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HomeMy WebLinkAbout0009 MADDAKET LANE c .` � =a `^ .� " :: ,� ., ti, o ".,.. � �� �, _ _ �. a ., .. Y�r� °o-, ., a v .. _ .% r �. . .. a , � . 4 . . �. ._. ., _ , . . A - � ... - � ., � .. � ,y �� �. a � n .. ., F .: .. .. a - .. �_ o n+� Town of Barnstable *Permit#a���� �� Expires 6 nonths from issu d d Regulatory Services Fee • 1AWMABL6. « MASS. Richard V.Scali,Director PERNi679 ♦0 • T Building Division Tom Perry,CBO,Building Commissioner AUG 14 2015 200 Main Street,Hyannis,MA 02601 . T� � F ���JSTA6LE www.town.barnstable.ma.us - O e. 0f�-8 ;_ Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY U t"l Not Valid without Red X-Press Imprint Map/parcel Number V Property Address residential Value of Work$ 1a 1 & Minimum fee of$35.00 for work under$6000.00 t' Owner's Name&Address nyN 4 S MTe n t' 1-'Oi ylfki Contractor's Name 'Pyfi c C iC C\1 Telephone Number 779 o21 Z Home Improvement Contractor License#(if applicable) 17 I `I Z Email: Construction Supervisor's License#(if applicable) p OS 9 ❑Work0Iam ' pensation Insurance sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ d (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to knrti4k Ad ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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&Construction Supervisors License is required. 01 SIGNATURE: Q:\WPFILES\FORM building permit forms\EXPRESS.doc Revised 040215 11-e Commorrivealth of-Vassachusetts _ - Departmtuxt c�,f'Ii dustrial Acciderds - y i O fire ofInvestigadons SOU Washington Street y Boston,CIA 02111 F� 1VIVIs mass govldia Workers' Campensation Insurance Affidavit-. B.uildersiCantractars/Electricians/Plumbers Applicant Infoa-mafian Please Print LeQibIy Name(Busi�mizationllndividud)_ C,'r Address: City/Sta&-Zip- -a ► �2G'3 Phone-,',,-- 271 Z Z cl t Are you an employer?Check the appropriate b Type of project(require: 1.❑ I am a employer with 4. I am a general contractor and I . employees(full andfor part-time).* have hired the sub-contractors 6. ❑New Remodeling 2.El am a sole proprietor•orpartner- listed on the attached sheet. 7. ❑Remodelig ship and have no employees These sub-contractors have g_ ❑Demolition w g, Ycapacity.for me in an employees and have workers' °fib ❑ [No workers'comp.iusmance comp.insurance# 9. Building addition required.] 5. ❑ We are a corporation and its 14❑Electrical repairs cr additions 3.❑ I am a homeoumer doing all work officers haveexercised their 11.❑Plumbing repairs or additions myself [No workers'camp. t of exemption per MGL 12.[:1 Roofrepairs , insurance required-]'s c.152, §1(4�and we have no employees.[N'o workers' 13.0 Other comp.insurance required_] 'Any apphczn drat chedcsbox 91 must also flloutthe sectioabeIowsbmaing thpi woskeie compensat onpolicy iafnrmsdacL Homeowners who submit this aftibxir;uffczd g they are doing all Work and dLen hire autside contractors mast submit a new affidavit iadie=g such.- zGontractors that checY this box must m ched as additianal sheet showing the name of the sub-contract a snd state whether or not(hose eatties have employees.If the sub-contracturshase employees,they musrpmvide their workers'comp.policy number. Lam au empk1wr that is providing workers'congwisdian irrsurartce for my employees ftetory is the policy and job site it formatiom Insurance Company Nam- Policy 4 or r�elf--ins.Lic.4.: F-kpiration Date: Job Site Address: q /R,1( A lGCk 1-4 e�,M�o�Y1 UC CityfStateizip: j L{ W Attach a copy of the workers;compensationpolicy 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 andfor one-year imprisomnwi as well as t izril penalties.in the fog of a STOP WORK ORDER and a Free 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 oflhe DlA far insurance coverage y-erification. .I d'a hereby cerfi,uarder the rs andpena a f :wry thatthe informadon pm i&d abm,#is bare avid carrect . Sionature: I}ate: e.-09��e Phone ig7 7 7y 7 Z Z 052 Z Official use only. Do not mite in this area,to be campleted by cfiy ortown ofefal, City-or Town: PertmtUcense## 4 Issuing Authority(circle one): 1.Board of Health 3.Building Department 3.City-frown Clerk 4.Electrical Inspector S.Plumbing Tncpector 6.Other Contact Person: Phone ih Information and Instructions Massar huseff s General Laws chapfra 152 rues all employers to provide workers'compensation for their employees. Pnrsuaatto this sbt ute,aa.mpIayre is defined as."