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Home My WebLink About0168 JAMES OTIS ROAD M. C iS 9—J)s_ w p e e 4 e � _ e P a r F 0 due aF Town of Barnstable *Permit „q� Expires 6 months rorry issue date `3' Regulatory Services Fee s/,� 0 .P MIT Thomas F.Geiler,Director 2659. . Building Division � 08 AU Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230, EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r b Property Address t Residential Value of Work_ 07570 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's NamedLwety 7y I �T�iJ�f lam/ Telephone Number- 9,� 7ZA?4 j Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner S PER [i]I have Worker's Co°°m�pe�n"s�ation Insurance � T Insurance Company Name lit l�7/r' Att4 0 yA-1 AUGA UG 1 5 2008 Workman's Comp.Policy# M161 C518 - TOWN OF SARNsTAB Copy of Insurance Compliance Certificate must be on file. �� Permit Request(check box) 0"'Re-roof(stripping old shingles) All construction debris will be taken to Ke- NG� r18�< ., f�G ��f1TGj ❑ Re-roof(not stripping. Going over existing layers of roof) J Re-side ❑ Replacement Windows/doors/slider§.U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:Forms:bui l dingpermits/express Revised 123107 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPJtOVEMENT CONTRACTOR before the expiration date. if found return to: Re istriit�1oix 44428 Board of Building Regulations and Standards One Ashburton Place Rm 1301 `}.' = �v-, Fjvala Corporation Boston,Ma.02108 SUPERIOR INOf)$ i SEAN GREEN ..< ,%' 33 GREAT RD SHIRLEY,MA 01464 Deputy Administrator Not valid without signature The Commonwealth o Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street 3 Boston, MA 02111- www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): L1 PC—RA OR- B )JDUSTR les. krt, Address: 33 6gr=ki Q D / -pb B6k, `7'7 City/State/Zip: It ' Phone #: 42)C6q - Lp J t -7Lo Is 3 Are you an employer?Check the appropriate box: Type of project(required): 1.X I am a employer with 56 - 4. ❑ I am a general contractor and I, employees(full and/or part-time).* have hired the sub-contractorsg 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' comp. insurance.$ 9. ❑ Building addition [No workers comp. insurance p 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. o workers' comp. right of exemption per MGL y [N p 12.[4 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: .. U 13�Ty kklfT-VAL ('iIWUP Policy #or Self-ins. Lic.#: VVr J — Expiration Date: 3 D.Z 2z009 Job Site Address: /fo f5 J41'Y)P S 1_2h_< A09 id City/State/Zip: Cen�Qrvl C /t-CA 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 $250.00 a day against the violator. 'Be advised that a copy of this statement may be forwarded.to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date: 7 �11 ® Phone#. Ste — (o t$ 7�d(ems 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 Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual partnership,association, p p, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of 1 insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the ' members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should f be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed_ below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 'Tel, # 17-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia ACORD CERTIFICATE OF LIABILITY INSURANCE DATE'er" 106/05/200e PRODUCER THIS CERTIFICATE 1 1 A MATTER OF IN N 5013ELLY YNSCRANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT A4r SMID, EXTEND OR 341 TIUMLO ED ALTER THE COVERAGE AFFORDED JOY THE POLICIES IICLOW, BErMONT, HK 02478 INSURERS AFFORDING COVERAGE MARC 9 muREO INSURER A: P —AWRI"A THIS CO BUP&RIOR 1ZOOSING INDUBTRIl1:8 U8 we INC. INSURER IX 64 SPICC'TA= PCHD DRIVE INSURER C: LITTLE", VA 01460 INWREAD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDINO 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS, POLICY EiFER.'IIVE PDucr EXPIRATION LTR aNam TYPEwDYSIIMNG POUCYNWRERR DATE(LRLNOrM DATE MM/DOfM Wars A IJAZIL r BUDIO16907 12/17/2007 12/17/2008 b-OH00cuRRO" $1,000,000 x COIWAMCVLLO9KRALLll11IlITY p er ) ! 