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HomeMy WebLinkAbout0087 VALLEY BROOK ROAD r e e q e .� C:2 6 6u;q . -PRESS RI� 2 Zoo Town of Barnstable *Permit# p es 6 ontlsf-0n:is u e Regulatory Services e NSTABLE 9cb 6 9 � Thomas F. Geiler,Director �TFDMAtA 6IG SislloL& Building Division s Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 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 ( ` Prop rty AddressV k Qd C t11 �- /A ..(✓ �J Residential Value of Work 6 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address " P14 I e Contractor's Name ., Os C e elephone Number Zb,7 Home Improvement Contractor License#(if applicable) T � w,J9 7Co `ction Supervisor's License#(if applicable) 70 a man's Compensation Insurance Check one: ❑ I ' a sole proprietor -YaI VI am the Homeowner I have Worker's Compensation Insurance lnsurance Company Name &W Workman's Comp.Policy# ` Copy of Insurance Compliance Certificate must accompany each.permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(pot stripping. Going over existing layers of roof) ❑ R ide s #of doors Replacement-Windows/doors/sliders.U-Value .Oi (maximum.44)#of windows *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. SIGNATURE: 1/✓� Q:IWPFILES\FORMSIbuilding permit forms\EXPRESS.doc - e 07/2 Board of Building Regulations and Standards HOME ..IMPROVEMENT CONTRACTOR Re9IStr OiQq t 26893 j .7-13I20f 0 yp2 SUpptement Card The Home Depot:.AlT�ortt@;�d�riae DARREN DEMERS 3200 COBS GALLEf;yA'PKtNK#20 ATLANTA,GA 30339 Administrator. License or registration valid for individul use only before the expiration date. If found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston;Ma.02108 I i 1. Not valid Without signature j �I:ao>:schze�cat� - !oo p:a.•tr It:t:1 , t'!'1:b c <'ilf•t.x of BuOdin-1 and st:ldardh _. Construction Supervisor License. . License: CS 70077 Restricted to: 00 JOSEPH C DUARTE 15 FALL ST_ WAREHAM, AAA 02671 ��- -- Expirmion: 1213&2010 c iwni•.i„n r Tra: 7662 ,� fin` °�:• ,°'' 110eN of Ruilet�o�ldemad5as®Jsrt. l,iCtreS�ar r®&itl.� R valid ft�r ift®io9dulusi�3}° 1�IlE t�IPROYEME�t�Afi13AC7Q4� i.etoev Ike r>.� etiemt r date. If bound POUR"1®: 19g o Ara OFftihti.t Afvi tinns sud Setetdsrds ftmgisbVU9nt 132349 t1m :lshburtitA.Vbtvi�t 13N Fwalbn: VI U2011 Yet 2?d91 %"tuw.k1a.11210b Type: ParinenhiQ ; J a J Remode" �. 1o'h puaRe _ S5 ra!I SI �•.(''''�'-'� - - - _ vszG4 witt0.ao9 ii�lt® ma42$71 ,dmini�V:r.a+ FROM :jamgad FAX NO. :5093622271 Feb. 1 2007 10:32AM P1 4 fJOME IMPROVEMENT CONTRACT PLEASE READ TRIS Sold,Furnished and Installed by: Branch Name: Boston Date: THD At-Horne Services;Inc. d/b/a The Home Depot At-Home Services �^ l� 345A Greenwood Street,Unit 2,Worcester,MA 01607 1�f N li ✓J / Branch Number:31 Toll Free(8W)657-5182; Fax(508)756-8823 V Federal ID#75-2698460;ME Lic#C 02439;R1 Cont.Lic#l6427 CT Lic#565522;MA Home improvement Contractor Reg. 116893 21 Installation Address: 6 el Q_-),b ` City State. Zip Purchaset(s): Work Phone: Home Phone: Cell Phone: [ l [ l [ 1 Home Address: (If different fmm Installation Address) City State Zip E-mail Address(to receive project communications and Home Depot updates): ❑I DO NOf wish to receive any marketing emads from The Home Depot Pro'ect Information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to buy, and THD At-Home Services,Inc.('The home Depot")agrees to furnish,deliver and arrange for the installation("Installation")of Alt.materials de,%cribed.on the below and on the referenced Spec Sheet($),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto,and any Change:Orders(collectively, "contract"). Job#: (kke—sdaefu Q Products: Spec Sheet(s)#: Pro•ect Amount / Ratfing Siding Windows LJ Insulation / / 3 r/ QGuttem/Covers ❑l:ti lloors ❑ b / Roofing LlSidiWVTmdow Insulaw" 1' ... / ❑(loners/Covers ntry Doors El. ,-. _ Roofing ElSiding 0 Windows LJ Insulation $ ❑Gutters/Covers ❑Entry Doors❑ Roofing Siding Windows.❑insulation $ ❑Gutters/Covcrs ❑Entry Doors rl Minimum ZS Ro Deport of Contract Amount due upon execution of thisoon4atA Total Contract Amount $ J� Mane Purchasers may not deposit more than one-third of the Contract Arrionnt ! Customer agrees that,immediately upon completion of the work for each Product,Customer will execute a Completion Certificate (one for.each Troduct as defined by an individual Spec Sheet)and pay any balance due. A.s applicable,each.Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or lead paint,other safety concerns,pricing errors or because work required.to complete the job was not included in the Contract. �t. t L� Payment Summary: The Payment Summary iA1_, included as part of this Contract, sets forth the total Contract.antount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth it)this-Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO TU, HOME DEPOT FROM THE. DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT T,TMMNG THE TIOMI;DEPOTS OTHER REMEDIES FOR RECOVERY.OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer. and The Home Depot with regard to the Products and Installation services and supersede.%all prior discussions and agreement's,either oral or written,relad'iig to said Product~and Tnstallatioa.This Agreement cannot be assigned or amended except by a writing signed by.Customeb,mid The Home Depot.Customer.acknowledges and agrees that Customer has read,understands,voluntarily accepts the terms of and has recei ved a copy of this Agreement_- Accepted Sub-WV ub by: Customer s Signature Dale Sales 0.1,ultanes-Signs tt / Date Teleplto No._ Customer's Signature Date Sales Consultant License No. CANCELLATION: CUSTOMER MAY CANCEL THIS l�nppticantej AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DFLIVERING WRITTEN NOTICE TO THE HOME DEPOT BV ?MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE - STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPF(3171CALLY P)?ESCRIBED BY LAW IN CUSTOMER'S STATE. NOTICE ALWITIONAL TREAN AND CONDFrtONS A RF 3TA M ON TIIF.REVERSE SIDE,AND ARE PART OF fHM CONTRACT The Commonwealth of Massachusetts ,Department of Industrial Accidents r - ®fJ"C('. Of rnVL'Stdgt9tl0l1S , t r:� 600 Washington Street Boston,JMA 02 711 wat�ss.r�tass.gov1d;I Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/P11 tubers Applicant Information Please Print Legibly Natne(Business/Organizatiotvindividualj: Address: f+ l l City/State/Zip: �L'+�' _ � Phone#: .� �'�' � ,� Are you an employer?Check the a propriate Type of pro cY(required): 4. 1 am a general contractor and 1. I am a employer with 6. ❑N construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7. Remodeling 2.❑ l am a sole proprietor or partner- These sub contractors have 8. [] Demolition ship and have no employees working for me in any capacity. employees and have workers' 9 Ej Building addition [No workers'comp.insurance comp.insurance.: 5. ❑ We are a corporation and its 10•❑Electrical repairs or additions required.] . ❑ I am a homeowner doing all work officers have exercised their 1 l.❑Plumbing repairs or additions 3. myself. [No workers' comp. right of exemption per MGI_ 12,❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees.[No workers' 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. 'Contractors 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: �. ,I '� ` Co Policy#or Self-ins.Lic.#: © � - Expiration Date: - l.Lli/ I . - Job Site Address: City/State/Zip:.��' , CX3� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expi ation date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a line 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 tine 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. 1 do hereby certify under e s and penalties ry that the information provided above is,true and correct. Date: Signature: Phone# 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): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6.Other Phone#: Contact Person: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations" 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): josech 0 U WE:: Address: City/State/Zip: i ' f, borotir-kA. aAcPhone.#: Are you an employer?Check the appropriate bog: Type of project(required): 1.711 a employer with 4. E] I am a general contractor and I 6. ❑N onstruction oyees(full and/or part-time).* have hired the sub contractors2: a sole proprietor or parhier-' listed on the attached sheet 7. . Remodeling ship and have no employees These sub-contractors have g. ' Demolition world for me in an capacity. employees and have workers' � Y P h'• $ 9. ❑Building addition [No workers'-comp.-insurance comp. insurance. required] - 5. Q We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself[No workers' comp. right of exemption per MGL 12.