HomeMy WebLinkAbout0492 SKUNKNET ROAD :� q�� e � �F�h
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11/14/14
Thomas Perry, CBO
Town of Barnstable
Building Division
200 Main St
Hyannis, MA 02601
RE: Insulation Permits
Dear Mr.Perry,
This affidavit is to certify that all work completed for insulation worts at 492 Skunknet Rd
(application#201401253) has been inspected by a certified Building Performance Institute(BPI)
Inspector.
All work performed meets or exceeds Federal and State requirements.
.Sincerely,
Conor McInerney
ConserVision Energy
a:. ;p
Co
376 ROUTE 130,SUITE C
SANDWICH,MA02563
508-833-8384 www.cbNSERVTODAY.COM
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Ifoi
Map. %(,c% Parcel oSl, try: Application #
Health Division Date Issued 3//0
Conservation Division Application Fee `
Planning Dept. Permit Fee _Aoe'
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address
Village���
Owner Address_`c%iL
Telephone t� e> - SO - 48o z.y
Permit Request w c e.%-..v Loaf, %%a V.5 C_�- w*.
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuatio z..omd .6� 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: OdFull ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq'��L :7,
Number of Baths: Full: existing Z. new Half: existing new,
V73
Number of Bedrooms: L existing —new
Total Room Count (not including baths): existing new First Floor Roo Count . zj
Heat Type and Fuel: ❑ Gas 2-05il ❑ Electric ❑ OtherCD
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ 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 Ld,.moZ w..c.\►.� ..5fia.N Telephone Number tb$ - 8'SS - $3$
Address License#
3�•-�a..� c.w., .�...a n z.��� Home Improvement Contractor# 0% LS
Email Worker's Compensation # .AcQ bS 35
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE `� n14 DATE `3
y
FOR OFFICIAL USE ONLY
9 ,
APPLICATION#
t DATE ISSUED '
MAP/PARCEL NO. L '
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
t FOUNDATION
FRAME t'
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL =
GAS: ROUGH FINAL '
t FINAL BUILDING '.
DATE CLOSED OUT '
E ASSOCIATION PLAN NO.
ti
I"
CSSL-102778:
CONOMb MCiNERNEY
30 SIASCONSET:DRIVE
SAGAM ORE BEACH MA OZ562
081.19/20.14
Office of toosnmer'Affa�rs&'Bu"smess Regulation`
HOME IMPROVEMENT CONTRACTOR
_ - Registration:., 171251 TYPe
:Expiration:. N112014 Partnership
CON=SERVE ENERGY
CONOk MCINERNEY
376 ROUTE 136 SUITE C'
_.. rT-
SANDWICH,.MA 02563 Undersecretary
License or'regis`tration valid for.individul useonly,
before.the expiration date, If found return to:
Office of Cores uner.Affairs;and Business Regulation.
10- ar.k Plaza-Suite 6170
Boston,:MA,61 i16
\ !k.
Not valid without signature
The Commonwealth of Massachusetts Print Form
Department of IndustriPlAccidents
Office of Investigations:
l Congress Street,_Suite 100
Boston,MA 02114-2017
www massgov/dia
Workers'Compensation Insurance Affidavit: Builders/Confractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/(Tiganization(lndividual):Con=Serve1nergy;Inc dba ConserVlslon Energy
Address:376 Route 130
City/State/Zip:Sandwich; Ma 02563 Phone#
Are you an employer?Check the appropriate box: Typeof proiect(required):
1.21 1 am a,employer with 8 4. lam a general contractor and I
employees(full:and/or part-time).
* have hired:the suti-contractors 6. ;New consttvcfpi
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.: '7: Remodeling
- bay. ors e
ship and Mite These subcontract
e no employees, - 8. Demolition
working for me in any capacity. employees and have:workers'
9: Budding addition.