50,000 ClAIMS N Q OCCUR MID EILP WM mw Pam) s 5,000 PPR$ONALAADVt"My 01,000,000 OPIERALA,OREOATE L2,000,000 GENI.ADKNREOATE UWTAPPU FM - PROWCTO-COhI WA00 !2,000,000 POLICY JET Loe AyIPONOM LE LIANUIV COMO=$INOIE LIMIT ! I ANY AUTO ALL OWNED AUTOS SOMY I LIURY s BCIIEWA.ED AlPT08 .. . KftD AUTOS SOWLY INJURY NON•OVWNW AUTO$ l�r SecIdNAO ! PROPERTY DMMOiE . (Pw mcddW0 GARAGE LyLW1Y µPTO ONLY.EAACCIDENT ANY AUtO OTMIR TNLAN EA ACC S AUTO ONLY: ,aG t EXCESSRIMSRBLA UASWTY - - EACH OCCURRENCE s 71 OCCUR n CLAMS MADE AD�Nt,►TE RDEDUCTISM RETENTION t _ 1MOMREL.GOrfNl.1RDRR AND ( ,CRY LIINTB Et va"vw 1JAM11W EL EACH ACCIDENT t ANY OR fi.L DISEASE-EA EMPLOYEE 1 N Pss Anmbe wdw .........__._.• ....._ ._- ..._. WMCML PROYMOM bOm E.L.ONIEASE•POLICY LIMIT ! OTHER - EKW nION OF OPERATIONS I LOCATIONS P VEHICLES I EXCLUMONt ADDED BY ENDORAEILENT I"WAL FRDWRIOIA - ERTIFICATE HOLDER CANCELLATION IINOLRA ANY OF THE ABOVE DEacmm POLICIES BE CANCELLED BEFORE THE EIOWATRON DATE THEREOF. ME MKOW RISURlR WILL 9NOIlAV6* TD MAIL 10 OAys MIUTTlN m&nm To "a oSRRACAys NOLDOI IAMSO TO TNl LEFT, YRR FALURE TO 00 SO WALL .NOOK NO C00047WN OR UARUTY W ANY RIND WON THE 0111UMR, I'M AOEM1 OR RBNIlSERA Au11NOMt�O ATRIE CORO25(2001/08) ACORD CORPORATION IM JUL 01 2008 16: 13 FR 6032455330 6032455330 TO 919787093031 P.03 Liberty mutual.. Liberty Mutual Group P.O.Box 9090 Dover,NH 03821-9090 Telephone:(800)653-7893 July 01,2008 Fax:(6W)245-5330 )E-mail:IMS@LibettyMutuai.com EMPLOYERS INSURANCE GROUP INC CIO EIGI OF NORTHEAST 281 MAIN STREET SUrM 5 F1TC11BUR0,MA 01420 RE: Workers.Compensation Insurance Insurcd: RESOURCE MANAGEMENT INC Policy cumber: WCI-31S-365185-218 Effective date: June 23,2008 Dear INSURED: This confirms that as of the date of this letter,the above named covers the employees of the insured leased to: SUPERIOR mUSTRl ..S,ty O125 RESOURCE MANAGE INC 10, BOSTON.MA has a valid workers compensation policy,with coverage for the state off �5T,, cti 510, 06J23/2008 through 031OW009. The policy number;for this coverage is WCI-31S-365185 218.�dve from Sincerely, f Claire Demers InvoluMmy Market Operations cc: RESOURCE MANAGEMENT INC IM00230995 WC1-31S-365185-218 Pane-1 ** TOTAL PAGE.03 ** JUL 01 2006 16: 13 FR 6032455330 6032455330 TO 919787093031 P-02 Liberty. MUtll ,. Liberty Mutual Group JULY 01,2008 P.O.Box 9090 Dover,NH 03821-9090 RESOURCE MANAGEMENT INC 281 MAIN ST STE 5 MCHBURG,MA 01420— Please see attached information concerning Workers Compensation coverage.Important information has been included regarding' recent transactions on the account referenced below. Thank you for your attention to this matter. . 'Insured: RESOURCE MANAGEMENT INC Policy Number: WC1-315-365185-218 INDUSTRIES, INC. ROOFING GUTTERS e COPPER . RUBBER ROOFS SIDING WINDOWS Donald Farrell April 7, 2008 168 James Otis Rd Centervile, MA 617-723-3600 j(I� Roof Will Be Hand Nailed Only 1. Details of area to be completed: Complete Home 2. Remove existing layers of asphalt shingles and dispose of properly. 3. Completely de-nail roof and re-nail roofing boards as needed. 4. Replace any rotted or broken wood(roofing boards) at no cost up to 100 linear feet. (Additional board feet available at $4.00 per ft. and $2.25 per sq. ft. for %2" plywood.) 