❑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'compmsition policy information. t Homeowners who submit this affidavit indicating they are doing ail 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 subcontractors have ompioyccs,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation - surance for my employees. Below is the policy and job site information. VInsurance Company Name: I�d/E/ j� JWL 67, Policy#or Self-ins.Lic.M �� Expiration Date: Job Site Address: V l%Y City/State/Zip:(.e,, Attach a copy of the workers' compensation policy declaration page(showing the policy number and exp' tion 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 tip 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 er the pa' /and pen 'es ofperju that the information provided above is true and correct �— Dater Signature: — Phone# J o�� (/� �' 7 ' 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,corporation or other legal entity,or any two or more ..of the fqregoing-engaged in ajom en rpnse—`tea "mclu-dm`�fie leg orrthe-=--.-_- receiver or tiustee 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 in-s race 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 pontiactor(s)name(s),addresses)and_phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(L.LP)with no employees other than the =mbers 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 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 permittlicense 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 may be 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 fo any business or commercial venture (Le.a dog license or permit to bran 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 Ma rbLuseM Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext-4.06 or 1-977-MASSAFE Fax# 617-727-770 Revised 11-22-06 www.mass.gov/dia •Asessor-s map-and lot number ../xfINE Sewage Permit' number ''... 3 ...�........//.fin........ e� AHB9T lDLE f: House n 6a� . ..: ......... ...... _ 13 + a MPY , TOWN - OF BARNSTABLE DUILDI-Nu INS.PECTOR APPLICATION FOR PERMIT'TO Constrir t Dwelling t, .. TYPE°OF!CONSTRUCTION Wood frame •, ............. ........ : , Y f. .......... f April 83 ................................................19........ TO THE INSPECTOR,OF BUILDINGS The undersigned hereby Applies'for a{'permit`'according 'to tire'following mformat►on Zot 17 Valleybrook' Road "Centerville Location ....... ...... ... ... .... ...... ............. }........ ... Single 'amily ProposedUse ........ .......... .............. ......, .............................................. Zoning District Residential Fire 'IJistnct Centerville Osterville James K. Smith i Barnstable Name of,Owner .......................................Address .......... 'James K. 'Smith Barnstable Name of Builder" ' ...................Address ..:.....:............................................ Name of-.Architect• .......... Number of Rooms f1V2 ... Foundation �pOUred concrete i ...... ................... .......... clapboard & w c s f asphalt Exterior ... • Roong' hardwood dr will Floors ..............................................................................I terror �. y... as warm. air - 2 baths Heating ....:�......... : ....:............................................. ..:....Plumbing ............ ...... ............................................ p orie Approximate Cost ....... 000 Fireplace ................ ... ... ............................................... .... 55,......... ...... .. .... .. Definitive Plan Approved by Planning Board ______________________________19_ _. Area ... ........®... � L Diagram of Lot and -Building with Dimensions Fee ................... ..... SUBJECT ie APPROVAL OF BOARD OF HEALTH- 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 ...... ! -.......U.,. .......l. Y... . • I c�o 5l90 SMITH, JAMES K.. 24977 One Stor ...... Permit for ........................... .. ..... ' Single Family Dwelling ,......Lot...17.....8 7... ... Val leybrookRd { Location ................................................................ Centerville.. _ .. James K. Smith Y a Owner .................................................................. ; Frame A j Type of Construction .......................................... 5 yly ................................... .a' 9 • , - - Plot ............................ Lot ................................ April 21, 83 Permit Granted ........................................19 Date of Inspection .......... .�.......G.............19 t A Date Completed .....1 .7.. Q--3: ......19 J Y' 51►:JGlL- FAMILY - 3 B6.ORcoM i,� � '�`" ►J0 GARBAGE (�62.ItJ-DER. r a`�" v�ILY FLow a Ilo x I SEPTIC, TAWK = 330x150% =-445G.P. t� USE ►000 GAL. . 