-.every person in the sravice of another under any contract of hie, empress or implied,oral or writtrm" An Moyer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged ia a joint enterprise,and mclnding the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,employing employees. However the owner of a dwelling house having not more t3aa three apadments and who resides therein,or the occupant of the - dwPlRag house of another who employs persons to do maintmmce,construction or repair work on such dwelling house or oa the grounds or building appurtenant thereto shall not because of such employment be deemed to be as employer." MGL chapter 152,§25C(6)also sues 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 shalt enter into any contract forthe performance ofpublic work until acceptable evidence of compliance with fhe insurance.. rem riremeut s of this chapter have been presented t a the contracting anthodty." f Appdcarn b Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your sitnaiion and,if necessary,supply sub-conizactor(s)name(s), address(es)and phone number(s)along with their certifacate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partaersbips(LLP)with no employees other than the members or partners,are not required to dairy workers' compensation insurance. If an LLC or LLP does have employees, a policy is required.. Be advised that this of idayh maybe submitted to the Department of Industrial Accidents for confrtmation ofingarance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuoned to the city or town that the application for fhle pemlit or license is being requested,not the Department of In d, ai Accident's. Should you have any questions regarding the law or if you ale req�to obtain a workers' compensation policy,please call the Department at the number listed below. Self insured companies should enter their s elf-in dinar,ce license number an the appropriate line. City or Town Officials Please be sore 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 peD�itllicense number which will be used as a reference number. In.addition,an applicant that must submit multiple pennitlIicense applications in any given year,need only submit one affidavit indicating cuaeat policy infbmation(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 may be provided to the ' applicant as proof that a valid affidavit is oa file for fvtare 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 (Le. a dog license or penuit to burn leaves etc.)said person is NOT rearmed to complete this affidavit The Office of Investigations would like to thank you is 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. Thu Cammoawedth-of Massachutfts Degar` ent of Lidu,5Eal Accidence Q fT ice of f-�ave&tgatlo= ��4asI�intan o an,MA G2111 Tf,-L 4 617-727-49W cx- 406 or i-& -hgM FF, Fax#617-727-7749 Revised 4--24-07 .masg-gctrf dia. C . 0 R,?;,E Y I 6 t a CONSTRUCTION POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards,Plywood Sheathing,Missing Metal Flashing,Side Walling or Any Other Carpentry Needing Replacement . will be done and charged for as an Extra: Materials Plus"Labor at the Rate of$ 80.00 per Hour. PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing.of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 45 Days of Acceptance.andSReceipt I of Deposit providing the Materials are.Available. i Please Make Checks Payable to: PATRICK CLIFFORD COREY & COREY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles your LIFETIME if the shingles becomes defective. ` CERTAINTEED Warrants the Shingles up to a CATEGORY III HURRICANE-130 MPH WIND WARRANT. f CERTAINTEED Warrants the Shingles to be Algae Resistant for a Full 10 Years._ COREY & COREY carries Workman's Compensation and Public Liability`Insurance on the above work DATE OF ACCEPTANCE: ACCEPTED BY: SUBMITTED BY: G� TOMAS LIPINS —TeAARLES COREY CONSULTANT HOMEOWNER COREY & COREY CONSTRUCTION l I n Y n '' mY�'3di1dS"11�f�t�'tsl�iilrBS aYStt�'1;�rn� �" 8 �14Vi �> Arta `:� •yy M ?h. L; a v-Officc of Consumer affairs&Busine s Regulation License or registration valid forindivi<fui use only ` CTOR before the expiration date. If found return to: a ME:IMPROVEMENT CONTRA mer:affairs anti Business Regulation . €, 0.