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HomeMy WebLinkAbout0051 JOAN ROAD 5l �own �o�. f .: .' .. _ ., ❑: _ S. o 6, o .. e I I Town of Barnstable. K Permit# r � ' Regulatory ServicesTei '"s o u�e�re 7.0 ��,y10S f e Thomas F.Geller,Director 1 R�S B Bunding Divisio '?/J) �+ n �o Tom Perry,CgO, Building Commissioner 200 Maui Street,Hyannig,MA 02601 Office: 508-862-4038 [ ww. .town-barnstable.ma.us" �' ESS PE)4T A1'pLICAT�O Fax: 508-790-6230 E Not ivaifd without Red X-Jfress Imprint N RESIDEN TIAL ONLY MaP/Parcel Number 2 .Property-Address S ? / . � idential ! G( a � Value of Work! Minimum fee of$25.00 for work under$6000.00 Owner's Namd&' Address J��Contractor's NameV G� Home Improvement Contractor License#(if a licable r Telephone Number 7 71.1 '7B ( PP ) !4$ o Constriction S npervisor s License[#(if applicable) �S 00VOrkman's Compensation �ance. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner i 411ave Worker's Compensation Insurance Insurance Company Name t Workman Comp.Policy# F . C �-( e $D �7Copyo 'nsurance Compliance Ce{r. cate must acy each ermit: Permit P . Request(check box) . k ❑ Re-roof(stripping old shingles) All construction debris will be taken t0 ❑Re-roof(not stripping, (going over — exrsting layers of roof) F ❑ Re-side Replacement• ludo ` ors/sliders.U_Value #of doors m — aximum.44)#of windows *Where required: Issuance of this 4 penis Goes not rxempt compliance with other town department regulations,i.e Historic.Conservation uc. ***Note: Property t er must si ' A copy o to Home�Premeentf C a tosser.of Permission. required, f License&Construction Supervisors License is SIGNATURE; - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registrationa=14$688 10 Park Plaza—.Suite 5170 Expira€io __ #82Q1.1 Boston,MA 02116 fi : Supp ri`ent Card LOWE'S HOMES C UEk&ffl `. JAYMI RODRIGGEZ1 =;_;- 136 TURNPIKE M-Sfi I&_VV SOUTH BOROUGH"MP 04772 Undersecretary 9��Nevvalidwvithout signature c- Fax Server 4/4/2011 7: 14 :00 AM PAGE 2/003 Fax Server CERTIFICATE OF LIABILITY INSURANCE ° O2011 �.. 031,8r1D„ 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 INSIIRER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an ondorsemeflt. A statement on this certificate does not confer rights to th certificate holder In Ileu of such endomement(s). PRODUCER NAME m0 100 N.TRYON STREET,SUITE 3200 Arc1 w FAx No): CHARLOTTE,NC 202M E4AIUL FAX(704)374-500 PM ' 47095-CASUAONLY-11-12 a18Uma2 AFFOADetOCOIIERAeE NAIL! INSURED INSURERA:Self bl"d Lon%Companies,Inc. National Union Rma Ins Co Pittsburgh PA 19445 and Subsidada INSURER B: PO Banc 1000 MEAR R C:New HampeHre Irsuance Company 23641 Moaes+Ae,NC 2B115 -mNSUREt o IS tlar nols Neel Ina Co 23817 INSURER a:1111MIs Unlon Inazonts Co 279M .Steadfast baurmax Company 26W COVERAGES CERTIFICATE NUMBER: ATL-002197856.10 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 CAMS. IN SR TYPE OF INSURANCE POLICYNualBn4t ADM INUOR POLICY EFF PD OIP UNITS GENERA.LIABILITY EACH OCCURRENCE. 