[No workers'comp.insurance comp.insurance
required] 5'. We are.a.corporation and its 10. Electrical repairs or additions.
officers have exercised their' -
3..❑ lam a homeowner doing all work 110 Plumbing repairs or addition
myself.'[No workers'comp: right of exemption;per MGL 12.E]Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employee"s.,[No worker's' 11❑✓ Other Weatherizabon;2013
comp.insurance required;]
*Any applicant that checks box#t 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.
tGontractois that check this box must attached,an,additional sheet showing:the name of the sub contractors and<state whether or,no[`those engties have:
employees. If the subcontractors have employees,they roust provide their workers'comp.policy:number.
J am an employer that is providing workers'compensation insurance for my employees. Below is the,policy and job site
njormaaon.
Insurance Company Name:Sel"ectlye Insurance Co.of the Southtast
Policy#or Self-ins.L c.#WG7956539 Expiration Date 3/14/20 .4,
Job Site Address City/State/Zip:. . .._ .._.
.Attach a copy of the workers'compensation policy declaration page':(shoiving the policy number and-expiration date).
`Failure:to secure coverage as required under Section'25A of MGL c. 152 cam lead to the_imposition of criminal;penalties.of a
fine up to$1,560.00 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 advisedAhat a copy of this statement may be forwarded to the.,Office of
Investigations of the DIA for insurance coverage verification..
1 do hereby egad under the. airs and; ,Wallies o er'u ihat.i4e in ormation provided above is true and correct"
_ _
Si nature: `' Date 3 Z 2013.
Phone#:508-833-8384
Official use only. Do not write in this area,to be.completed by city or town;of ciaL
City or.Town: N effilt/License#
Issuing Authority(circle ouel:
1.Board of Health 2.Building Department 3.City/Town Clerk 4::Electrical Inspector 5.Plumbing Inspector,
6.Other
Contact'Person Phone#:
CONSENE-01 MVAUGHAN
ACORO' LWAWn'YYNI
CERTIFICATE QF LIABILITY ISU
NRANCEF-06ATE
0112612613
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 OOE8 NOT:CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORRED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE.HOLDER.
IMPORTANT. -B the cerMcate holder Is an ADDITIONAL INSURED,the p licypes)must be endorsed: H SUBROGATION IS WAIVED,subject to '
the lerma and conditions of the'poltcy,certain policies may_r_quIrean endorsement.A statement an this aertl(icate.daes not confer to he,
carttgeate holder Inileu Wsuch endorsements_.
PaooticER NAME Strafe is Business Unit
Rogers 8 Gray Ina.-Dennis Branch PNORE 608'398-7980 . F : 877 816.2156
43f Rio en EODRE8S
South Dennb,:MA.02880
I
.INS AHfeR0llq COVERAGE:
INsumm .,SeiecUve Ins.co:gt ihe.3outhBBsF
-;INSURED _ - .. .. ._
'INSURER 8:-'
Con-Serve Energy,Inc.. INsuRERc:,
dba CorrherVlsion EtleFgy
607 Main SE INsuReRo:.
Hyannis,MA 024W INSURERE:
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 WITHAESPECT TO VIMICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS:SUBJECTTO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS
NMI
rMOFIMIRWANIX ... POLICY NUNBEIL. .. ... EFF _ :LIMIT$
OENEBAL LIABLLIIY :. ..._.. -. ,. ._...._ .... ._ . . .....
EACHCCCURRENCEi
A 'X ODMME CAL.GE►f-ERALLweanY 20112" 3M4W3 3H412014 DIU&%E1 om�ce s 100,000.
Cl.AedSMADE. .a OCCUR MEDEXI' alaveraon) S 10,00
PEP
SGNALbrovINJURY s-- --_ 1.000,000
GENERALAGca RYE
QENLAGGREGATELAMTAPPUL3:PM PROGICIS--COMPADP.AGG S 3,000000 .
X POLICY tAC', f
amBm aoddanl- .rt. .
ANYAUFO .:._...,... ..