• fiice of C..onsu � egistation: 173192 TYPe:. O To Park Plaza-Suite:51/0 Expiration: 9/11,12016 rJBA B.oston,,N''..I A 02116 COREY AND COREY CONSTRUCTION PATRICK CLIFFORrJ'' 12 BALDWIN RD ature DENNIS>MA 02638 ('.ndersecretary Not valid without ;n E< ma's n ....._. /12/2015 MON' 13: 5 FAX 5089923.538 southeastern Z'A : m001./001 coRo� CERTIFICATE OF LIABILITY INSUR�gNCE °" " °°""r" 1/12/2035 IS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANDCONF:ERS NO RCGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE bOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BEFVHEEN THE ISSUING INSURER(SJ, AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT: IEthe certlticate holder is an ADDITtONAL INSURED,the poilcy(IeS)must Do endorsed: If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may.,Yequire an endorseitlenL,A;Statement on this cent ROG does IS WAIVED, onfer , subghts ec the certificate holder In lieu of such endorsements. PRODUCER- Southeastern Insu-rance NAME:- Joanne Bretton Agency, Inc. PHONE; 439 'State-;Rd. AIC N (5D'B)997-6061IL ax (508)990-2731 Box 7539.8 " 7breEton@southeas'ternins.com North. Dartmouth MA 02747 dNSUREk(S)A4.0RDINGCoVERAGE - :INSURER INSURED '-- : INSURERA Arbella. Protect30A n I•A51]rdce' — — -_.__. . f1360 All Cape'Exterior Remodel `hLC 'NsuRERs:AEIC - ...........- 12 Baldwia Read _ INSuRERC INSURER D ,-Dennis , INSURERS: MA 02538 INsuRERF. - _- COVERAGES CER 'IFICATI'dE.NUMBER 2015 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED$ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASOVEB OR THE POLICY PERIOD INDICATED. NOTWITHSTANDING A g REQUIREMENT TERM OR CONDITION'OF ANY'CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYiBE ISSUED'OR MAY PERTAIN THE INSURANCE AFFORQED BY THE POLICIES DE$C:R_R DOC R'EIN>IS SUBJECT E ALL THE TERMS, EXCLUSIONS AND CONDfPIONS.OF SGCH POLICIES LIMITS SHOWN'MAYHAUf:BEEN REDUCED BY PAID CLAIIVS. INSR, - LTR E TYPE OF.d4IRANCE E.' .. i_.. POLICY ...NUMBER ` + , '`F .: i POLICY EXP .-.-----_— -- GENPRAL LIABILITY MM/W _ ..: MMl LIMITS - A000,0 4 r�O M,sA trGa�r ERf ALi (! AC- JL -r —r 00 LIABILITY oM r—XCCCL:K ! _IN-1(o) 500:04+933:' I14/2015 a e /19'/20 16 sMc^,EPA spar is SONA .i&ALI 4J' c 1,000,000 c J.AG�,RE A.c'UM '.? I' J-o' fF € � 1 ... N.ERAL A < d1.E--'SS` X `°i �r R E S PRvO C04,p,Qa a. I C T i AuroMOBILE LIASILm ---E ANY 4'TCC,GS A�..Oc'Ncjj E AL C�ULyJ t' I E t BODILY Wki aY s..a L_ UTC (�aT:. l 'L J 7 CILV tN E B 3 MS F.:E �— UMBRELLA LIAR e a $XCESSL At3 - e A wsr.A !t AJC�(cJ P — _--- $' VlOW(ERSCOMPENSr,T10N AND EMPLOYERS'.LIABILITY ANY 00000 t ; 'fOLr O�FICER/fDARTM1�REXwlTltr r IfJ R ' I --- (Mandffiory in NH) � I N t A .;A i Eti y 1,000,000 tasde58Csurder.. IVCC50018962034A Il/3%2015 /9/20:16 D SCR7?TI rr OF-Ow4RATIONS;ce w L a� a P Y 3 1 00'0 00'0:...:..:a$t- Y,.T I, 1 1 0001 000 i l .DESCRIPTIDNOF OPERATIONSI LOCATIONS I VEHICLES yAttach ACORD101,Additional Wei:If Spa ce;is-raqutreigl CERTIFICATE HOLDER CANCELLATION" <.SHOULD'ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE "EXPIRATION DATE 'THEREOF, NOTICE WILL BE DELIVERED IN Home Advisor ACCORDANCE WITH THE POI ICY PROVISIONS. 14023 Deaver West Parkway ao1d II� CO 80401 ,AUTt10R2ECREPRESENfATIVE Joanne Bretton/.JBa b ACORD 25(2010105) ING+►7s ©1988=2070ACORD co All rinhts raaarvari oFr Town of Barnstable *Pernut# P� °wti Expires 6 months from issue date sn"srnen.i±, = Regulatory Services Fee � — v MASS. c� 1639.. .0 Thomas F."Geiler,Director HIED M1°'`A Building Division Tom Perry, Building Commissioner X�PRESS PERMIT 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 S E P 1 9 2U�2 EXPRESS PERMIT APPLICATION - RE'ESIDENT "QNLY�ARNS BL Not Valid without Red X--Press lurprint vlap/parcel Number ]9)- U f ?roperty Address "t, ./lQ� V 1 Residential Value of Work Dwner's Name&Address � M0 klm a S //J/'so 5 k1 MA contractor's NameC4 n iz I4O Y1r1F_ � �i1�/-M Q(14 Telephone Number Some Improvement Contractor License#(if applicable) ICO 7Y0 Construction Supervisor's License#(if applicable) orkman's Compensation Insurance Check one: ❑ I am a sole proprietor c I the Homeowner rn n ❑ have Worker's Compensation Insurance Insurance Company Name /I la kv an d— :LIM,ucC�a C-- lJ/'•U.vD Workman's Comp.Policy# C� , Q Cc) Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑ Re-roof(not stripping. Going over o existing layers of roof) ❑ Re-side EV'R"eplacement Windows. U-Value r 39 (maximum.44) WavAL b!? [IL-6ther(specify) tl P !