5. Next, apply a Certainteed Roofers Select or GAF Shingle Mate felt paper to the remainder of exposed roofing area. 6. All wall flashing will be inspected and replaced as needed. Any and all rotted or damaged trim or siding that needs to be replaced to ensure proper flashing will require a Master Carpenter and will be billed out at an Hourly Rate plus material cost if completed by Superior Industries, Inc. Any and all lead or copper wall flashing which needs to be replaced or installed will be done so at an additional charge. 7. All skylights will have ice &water shield around them. Older skylights may require new flashing kits, which will be purchased and installed by Superior Industries Inc. at an additional cost. 8. Chalk lines every five inches. 9. Install eight-inch aluminum drip edge to all rakes and to all eaves (white).. 10. Install pipe flanges as needed. 1-888-618-ROOF (7663) 978-425-0812 Fax 33 Great Road -Shirley, MA 01464 �° Serving NewlEngland a 11. All shingles will be fastened using 1 `/4-1 `/z hand nails. 12. Apply a thirty-year Certainteed or Gaf Architectural AR Shingle. Color: 13. Re-lead chimney Yes 14. Install a Certainteed Air Vent Ridge Vent on the House to allow for proper ventilation. 15. Install 4"x 16" Rectangular Eave Vents (No) 16. Work site shall be cleaned on a daily basis and all areas will be gone over with a magnet to pick up the nails. 17. Superior Industries will supply the customer with any and all permits pertaining to the job. 18. Superior Industries will furnish a Certainteed SureStart warranty that entitles homeowner to fifteen full years or GAF Golden Pledge warranty that entitles homeowner 15 full years of non-prorated coverage including labor, materials,workmanship errors and disposal costs. 19. Superior Industries will supply the customer with a liability ($2,000;000.00) and workers' compensation($1,000,000.00) insurance certificate. (All workers are employees, not subcontractors.) Massachusetts License#133639. Better Business Bureau#83356. 20. Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. 21. Payment to be made as follows: 1/3 deposit due upon signing,1/3 due halfway through the job and the balance due upon completion of the job. All Jobs to be started approximately 30 days after contract is signed& deposit is paid (Pending Weather) . 2 Total Investment: $ 9,750.00 Total Investment ACCEPTANCE OF CONTRACT The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Superior Industries, Inc. Homeowner or Authorized Signature A e Lhorized Agent Name: Date Date We now accept Visa—MasterCard Discover American Express! Credit Card# V# Exp.Date: Prior to Superior.Industries commencing the Roo ftng project, a Superior Representative must inspect attic for mold. (Sales Rep Signature) (Customer Signature) Comments: 3 ; . Town of Barnstable MAS► anxNsraeLe. .16;9 Regulatory Services �� Ar�`4 µAAA Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town barnstabie.maxs Officer 508-862-4038 Fax: 508-7.90-6230 Property Owner Must' Complete and Sign This Section 'If Using A Builder as Owner of Pro the,sub _ 1 per.tY hereby authorize �iC to act on.rny'behalf in all matters relative to work authorized,by this.bu lding permit application;for:. (Address of Job) Signature of Owner ate Print Name Q:Forms:buflft Crmits/eVr= TOWN OF BARNSTABLE Permit No. 26213 Building Inspector � luarr.n Cash � rua ay •D7o• � V OCCUPANCY PERMIT Bond Issued to {! Address Wiring Inspector �( = Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date ,�i x/�ficc THIS PERMIT WILL NOT BE VALID, AND 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. ......................... :s'......