41 A X COMMERCIAL 13ENERAL LIABILITY 304named OW12DIl 04101012 -ONM3M RENTED PREMISES Ma a UrMF=: s CL42484AADE OCCUR MED EXP one person} _ PERSONAL BADV INJURY i GENERAL AGGREGATE S GEN'L AGGREGATE LaNR APPLES PER PRODUCTS-COMPICP AGO = 1-1 POLICY I PRO LOC $ AUTOMOBILE UWAALITY COMBINED SINGLE LIMIT B X ANY AUTO CA4309409(AOS) 011D112011 04/0112012 (Ea amrderd) i 5,000,000 C CA4309410(MA) 01101011 0410112012 BODILY INJURY(Per; 1 ALL OWNED AUinS B CA4309411(VA) 001121111 04111l2012 BODILY INJURY(Pw aaident) SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Par eeddanq NON 47MED AUTOS $ F X UMBRELLALL40 X OCCUR IPR3792301-00 0410 rAll 041 im% EACH OCCURRENCE $ 5,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE S WWI) DEDUCTIBLE $ RETEMICN $ WORKERS COMPENI ATION X YrrC STATLL OTN- AND 9 FLOYEUr LIABLITYER O ANY PROPRIETORAARTNEJEJECUTN EN E r I N XWC48MM�) 04I Ol l - 00112012 E.L.EACH ACCIDENT S 2,000,000 O�FFN:EBMEM EX CLUDED? N!A (He wWw j in NH) WC061967335(MN) 002011 04101T10'12 EL DISEASE-EA EMPL $ 2,000,000 bel deeaesuMw e PeiAT>a El.DISEASE-POLICY LIMIT i D DStxIIPr10N of oNts ow WC061987334(1M) OIA112011 0410112012 2,00,000 B Emsea WC 10NC4MIln(ADS) 04A112011 �owi)2012 WC:SW1EL$3md1;n IDmll SIR B Elo:eee WC jMC4=M(FL) 040112111 M IM012 WC:SW EL:119ndl;n 12mil SIR DEECREnON OF OPERATIONS 1 LOCATIDNS I VEeCLES YWAM ACORD 1M,Addemnd Rwnwla Schedule,N more spew h t4qutad) evidence of cmwW CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE L=9%Companim,Inc- THE EXPIRATION DATE THEREOF, NOTICE MALL BE DELIVERED _IN and subsldiaties ACCORDANCE YMITH THE POLICY PROVISION& PO Bmc 1000 Moore oft NC 28116 AUTHOR®REPRIMMATNE of Mweh USA tee. - Diane Bentley F (�. 401988-2009 ACORD CORPORATION. All rights reserved. ACORD 23(2009109) The ACORD name and logo am registered marks of ACORD 3.a. Massachusetts- Department of Public Safety Board of Building 11q ulations and Standatds Construction Supervisor License License: CS 94688 Restricted to: 00 ROBERT W CHASE 110 CONDUIT ST NEW.BEDFORD, MA 02745 - d�G_ Expiration: 10/31/2011 Cnnmiis�inner Tr#: 8302 May 11 11, 10:25a Bob 5089955798 P.1 ��ae i�a»arnoreraea.�l�o�'�caoaaceQsrae�d -. . Office of Consumer Affairs&Business Regulation License or registration valid for indiridul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Registration 164094 Office of Consumer Affairs and Business Regulation 10 Park Plum-Suite 5170 Expiration: 801l2011 Tr# 288097 w Boston,MA 02116 Type: Individual A-LINE HOME IMPROVEMENTS ROBERT CHASE � % 110 CONDUIT ST NEWBEDFORD,MA 02745 Undersecretary Notvalid w1thout signature''- r • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations _ .600 Washington Street Boston,MA 02111 www.mass.gov/dia Worker's compensation Insm'ance Affi&avlt:BUMft JContradorsMec1ridans►plambea's Applicant wormation Piease Print Legibly Name(Bnsiness/Organizatiowlndivi&W)' S Address: W V cityistatdl ip: W&CA A* it rn 4 0 a59 l Phone# Are you an employer'Check the appropriate bus: Type orprojed(roguirad): l•❑ I a employer wig_ 4 I Remodeling am a general contractor and I have 6. New cormuction employees(fall and/or parttom)•• hiredthe sob-cocoas li.�ed an 2 the attached sheer.# I am a sole proprietor or partnership These sob cemtraors have 8. Demolition and have no employees working for employees and have woken'comp. 9. ❑Building addition" me in any capacity.[No wingers' insurance.#CO 10.Q Fdectrical repairs or additions S Oe -1 S. We❑ are a corporation and 3•❑ I am a homeowner doing all work officers have exearased their tight of 11.