0151>05AL PIT USE too 0 GAL. � � "- 5 pG vJAt.L ARF.Is = I -SA 50TTOM AREAS.. 50 s.F x I o ��p G•P�� '' t -ToTA L. Eri1614 r 4Z D. AA 'TOTAL TpA I LY FLOW = 330 G.PD• � •.w Z3s �` PE2GOLAT{ON RATEr L'rN 2M{N OVLL555, 14Of ,n FUCHARD AW . N s' , s ` •� �. i A. O AXTER u ES ,i„ 10 1 ` No.240480 t ' R�' TOP FNDz 37 t>'r' 3 ,N,,. , ,i 'Y pIST INS• G�►L. _ ES✓�SO/(^. Btj�C �gPTIC. PIT wriru 3. 7 '� WAS GD I 6 Ira N6 . r No-r'Vf�T, CEP.T1FIGD PI-o'T PLAN ' PR-OFILt~ LcCq'rlol•l Il..L. -- I G�r�C�Y NO SGA1..E5CALM S p L.p.N JZG F GR.EN C-S 1 EE RT1FY ?NAT TNT Fcxl NpA GWW NEREo1.1 GOMC�l.YS >1JITN'TNE S1 DEL1N E �„_o--f'- ..i 1 AuD 56Teo•G 9.60019 >rM>cN't'� 4F'TµE - L..G. 3 j 5 y-iyp 'To STAZt-EA ND LOGP.T D .WITN1 T 6 F oD P IN DA-rE 483 AxTEiZe N`(E INC. t B S'T.fcSCED'I•AW D S u My riNfOL "fins PLAKI I<-v KICOT oa AN osrE¢vILLE • MPSS. ••IW5T9-uMaN'T 5v2vG-Y 4-TNE oFc-'SE'r5 '6Q0UL No-r e G V�1�U"TC► C)C:'T[:.t'.. Al"[ Lc�'�' APPL.II A►JT � G✓ T1-� t TOWN OF BARNSTABLE Permit No. :__2A R '1______.._-- iffAU ; Building InspectorSAU cash •sr.� l OCCUPANCY PERMIT Bond _,_____x _ ___7V'l Issued to James K. Smith Address Lot 27, , 87 Valleybrook Road, Centerville f ` Inspection date Wiring Inspector46 Plumbing Inspector/ Inspection date Gas Inspector Inspection date 7�7A.) , ?� X Engineering Department f i Inspection date -- Board of Health ! (� ', Inspection date r 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. /� f j � `� Building Inspector Assessors map and lot number .......... ?NE OI` Sewage Permit number .... ....�..4. ........../. ! ......... d s � Z 33MSTADLE. i House number .. �i ............................... 9O Mash p t639• `009 0 Mix TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .,,,,Constrm t Dwelling ........................................................................................................ TYPE OF CONSTRUCTION ..............��T. ... .................................. 00A frame ........................................................... .. ....... ............. April 83 ...............................................19........ TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: Location ...........Zot...17 Valleybrook Road, Centerville .................................................................................................................................................................. Proposed Use .Single Family ............................................................................................................................:..................... Zoning District .,,.Residential Fire District ... Centerville—Osterville ........................................... ............................................................ Name of Owner mes Ja K. Smith Barnstable ...................................................................Address .................................................................................... Jam.es K. Smith Barnstable Nameof Builder" ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......�iVe............................................................Foundation ....poured concrete Exterior clapboard & w.c.s........ Roofing aispha.lt . ............................................. .................:.................................................................. Floors ........hardwood Interior ...........drvwa11................................................................................................................................... Heating f7� warm air ...Plumbing .........2...� baths Fireplace ...0P1 ......................................................................Approximate Cost u ,000 Definitive Plan Approved by Planning Board --------------------------------19--------. Area .............. .............. Diagram of Lot and Building with Dimensions ` Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I I 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 ...... ... t\ry .........K!........... ^... :.. SMITH, JAMES K. A=188 4^ No Permit for One S ory ...... ........ .................... Single Family Dw 1 ng Location .Lot„17,......87„Valleybrook...Rd. ...............Centervil.le ................................... Owner ... ames K. Smith ..................................................... Type of Construction ..ZVaM.Q.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....A...p....... ri1...21.............19 83 Date of Inspection ....................................19 Date Completed 19 ; l l � J