._. .9ODLY.INJURY Qwfw-o S
... �DH.SCHEOLLED :.BODILY INJURY(Per afdQ811I)HIREDAUTOS :AUTOS
S.
UUMN-UAL" OCCUR; :EACH OCCURRENCE 5
EILCESS1.1149. CLAIM ;` :AGGREGATE S
DED' RETENRON ,____ ._......•...,... .._.._ .. S
WORRMCONPENSA1rOX ATU- :OTH•
ANOEMPL:o'rIASLIAaLITY YIN` .'.. ITORYI � I
A ANY PROPRET0PAV mEW-X8WTME C7968639 =3/14/2013 3M412014 E-L&4IIArWENY s 600,
O MOCLUCED7 O.:NIA ...
pryi+wrl. E.LDISEABE-,,EAEMFLOYE S 600,00
OF.OPERATIDN6bft.;. _- ....-... ._.__ .. E.LDISEASE'-POLICYUM(T 3 600,000. N:
` DEECRIPT.M 01P OPERAMM ILO W1ONS I VENUES(A&r ACORb 1101.IWdYIoeN Remh6 ScMAuMi,R ma a Opus ti dmd).. _
OFFICERS UNDER WORKERS COMPENSATION:CONOR&COURTNEY MCINERNEY"NOTE THAT BLANKET ADDITIONAL INSURED.
OVERAGE APPLIES TO THE COMMERCIAL:GENERAL'tJABILRY(IFA WRITTEN CONTRACT IS IN PLACE).;
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR E.
THE 'EXPIRATION DATE. THEREOF; :NOTICE YIINEL BE 'DELIVERED`_IN
Rise Engineering; ACCORDANCE IMTN-TIE POLICY PROVISIONS.
1341 Elmwood Ave.
Cfanston,R102910 __. ........ -.-,
AIM6104RE0 NEPRESENTATIVE
A
019882010 ACORD CORPORATION:-Ai1 rights reserved:,
ACQRD26(2010105) The•ACORD narne and Logo ace reglatered rnarila of ACORD-
Federal al),#:05-W5629.
RISE Engineering RI Contractor Registration No8166
MA Contractor Registration No 120979
A division of Thie)sch Engineering CT Contractor Registration No 620120
25.Mid-Tech Drive,West Varmo.uth,NIA 02673
CONTRACT
508-568-1926 X-6613 FAX 508-568-1933
Page 1
RI S E PROGRAM' :THIS CONTRACT IS ENTERED INTO BETWEEN.RISE.
CLC-RCS: ENGINEERING AND THE CUSTOMER FOR WORK.AS
ENGINEERING DESCRIBED BELOW
CUSTOMER -PHONE -DATE: CLIENTd.. WORK ORDERr
Kathy J Martin (568)7904024 01/27/2014 102165. 00003
SERVICE STREET: BILLING STREET. - -
492 Sk-unknet Road 492 SkunUet Road
SERVICE CITY;STATE,LP BILGING CITY;STATE,ZIPS
Centerville, MA 02632 Centerville,MA`02632.
JOB DESCRIPTION-
Provide labor and materials io seal areas ofyour home against wasteful;excess air-leakage This work will be performed in conceit
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,tiveatherstripping and other products.,Primary.
Areas for sealing include airleakage.to attics,basements,attached garages and other untreated areas'(windows are not generally
addressed.),(8)working hours.
-At the completion of the weatheriration Work,and al'_n.o additional cost'to the homeowner,a final blower:door and/or combustion.
safety analysis will be conducted by the.sub-contractor to ensure the,safety of the indoor air quality:
$616.00`,
Homeowner is responsible for the removal of the stored items_biocking,the installation of weatherizatlon work-in the knccwall and
-
attic areas..(clear out closet.iOnd bedroom).Removal must occur prior to the schedu]6,d work-start:
$000
Provide labor:and materials to install a 9"'layer of It31 Class;l Ce)lulose added to_(544)square-feet of open,attic space..