❑Plumbing repairsor additions myself(No warkeas' eaemptl per MGL c.152$(4),and 12 ❑Roof repairs gyp• we have no employees,[No workers' insurance •]t comp.insaranoe requited 13. ] ❑Other °ADY aPPhcaM that checks boa#1 moat also sn out the seem below sbaw*then waskas' ' t Ib ovneas who submit this affidavit is ingrbey are doing all waag and oatstde P�h>fa�a L tconaactus mat check - m»st sb)�tt a the mm bay must y m an vvid mal rhea showFog the name of the sub- fteo tics a� � saw leas Lave�Yees.they mast provide ibeu WOd;CB' smsc whether�not those have ataployeea.If oatop•policy number �o mloyer drat is proPl�rtg wonters'cotapertration kat rance for sty Mpbyees.Below is the po&y and job atte Insmanc a Company Name: / , Policy#or Self-ins.Lic.# 4®G a(�3 / /9 �' \ }:xpitation Man- Job . Job site Address:� Rd CitY �t�;_(•Cn�t,d L} MA— 5 a(0 3&— AUKb I ro she d&e wOrkeW compensation 1�declaridon�W—Ing�ply nmobea•and aa�afi-data). as re4�d tinder Section 25A ofMQ,a 152 can lead to the imposition of criminal of a fine to$I,SW.00 and/or z a wear of ft mormeM as t�well as dvfl penalties in dte from of a STOP WORK ORDER-d a fine of tip to 00 a dal agaiost�violator.Be advised may be forwarded to gm Office of Inves8ations of the DIA for bsurance coveaage veffmd n" I do eY under the aitdPeaaldies of perytrry drat the infaron provided above is true axd eonoact. Signature: Date:_ l•'(.�— / Phone# — ' Offic d only.Do not wrke in a&area,to be compid d by d&or town qffidd City or Town: # Issuing Authority(circle me): L Boas ot Health 2.Btmdmg Deparfineat 3.Clfy/rown clerk 4.0ectrical Iospector &Phanbiug Inspector 6.Other contact Pinson: phone rS � PA t- Lt C oVI�rGtG{a/� oi/L j Rob<,,+ C f 6Ae CONTRACT#0 0 0 1 6 6 4 -d ,. MASSACHUSETTSXT.EERIOR,SOLUTI0NS 1NSTLLE[- SALES.CONTRACT 1,.,: INST LED SALES SPECIALIST NUMBER ( CUSTOMER STORE NO. STREETADDRESS -` STREET ADDRESS - CITY STATE P rr +n CITY STATE ZIP / 7 Vrrz TELEPHONE L _ TELEPHONE �� ... _ 3003 DATE_ _ FE NE"O��ENTERS,INC:S MA HIC NO.:148688 , R ` - =p ACC CREG J JY\ This is only a Quote for the mardtandise,and so iws prin led below.This becomes an agreemerd upon,p3ymeM.11Pon paYmen4 tlre,enbre agrearrlent including the specifically completed pages of thls document,the Terms and Conditions included with Oils oocumentand:any_other'addenda.8rrd Wdiiraents hereto,shall:,be eefen¢d Wt:br6in as tNi'Coidracl' PLEASE READ ALL TERMS AND CONDITIONS ON THE REVERSE SIDE OF PHIS PAGE AND FQI,L01MN0 P..4GE§.BEFORE SIGNING - INSTALLATION STREET ADDRESS CITY STATE ZIP I T.�l F :I ty 1 ✓ .I + '✓cam( : ). _ 4 ,, t/G/O GtJ i ;� S •r�r'i�. Contract Total Al 3 / �/ O O Are permits required for this installation?:�Yes [ ]No 'applicable tax included J NOTICE TO CUSTOMER: Federal law requires Lowe's to provide you with the pamplet Renovate Right.By signing this Contract,Customer acknowledges having received a copy of this pamphlet before work began informing Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit. PHOTO RELEASE:Customer grants to Lowe's and Lowe's employees the right to take photographs of.all work performed at the Premises related to this Contract,and irrevocably grants to Lowe's all right,title and interest in and to the photographs for use in all markets and media,worldwide,in perpetuity, Customer authorizes Lowe's to copyright, use and publish the photographs in print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including,but not limited to,marketing, advertising, publicity, illustration, training and Web content. By initialing here,Customer agrees to the foregoing.f X2. [Customer to initial to the left]. Work is to commence upon reasonable availability of Contractor and/or any special order or customer made Good(s)which is anticipated to be — 7— �r�_[fille in date].Estimated completion