(j U_i/V&J: J�1 At-k "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature 6111)6144 Q:Forrns:expmtrg Revised121901 WWI TOWN OF .BAI NSTABLE Permit?.xo. t e i .,....... �_ l Bulldinglf inspector ,OCCU RANCV' ,.PERMIT Bond 4 ' No building, ndr structure shall.,be erected,,and no,land, building or structure ehall'be; used�.foi•a,new,.different, changed,, or°enlargedAuse without a Building..Permits therefor '.. first having,•been obtained from the Building Inspector'. No.building shall be occupied unto a ' certificat4of occupancy has been'issued by the. Building Inspector:'' Issued to Ba s`id0:' Building Co. Address Lot. 6*23_ :9 Mdddake� lane Wiring,Inspector %t ���� � � �� Inspection'date 1 1 �.. Plumbing inspector�r"� i y Inspection'date r ' v r Gas inspector '�. (� Q ,. k Inspection date• y F'k A7 \\\ ;)/.Engineering.Department .c c l�lr f f?� i3 Inspection date 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 t` �- Building'Inspeetor •,y, •) tom" ...0 } 'I _I �,.` T( •i -.'1 _ �1µ�,. r ,r :: pay yti lL� CDTTY pl� � L,4 t.,!E 2i 1 24 9�o o, LoT 2 3 p 1-7, O-7 I S. F ± 4$'+ �( PLC 15,000s.F W i D'TFi = too' F.S.B. = 1,0' i 2S LOT 1-4 - I OF ` CERTIFIED PLOT PLAN LET 'L3 - 4wcn-r`f DiLia LA►JE C�tiJTEP-./l LLE NEW CONSTRUCTION ONLY TOP OF FOUNDATION IS a.5 ET �9Nn sug�y°� IN ABOVE LOW POINT OF ADJACENT g4t2�.15T�BL2= ROAD. SCALE: DATE : 1 l 04 g I LDREDGE ENGINEERING CO.IN ,� I CERTIFY THAT THE �NDA-n20 CLIENT SHOWN ON THIS PLAN IS LOCATED EGISTERED REGISTERED JOB: NO, $low ON THE GROUND AS INDICATED AND. CIVIL I LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR.BY, OF �"'5rMuQRL e , M 'SS. 712 MAIN ST. CH.BY' HYANNIS, MASS. SHEET OF I DATE LAND SURVEYOR 4ss,A0 � r , p and lot riumber .. ,C�l. �,....,. " Sewage Permit number ...... /�.. ,�............................... �t�- f _ MUST 3 w ' INSTALLED IN COMPLIAN H TITLE 6 EasTanLE, WITH o use number ..............'..........�...� Ba ...................................... ' -. TOWN OF BARNSTAN LEIONS BUILDING INSPECTOR j APPLICATION FOR PERMIT TO l(;e h! -Y. -....../ . . .ids /.. .. . .. TYPE OF CONSTRUCTION .......:v ...... ..... . . .t.............................,......................................... .........040�:..:.....Zf..........19S/ TO THE INSPECTOR OF BUILDINGS: The undersi ned hereby ap i r to the following information: LocationQ� . . ....... tr�......................... ........................................................ ProposedUse !.n. 1., ........................................ ....................................................................... Zoning District ..... t...........!!�....... ..:.. . . ............Fire Distri .... ct .... . .1..' .. ......... Name of Owner 1' ......Address .... 4........ Nameof Builder ....... � — .....Address....... .. ... . ..... ......... .. .. ..... .. .................................................. �—CJ C Name of Architect .. ..r. ... . /►� Address .............. .:"..L..................................... ....................... Number of Rooms ............4................................................Foundation . ....r �...:................. .... .. . .... ......... Exterior / fG .. .....J ,,1!Foofing ...... .. . .;.. . . ... .................... ................ L r � Floors ........G �v�� a ...........................Interior ... ...fi......... .. i.:.L......................................... Heating ... ........ .. ....................................Plumbing ..... ..... ..... � ......................... Fireplace .... ... ..... .............................................................Approximate Cost ..... Definitive Plan Approved by Planning Board __ ______'_________19 t2_ Area . ...... ,........ Diagram of Lot and Building with Dimensions Fee . ..:.... : ...... ..3�/�' CT TO APPROVAL OF BOARD OF HEALTH 'J�(( INV ll Barnstable I hereby agree to conform td all the Rules and Regulations of the Town of e ardin th bove construction. Name ... ........... BAYSIDE BUILDING CO. , INC. hN6 ..........�-.q-lftmit for Build One Story . 