$7;l$08
hNEEWACL FLOOR:Provide labor-anti materials to install,a:9"layer.of R-11 Class t Cellulose added to(164) quare feet of open,
kneewall Floor -
S213 20:
..1'royidc labor.and.materials to:install 2" .FSK fiteed'semi-rigid'fihe iass:board;insulati6n to:(147,)square feet of kneewall,area,...
$4$6,51
Provide labor and materials to install(I) new,finished plywood,with 2"rigid Thermax board,weatherstripped attic space access
hatch. Prime coat and/or paint is not included.
$120.00
Provide labor and materials to install(1) new,finished plywood,kneewall space access hatch.The hatch will be;insulated with code.
compliant 2"rigid Thermax board,wea6cT-stripped,'and held closed byeye hooks. (Wood`surfaces-will be unfinished. Prime coat
and/or paint is not included:)
$120.00
Provide labor and materials to:install(1)`insulated exhaust:hose with roof mounted flapper'vcnt to exhaust existing bathroom fan(s)`
$'i16-10
Provide labor and materials to install"ventilation chutes in(76)rafter bays to maintain air flow,
S26524
P pvide labor and materials to:insia))(4);4"X I6"rectangu)ar;alumin,um soffit vents to:increase}ventilation iwzittic areas_Specify:,
color White:,
= $I15614
RISE Engineering will apply all applicable,eligible incentives to this contract.You will be billed only die Nd amount.'Fora limited
time,the Cape Light Compact is offering 100%incentive towards eligible insulation measures,not to exceed$4,006 per calendar
year and all incentive of 1.00%for the.AirSealing measures;
$0.00
S
Federal10:#054466629
RISE.Engineering' RI Contractor Registration No 8186
FAA Contractor Registration No 120979
A division of Thielsch EBgiaeering: CT Contractor Registration No 620120.
251Ntid-Tech Drive,NYe_s_t Varmouth MA 02673 �aOw'iVTO w�+
r 508 568 19261-6613 FAX;508.-G694933. �+ R?11.►
�* Page 2
PROGRAM THIS CONTRACTOS ENTERED INTO BETWEEN RISE
CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORKAS..
E N GtN EE RING DEscalsEo GELow.:
CUSTOMER .. PHONE - DATE _ CLIENT�A. WORK ORDER-
Kathy J Martin (508)790=8024 . 6. /27I2014 1021,65 00003 .
SERVICE STREET BILLING STREET'
492 Skunknet Road 492 Skunknet Road
-SERVICE.CRY,STATE,LP III IGNG CITY,STATE ZIP
Centerville,:MA 02632 Centerville,MA 026')2
JOB DESCRIPTION
Total; $2,77083
7 .
Program Incentive: $2;T70:83
Customer Total' $000
WE AGREE HEREBY-TO FURNISH SERVICES-COMPLETE IN'ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF
"**001 Dollars $0.00.
UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER;AGREES TO.REMIT AMOUNT DUE IN.FULL.INTEREST OF 1%WILL BE CHARGED:MONTHLYON ANY
UNPAID BALANCE AFTER 90 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTORREGISTRATION.:.
DO NOT SIGN THIS CONTRACT IF THERE ARE ANY$LANK SPACES`:
:AUTHOR SIGNATURE'.RISE ENGINEERING-" - -- CUSTOMER ACCEPTANCE - -
R f� ..
NOTE THIS CONTRACT MAY WITHDRAWN BY US IF HOT EXECUTED WRHIN-. DATE OF:ACCEPTANCE - �------ - ACCEPTANCE OF CONTRACT-THE ASOVE•PRICES,SPECIFICATIONS AND CONDITIONS ARE:
�aSATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO OD THE WORK
DAYS: AS SPECIFIED.PAYMENT WILL BEMADE AS OUTLINED ABOVE
P
y
OWN
ER ER AUTHORIZATION FORM
I,
(Owneffs Nam
owner of the property located at
l ( ` 4 �he �
(Property Address)
Leh f� ' v ,/l GZ
(Prooerty Address)
� 1
hereby authorize \
(Subcontractor)
an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a buildi
permit and to perform work on my property.