date Is Ill _ / /—/� [fill In date]. Said estimated substantial completion date is not of the essence.A statement of any contingencies that would materially change said estimated substantial completion date is as follows: (if applicable,insert-a statment of such contingencies). IF THE CONTRACT TOTAL IS$1,000.00 OR LESS Customer must pay in full. COMPLETE THIS SECTION ONLY WHEN THE CONTRACT TOTAL EXCEEDS$1,000.00: (i Customer to Pay in Full; OR [ ]Customer to use the following payment schedule: (1)Deposit $ to be paid upon siging contract.Deposit should be 1/3 the total contract price;and (2)Payment of$ to be paid anytime after this Contract is signed and before commencement of installation.I/We authorize Lowe's to do one of the following(check appropriate box below): [ ]Charge my/our credit card for the amount of the payment indicated above anytime after the date this Contract is signed; or [ ]Deposit my/our check for the amount of the payment indicated above anytime after the date this Contract is signed;and (3)Final payment of$100.00 to be paid upon completion of the installation and both parties'satisfaction. NOTICE REGARDING ARBITRATION AGREEMENT FOR CLAIMS COVERED BY M.G.L.c.142A LOWE'S AND OWNER HEREBY MUTUALLY AGREE IN ADVANCE THAT IN THE EVENT LOWE'S HAS A DISPUTE CONCERNING THIS CONTRACT,THAT LOWE'S MAY SUBMIT SUCH DISPUTE TO A PRIVATE ARBITRATION SERVICE WHICH HAS BEEN APPROVED BY THE SECRETARY OF THE EXECUT- IVE OFFICE OF CONSUMER AFFAIRS AND BUISNESS REGULATIONS AND THE OWNER SHALL BE REQUIRED TO SUBMIT TO SUCH ARBITRATION AS PROVIDED By: tip! Date: Lowe's Ho Centers,Inc. Ely: Date: = Owner Ignature THE SIGNATURES OF THE PARTIES ABOVE APPLY ONLY TO THE AGREEMENT OF THE PARTIES TO ALTERNATIVE DISPUTE RESOLUTION INITIATED BY LOWE'S PURSUANT TO M.G.L.c.142A.THE OWNER MAY BE PERMITTED TO INITIATE ALTERNATIVE DISPUTE RESOLUTION EVEN WHERE THE SECTION ABOVE IS NOT SEPERATELY SIGNED BY THE PARTIES. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AND UNTIL YOU HAVE READ THE TERMS AND CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT. BY SIGNING BELOW,YOU ARE ACKNOWLEDGING THAT YOU HAVE READ,UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET FORTH ON THE REVERSE SIDE OF THIS PAGE AND THE FOLLOWING PAGES OF THIS CONTRACT.YOU ARE ENTITLED TO A COPY OF THIS CONTRACT AT THE TIME OF SIGNATURE. WITNESS OUR HAND(S)AND SEAL(S)BELOW THIS 1st DAY OF /i/ 4 Lowe ome C rp,In . S ecial' or Above Own Co-owner or Witness Gusto " r acknowledges receipt of a true copy of this contract which was completely filled in prior to Customer's execution hereof.You,the buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction.See the attached notice of cancellation form for an explanation of this right. #90981(Rev.12/10) �F'r_-COPY ®Zere4rey tee tac marksoft-F CoaMo ton. ®� ► s: ere Work • tlr�ia ,� ears'Cops #ion A ' cat. ' fibers h Name i M �r..D� r *ty CI. /sb el : IL A reo'V an. elmploy�er"' pia aPp am:a.:ey 4 a P f�Qau'ed): tit , :a.jOIG�r and hav, mg in TiIC&ubi-opo � i L GlIlDi({8iII ' Y wori4 s...Col [No ..workin cazdP:'imsmice S 0d 1 a aa :#s gadditon 3.01a�n a try Gof rep�trs.or additidw ess comp a"IMIR* W. p taus c�z addition � l C] '�Y a : y fol �' ''� l�] T3eC vbDft tlsta�o: HOMDwnas wbo eloivY >WN . a [ al dn � � r �p �QI'�Q�',4 i�jD��,[i��ts��ra�rc , •• la a=Co V=y Name: E . Policy#w Self i ts.Lic.#: JQb Site : Attacb a copy ofthe:rvorh _ � Pq de�lar � Faihue to ,, Pie� b poly.