_ 't..... , 19............ :...: .: ry�:".r � »'./ ''�� ` ` .."� ._.......... Building Inspector I gING►..c- FAM►►-Y - � BEORnoM v�I�Y FC0w : Ilv x 3 = �3oG Po 0 :jEPT1G -rAtJK Z30xl5o% =A9rG.Po v5E- 1000 GAL. �, �� :► D15Po5nt_ PI'r v4E 1000 GAL_. -#Z47 ' S�p�.WA�u A2Cl� = I�0 5.F ` „'.� +• \' 18,�}�6 s.F. BOTTOM A2E.Ar j�o S.F, h �6'fou•'oAr�c►�, ` �O $.F K I• 0 F 50 G.PC? ^ToTAI-. pE5►GN * �25 G.P. D. -TOTAL ' >A►►-Y F�-O►t� .. 330G.PO• :� g< a ►9(P PE2Go�ATIoN RA?E� I''IN ZtAW 09-LESS aryl FPcP. f i ji AR, q � Gj''li P►T "' SIR s14 OF 'y Ley I r; RICHARD DAY) A ^ `w C. Ic? BAXTEH y1S o THULIN No.2;043 Q No. 2y, y �� GlVI✓�O Q II I QISTe NO SUa,►p� lI . � R`Is' f /ONA _o-? y To P F W ID 53 � Y^� •�- LoMM 1000 INV. 5a805otL- �- D►ST. INS. ca BMX 56P'r Z IOPO INV, �9• -rgnlK q- I; 5A001 P_IT I INV. INV. ,( _ WALNGD 6TvN6 �� SAUD GE2TIFIGD P�07 Pl-A-W i PROFILE Lo44-TloIN C�.I,r=snztltL.1..L No SGALE ScAI.E � �L 5J �P•TE 3-'i3-� `I o VJAJ-6 P�-A N REF 6 rLEN GE• t II o cz ►FY -THAT T1+� �puU�4T►v�1 �Noµ(N ! NEREow GoMPLYS YJITN'[NE SIpE►..►Nrc LOT 2d-7 A Q P 56Te�AGK R.6Q019-eM6NY'�l of Tµ� ITowN AND IS L.OGP.TED WITNI*1 T ooD Pl.A1N �L-. f3iLo� Pfo DATE 3"23�' G � BAXTEiZ.e N`{E INS• ; R-EG 1 S'T�Q6U'tA�1 D 5 u�.V EYoe`� (� -t'uls PL�.1�I ►S Nam' 4n5t�p o-►d: AN _ os-rE2VIu..E • MASS• I I� luS--R.uM6NT TbQ 'T C>e7e n►4G LQT- '-HE-t5 APP�.IGAN'r Ass or's map and lot number ,(. 7NE T Sewage Permit number ......�1�..................... ... ...... . .. ... _ r, E c ; �w �,e4,LLED IN COINAP'L:$ `t"BaEasTADLE. House number .................... , 9� ......- .... : WITH TITLE 5 M6 9., 6 r '„�E�4'�e��,.,, CIO ��wOYPYpr P� YJ VV TOWN OF B*r RNSTABLE k_ BUILDING I'NSPECTOR ` - i r . APPLICATION FOR"PERMIT TO ..... ............... ....................................................................................................... TYPE OF CONSTRUCTION ................................................................... ..... Ll .................19.0T TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies for a' permit according to the following information: , Location •. 2 .. ;7.........dG .... .... . . ......... ... .. ' .!k!"...... � ProposedUse ...... .. ...................... ................................................ ............ ...................... ......................... Zoning District }..... ...Fire District Name of Owner fZ.r... ...... .............................Address ................. ..:. .. .. ...... ........ Nameof Builder ........ .......................................................rAddress ............................................................ .............. Name of Architect .. ......Address................. Number of Rooms ........ ................................................ �.......... .................... ...... ........Foundation� .....��;C%'�, ¢`� Exterior ... . .. ...................... . ...............................Roofing ...................................... Floors C ! ,.............................n....................................lrtterjor ;.,:. .... ...... Pr .. ..... .... �< Heating .....1......... ....... .........Plumbing .... ..... ............................................ a . Fireplace ..... ..... . ..............Approximate Cost ..... .. '{'... i Definitive Plan Approved by Fla'Iding Board -----------_------_-----------19_______. Area ... .l09....4.:............... Diagram of Lot and Building-with Dimensions fee SUBJECT TO APPROVAL OF BOARD .OF HEALTH r • M � OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re ing the above construction. Name ......................� ..................................... Construction Supervisor's License ............ SMALL, ALAN 4 One Sto '................. Permit for .................�'............... Single Family Dwelling Location ..Lots ..... �34-D }fee T..... _,oy Rd. , ...Centerville....................:.................. _ a a' ' .......Alan Small ................ , - Owner ...................... .. Type%of Construction Fr Plot . .......................... Lot .:.........l ,f ril 9 Permit Granted ' .......19 84 Date:of'Inspection .............................�.......19 Date Completed C 3.... ..............19 - t rj Assessor's map and lot number .. ........ � �G� . "may... yoF toffy TH E Sewage Permit number .......... Q .7......a.S ..:.1 Q Z BAHHSTABLE, House number ......................//.A..9.��......�^`................... yp MABa p 039. \0� • �FE MAC a' TOWN OF BARNSTABLE BUI=LDING INSPECTOR APPLICATION FOR PERMIT TO ..... 1/ f��'................................................................................................... ... TYPEOF CONSTRUCTION ...... /� /�`I%� ^................................................................................................. .................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to //the following information: f Location .... - !Z t ..................................... Proposed Use /�-��-� ZoningDistrict ............:..........................................................Fire District ................,............................................................. Name of Owner ....:'�<.a' ?: .r'.......:� `' :.. .. ...Address ............... .fK. ....... ...........:. ............................ !r Nameof Builder ....................................................................Address .................................................................................... y Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation .::z-< t ..... �...................... ................... <_ Exterior ....:1�:/.?::::_.....�::...................................:...................Roofing ..........(-........................................................................ Floors ...... \� ........{'.l . .i..:.. ...................................................................Interior ................... ........................................... �• Plumbing C Heating ..............:..........:.....�.�'J........... g ..................,.......: ...:.................................................... Fireplace ...... ......................................Approximate Cost ..... ............................. - Definitive Plan Approved by Planning Board -----------_------_-----------19--------. Area ................................... Diagram of Lot and Building with Dimensions Fee )6�S'-aS............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS II a, I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...:........... V, ....... Construction Supervisor's License ' SMALL, ALAN A=170-147 No 26273..... Permit for .�17e story .............. Single Family Dwellinq "Ja-ma................................. ... ............... . . .............. .... Location ..... .. 6, 7 Rd. ... ................. Centerville od mod. - ,r. ............................................................................... Owner ...Alan.. ......................................... ..... .. Type of Construction .....Frame.......................... . ................................................................................ Plot ............................ Lot ................................ Permit Granted ril 9, 19 84 Date of Inspection ....................................19 Date Completed ......................................19