Owner's Si ature
Date
i
��e (po�nvr�Loaactsen.�o�C�aa�u�eC�- --- •
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only `
ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
egistration 171251'. Type: Office of Consumer Affairs and Business Regulation
xpiration: 3/1/20.16 . Partnership 10 Park Plaza-Suite 5170
�r Boston,MA 02116.
CON-SERVE ENERGYt 00.•�
CONOR MCINERNEY:,.
376 ROUTE 130 SUITE
SANDWICH,MA 02563 f
Undersecretary Not valid without signature
,. y .. - •� III
• a
h •
aAsse sor's map and lot number -, .. ........ ... .
!!ff
S 71C S�-.�'SYSTEM
`MUST
Sewage Permit number ....... .. .~..1.... ... .... '�d��.�. 1B`. r
Housa number ...... .. . ..... ........ . .... ............... .......
039.
a�
a a t cw M" LA )a B MPT
' 0, 's
. TOW OF °BARNSTA•BLE
BUILDING IHS.PEC TOR
.
APPLICATION FOR PERMIT TO .... Construct,IhVellin
TYPE OF CONSTRUCTION .:.......................................................................
Ti
June19.83.................................................
TO THE, INSPECTOR OF_-BUILDINGS;
The undersigned hereby applies for,a permit according to the 'following.information:
Lot d Skunknet Road Centerville ,
Location ...... ......... ..................... ................. .......................... ..... ............... ......... ......:.. ........ .. ... ..:
Proposed Sinl
,Use .... ge f'ami.11:.........
..:.. ................................ .........
' Zoning District ...-�,esidential.... . ........ .. .Fire District ..................................................ri ..................
Name of'Owner R James K. Smith ....,...,Address ...Barnstable
..................... .... ....... .....
,Name of Builder .. J.ames..K.•...Smith ......................Address ................:�arnst;able........................ .............
,.
Name of Architect ............:......................................................Address .......... ....:.. ..
ourcd. con;cr.
Number of Rooms Foundation _P ... : ..............................
Clapb t ?Exterioro. a9.. �.,oak Interior drirvlall
Floors• ........ ..........
Heating 1..wa.rm..air... Plumbing ...... � a�at�i
Fireplace On2................ ........ ...................Approximate Cost . . ::d�Z.9.�.��.........
. .. ..... ..... .... ......
6 s:
Definitive Plan Approved by Planning Board _______________________________19________. Area ............................. .......
Diagram of Lot and Building with Dimensions Fee
49
SUBJECT TO APPROVAL OF BOARD OF HEALTH
2 4x'
2 ;stories'
no garage
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS'
I hereby agree to conform to all the Rules and.Regulations of the Town of Barnstable regarding the above
construction. 1 '
.`Name .... L1J(`lv!''.: ... .>." '..............
Construction Supervisor's License #5 9
,j SMITH, JAMES K.
25262' 1 2 Stor
to .............j. Permit for ...................... y..........
...S.ingle .Family...Dwelling................
Location . Pt...4.,....49.2...Skunk4et...Raad
I
Gen exv. .�.J ..................................
4 Owner ......?=eS...K,....SX(dth........................
" Type-,of Construction, ..F.rame..........................
j
r..................
f .Plot ............. ....... ....... Lot ................................ '
Permit Granted ....June' .................19 83
[ _ -
'f3 .Date of Inspection .:.... /...' � .......19 F -
Dates"Completed .. 1 149 ^
r ..
w�•^rc.a N C�
'p6r516ki DATA
�. GisaGLrm P'AM ILI-{ 3 8meooMS
Uo 6AQBA,loE QF11..1DE2
` AV6, =h&�IL.Y FLOW • 3 x 110 s 33o GPI
SlaQ'['lC •rA+.ItC = aSo x ISO�o d95 GPD l . . _ .. . . .