#offer _ Zr t W OIi de). ' �9. P?�a1tiC.4 of8 of day vvseli ss 9i`� T lCR up t°5250.00 a y f aid a fig.. v�' os of the DI14 far imsurmoe oowcragty'Q 'slafemt +,. ffie Qce of I do - ja y u�rder dW pafps.mtd p ofp� the rn ` , , e�ti"aaen fs�ir 2 ar rdcorrept #: O iol use arty. Do not wr a ia.tlds.apt%to � , Cfty or Town: x umwg Aatho drele Per'►it/Irioense may.( one).: I.Board of$eatth L. �.Other Dt 3� ow 4rtor.,, PI uibin8 Inspector Contact Pima: d O.� W/Aif�iN `b Bost ZOO /OOQ G/9LdO�/ IZ so 3 ,�g.Eo.r2oo�u i a OF 1lggSs 3 I per' JAMES _ o J ELH to 9S. Od - Ago FGrsYEQ6�� .. A /`/ O 10994. �SSlONAvF� �lyCp O 'dE�> PLOT PLAN SHOWING , PROPOSED CONST CTION L O C A T l O N: _C E.A'17`E `/jG[.�> SS. � �a+..•�ss► SCALE: / " �� � DATE REG. LAND SURVEYOR REFERENCE: ,,6 --1NG Go-7' OS As .:sN4^>,40 o.✓ S�Z/j,1� _ © A D A T E ZNOFM�ss'C JOSEPH N. a MONAHAN,JR. y BARNSTABLE SURVEY CONSULTANTS, INC .. "4C�STf�yo� R E G i sr EA E_D_`E-N G T N E'E'Ft S A, -L fc'iY fl 8 U R v-E Y-Oft 5 - -_ N� SURF' WEST YAR'MOUTH MASS . ©c�f,►.�,E r8 71 �ssessgr's map and lot number ...... . ... .. ._ INSTALLED IN CX,' PI IANC£ WITH A,t]� r-E 11 .L Sewage Permit number ............................ `� lT�ks�' CC'i 70wN REGU-LATLW,,, ,_ �PyQF7HEtp�yo TOWN OF BARNSTABLE BAUSTADLE, i 1639. BUILDING INSPECTOR �'� �•o ynY a' t APPLICATION FOR PERMIT TO .. ........... ...�. ......... .. ... . .................................... .................... TYPEOF CONSTRUCTION ...... ........ .... ........................................:..... .. . ................ ........ ....................... .. ..................... `...,�C....19!..S^ TO THE INSPECTOR OF BUILDINGS: The undersi ed hereby applies for a permit according to the following information: Location ....... ................... ..�...... .................................................................................... Proposedse .. ............ ........................................................................................................................................ Zoning District ..... ...... ........ .. ... ...........................Fire District ........,... ............... ...................... . Name of Own ..........Address ............... .... .... Nameof Builder ... ...... . .. ..... ...... ...... ....... .. ...............Address ...............�....................... ......�...... Name of Architect ... ......Address' /.../ Numberof Rooms .. ........ ....... .......................................:Foundation . . .... .. ... . ........... ............................................ Exierior. ............. .... ............ ..... �..............:.......................Roofing .......... ....................... ............................................. Floorsli?� Interior.................................. .......................... ..;...................... ......................................................... Heating . ..� ........ . ... :................Plumbing ....�/...... ........ ...... ./. ......................................... Fireplace ......4G- .'.........................................................Approximate Cost .....Gyo- . ........................ Definitive Plan Approved by Planning Board ________________________________19________. Area ........t—,Vob..... ............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OIL I hereby agree to conform to all the Rules and Regulations of t e Town of Barnstable regarding the above construction. Name �. Doherty Corp. / ' . No � ..... o..muf..'