236 .................................... Single_„Family,.F.ami.ly...p��p.j;Ling............... . ......... ..... Location Maddaket Lane .......................................... ...................Q.Qrxf;.P,.X1V.i I.Ig.................. ............. Owner.......B.ayside Building Co. , Inc. ...................................... ........... Type of Construction ...Frdme....................................... Al .............. ......... ........................... ....................... Plot ...... ................... .... Lot or November 10, 81 1 �A I Permit Granted ........................................!A 9 AK Date of. Inspection ..............................­ . 1-9 Date Completed ...... ....... 9 PERMIT REFUSED 4 ............ ................:....................... .... ig ................................................................................... ................................................................................. ............................................................................... ............................... ............... • App roved ......................................... ...... 19 ............................................................................ 10, ......................................... Assessor's map and lot number .,. .. 1 ��. .... J s ✓ . �F TH E t0 Sewage Permit number .....!��' ... 45.3.............................. d 07 Z MAR3STADLE, i Ho use number ........................? . CC FOr aM . ................................: tYf1'I ' a. TOWN OF 'BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION .......:v !.... .. ...................................................................... ....... ..I ....../►..............19. / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following/information: Location ......................................................... ProposedUse .... !. ../ !/ ..�r/ .............. ...... ... ................... .. .............................. Zoning District ... ..!`... ............ .... ... .......Fire District ....... Ak Name of Owner ��'��.....,.... ....;,..,.,.,.!�/,f.......Address .....!...�..�,?..1�,�1......l.:�� ��/Z;v�//..L. -........ J Nameof Builder ......................��., .......................................Address ............,::, ................................................ Name of Architects_... ��ra Address J L. Number of Rooms ............ ................................................Foundation L ..... .e .:!4.......... ......... Exterior `�. �I`J! ..5, 1, S (yRoofing ..... . ...... ... ............. :.......`.....:. j _ _ Floors 1� .t'J� :.. //t '/y? ...........................Interior ..../ ...... / �� ........................................ _. Heatingy� M �.,�. .... !t. ....................................Plumbing ....., �/,,...,�e..v ......................... Fireplace .. ,o.. .............................................................Approximate Cost .....�/� <,............., .... � /may .... Definitive Plan Approved by Planning Board _ :---------19 � Area :. ..... Diagram of Lot and Building with Dimensions Fee _ ......../;--'f`� �. SU'BJ.ECT_ TO APPROVAL OF BOARD OF HEALTH ! 1 i I hereby agree to conform to a the Rules and Regulations of the Town of Barnstable regarding the above 4 construction. Name . ,. .� ................... ...... i. ... . ..... BAYSIDE BUILDING CO. , INC. �A-191-70 23629 u' d One Story No .........��. rmit for .... ..... ......................... y Single Family elling .................................................... ......................... Lot '2 q Location .. 3 1 r�addaket Lane Centerville ............................................................................... Bayside BuildingCo. Owner ............................................ In*9 Type of Construction F.rame. ... .. .... ......................... ................................................................................ Plot ... Lot .: ................... r Permit Granted ....NQ p-mbar...1.0.,.....19 81 fib . , Date of Inspection ............,.......................19 t P Date Completed o- PERMIT REFUSED ................................ .Ii............................ 19 ................................. . .......................................... r ..............................:................................................... ................................................................... .................................. Approved ................................................ 19 ............................................................................... ................ ......................................................... i