(0oc>
. F't MLx> • ui E:2- p•vw of FFu55oK5
• SIbEWA.�..L d¢ELa s -1B 5F (i�,Q�jR , ..� : , �a
,. .-.._ �7d+48�!•o8)C.2•S) = t94 G.Pp: . . .-,' ::. . _. ..1. . _ -•-.p. _. ,, . 1 •._...• -
•50TTOAA AIZ9=4 . = 288 5F _-
,1 i 31
-L88 6••PD.
F.
,"T°oTAL- UESt G1-4 = 'ABS GPI '! N r
PZ ZGot.ATI o W GZ4T1= (" I t,l 2 AiM. OZ.LW. i 3 J NM
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: e,�U �Nv �>zya�. �
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tow iuu 1uJ CKT IUD 'L SoSsa��,: :� A
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l o �i�P1'1C 1 uv �'
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i W rr4 d°of 3/d I'/t WASHED
-6TOUE ALL AZWWZ>. Z• OF N
WASLIED PSASTaN6. oN ToP
t pq�
fq
PPoPoSED joWEs...
ale-
THE
,`};.-� TOWN OF BARNSTABLE Permit No. _____-_____-
Building Inspector
11Ausr.n, Cash --_--------------------
OCCUPANCY PERMIT Bond
Issued to J a1Re:- Mi t . Address
Wiring Inspector Inspection date
Plumbing Inspector !f 6�` ( j '� / Inspection date
Gas Inspector Inspection date
Engineering Department Inspection date
Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
1.
. .
IL= Building Inspector
Assessor's map and lot number
THE
Sewage Permit number ....... ....
33AUSTSIILE,
Housf, number MAS&
..... ......................................
1639.
Or.
TOWN OF . BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO Construct Dwel
..............................................44. ....................................................................
TYPEOF CONSTRUCTION ...... ..........39qqA...trame..........................................................................................
................June......................1983
.......... ........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .........Lot. ...4...S.k.unlme.t... Centerville
..... .. .. .. .. ............ .. .........................................................................................................................
ProposedUse .....Sin.gl.e...fami.ly.......................................................................I................................................................... .... .. .......... .....
Zoning District nt-
...Re.s.id.ent.ial ........................Fire District Cent-fps........... Ost
. .. .. .... ....... ....... ...................................................................
X James K. Smith Barnstable
Nameof Owner ......................................................................Address ....................................................................................
Name of Builder .... Smith...........................Address ................1�!AAIAA.........................................
..............................................Address
Name of Architect ........Address ....................................................................................
Number of Rooms .......4..........................................................Foundation ..........Pq 9.4...PPACTRtg............................
Exteriorclapboard. WC S t 111 ...............Roofing ............................. ........v.......................................... .................................................
Floorsoa k
.......Interior .........
............................................................................ .1 ...7WA
ll................................ ..............
Heating vrarm air
......................................................................Plumbing ....................bath....................................................
Fireplace PAP.........................................................................Approximate Cost .........M.—t,V'W..4-�9q.0.0 0........... ........
Definitive Plan Approved by Planning Board -------------------------------19--------- Area ..........................................
sd
Fee ..........Diagram of Lot and Building with Dimensions ...........
SUBJECT TO APPROVAL OF BOARD OF HEALTH
24x-")4
stories
no garage
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..... 0. .......
............. ..............
Construction Supervisor's License �53.9.0.......................
1
SMITH, JAMES K. A=169-93-3 V
4
25262 1z Story
No .............. Peft1't for .................................... +
S.ingle. . ...Fam....ily. ...Dwellin. . . g............... .... .. .... ..... . ..... ....... .. .... .....
Location .... ot 4,. 492 Skunknet Road.
.............................................
Centerville
...............................................................................
Owner .....James K. Smith
..................................................
Type of Construction ... rame
Plot ............................ Lot ................................
Permit Granted „June 29, 19 83
Date of Inspection ....................................19
Date Completed ......................................19
a
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