`.... ........ ` ~ I / � � . .............. ................ �� Locodon��1—..JQ4�.{�Qa�----------- ' ^ _______ _ l��__ ° Doherty Cmrp ' Owner .................................................................. i frame ' Type of Construction -------------- . , . ' . --------------------------' Plot ............................ Lot ___________ / June 19 75 Permit Granted -------------.l9 < .` ! ! ~ Dote of Inspection �� ��� �-� � - Date Completed lq ' —«�--°—.=----. < ` ' ^ ^ � PERMIT REFUSED . -----_—.----------_-- lV --------------____________. ' - - -----^-------------'------'' . ' '—'—~------------'---^—^—^---' ' � ---------------.----.---..,^. ` ~ ( Approved ................................................ lg � � ---------------^-----~^---- --------------------^--^^~^` i / / Assessor's map and lot number r%� .............. . �-f/ f �/�� 73 �s r Sewage Permit number ... ........ yoFT ETo�y TOWN OF BARNSTABLE BARNSTADLE, q BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... ....- C%...,.r................................... ........... TYPE OF CONSTRUCTION .................... /. ....19 . TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies for a permit according to the following information: Location ... ........ .................................................................................. Proposed�Use .......v,.:.,......:...,,....................................................................................................................................................... _ ..........................Fire District ,Zoning District ..............................:f:.......,...... ................,............................................................... Name of Owner% r,...... �� *... ........................AddressJ��.1�{,....... Nameof Builder C ��2.............Address .............................................. ................................. r Name of Architect .......:..................I:�! ?r7...(,.,:,-� '. ........Address ................/i.,...........................:�.f................................ Number of Rooms ...�!.................. .....,.........................Foundation �� �.... . ...... ,,....,.. ..... ................................. 6 17 Exierior ........................Roofing ...........,..,..:..,................................................................. /�.�(/✓ Floors .............................:.Interior��.•................................................................................ Heating ;,... ;.Plumbing ..... ........,........ .:. Fireplace .......� -:...................................................r..Approximate Cost ......A, .......�„ Definitive Plan Approved by Planning Board ______________________J________19________. Area ............................... ........... Diagram of Lot and Building with Dimensions Fee � � SUBJECT TO APPROVAL OF BOARD OF HEALTH 36 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name I l n (; . Doherty Co a=228 no . � . No Parf�jl, for*single family dwelling ^ Location 5 ` ~~_- -_-- � . Centerville \� Doherty Corp. 44 Type of Construction . ������� RM V ----._--------------.. lA ~-------------------------' -'------------------------- '---------'----'--^---^'~----^ ------------- -.-.- ' � ^^ ^ � ^r �~ App,oVed !�-�',�-'��-�--- ..��-6 lg --------------------------' ----------^^-----------^--^- � ` _