r �C Size of Shed Map/Parcel# _ Q3 S gnature Date Hyannis Main Street Waterfront Historic District? / Old King's Highway Historic District Commission jurisdiction? %V Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 C . Ma91 p . ................... ........ 1 9 82 .... ............................... F:\dgn\conservation.dgn 08/04/03 10:53:13 AM t or I Assessor's map and lot number .....��� SEPTIC SYSTEM MUST BE INSTALLED IN COMP LIAN Sewage Permit number ......... f�.. g '.� ...................................... WITH ARTICLE II STATE ' SANITARY CODE M® TOWN �Q�OFTHE T��`,► TOWN OF B A R NST'WBIX i 1339HB9TADLE, i 9' Mb 9 �0� BUILD`IN-G INSPECTOR Ile - 1iAPPLICATION FOR PERMIT.TO .........l. . ...... .1J9*eQ>� ...... TYPE OF CONSTRUCTION (1.A..P... . ........ * *� .................... ..c....................19 A TO THE INSPECTOR OF BUILDINGS. The undersigned hereby applies fora ermit according to the following informatio Location ....../..-r... 7.f.............. ...`�� ��a.. .... ..........� ...................... ProposedUse ............. ....... e. ...................................................................... Zoning District ........ ..Y....!...........................................Fire District ..5� �' .:/. ......... I ...................:.........f Name of Owner ... .... ....... ...................... ..................Address 2�4...`'�:: .. ..... Nameof Builder ............'..................................`...`..................Address .................................................................I.`......G.. Nameof Architect ..................................................................Address ..................... ............... °y Numberof Rooms .........../......................................................Foundation ............ C? t. ....................................... _e a /J c Exterior ..........� 1... .............Roofing ................ arC..!:.......................................... Floors .......................................Interior ............... 9 Heatingd�.�Y..Y .. Plumbing ......................... .............................. . .................. Fireplace s1'--Q� .................Approximate Cost Zc .00d...................................................... Definitive Plan Approved by Planning Board ________ __"__ G______19 _. Area .............. .................. Diagram of Lot and Building with Dimensions Fee .� SUBJECT TO APPROVAL OF BOARD OF HEALTH <3 gxa•�9 �- _ - CNWS 01?, &-ay=-v t v Y I hereby agree to conform to all the Rules and Regulations of the.Town of Barnstable regarding the above construction. Name ............. .... . . ................. � Breen. Joseph . ' � —Permit for I12 � . ---�z�t���. .�»�» --'' ' � ���^ ���, � �ocunon --.����r��m Gleneail�-.�.���---.. .Centerville | .................................._.-.----------- � . Owner ........... .............................. � � Type of [ono/ruction ----.��aou�_____.. � ! . —.---..--------------.. ---- ` . ' -. � f Plot ---------. Lot ................................��� ' ' f / , . =.. .~...=' = , ., '- � Date� ^ -rr- ° ~ � ' Date Completed lg | - � | ` | ' � Y } PERMIT REFUSED L / .................................... ------ lA 4'0*�� /� �~ ' ---.-.�]..�..^^................................................... \ . � ^-------..----.-----...------- .......................................................... ______. ^ \ ----.---------...-~.. --- .. -.. . -. � � Approved �'--------------- lV ' � . ^ -------'-------'-----------'' ----------------------'---^' ` � | � |