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HomeMy WebLinkAbout0064 VICTORIA STREET . .! . � ©© - � • « » 2 " © � a . \ . \ <\` . \� - � lip, \/ `/ ,? « :. %^ n> \ : \ \\ .\\ \ \ 2J \« ^� 91\ d\\. . . � � ^`\\. �. y� \� � �. . . a ' • t , Town of Barnstable Building., Post This CarKAM d So Thal It isaU�sibleFromxthe�Street Approved;Plans Must beRetained onJ`ob and this Gard Must�be KeptS �' ■AYtN$rABIE, a �,. a yp. n' ..t' �� .-a- a �. :a ;. '' ,;�. $'z'� E'z` 16 � Posted UntilhFinal Inspection Has Been Madev vs R : . , H x Permit Where a,Certificate of Occupancy'is�Required,such Bu�ldmg shallNot be Occupied until a Final Inspection has been made .vwva...n,b.:..x:: ,....,x..�m .d ...�'; ..Tti .e...«emu.."..ab:..,,,. .�;, •.,,�. .3n...�rs.��,..aE:� � ..�,.x�,mu�.:avu.:�?.:�..�,�. .>ia... x. .:� ..?:...s?.�w,a.. .....�..bo�•.`a. A:'...a.. ,�..�rr:"de�a..,new.�?'c�« .vu..��...�.a.. ....3r-.re Permit NO. B-19-1185 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC Approvals Date Issued: 04/11/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/11/2019 Foundation: Location: 64 VICTORIA STREET,CENTERVILLE Map/Lot 148-065 Zoning District: . RC Sheathing: Owner on Record: O'SUCLIVAN,ROSE F Contractor,Name: , BRIAN D DENNISON Framing: 1 Address: 64 VICTORIA STREET Contractor License CS=095707 2 9 3 . CENTERVILLE, MA 02632 Est Protect Cost: $5,684.00 Chimney: Description: replace 1 door r Permit Fee: $35.00 Insulation: Fee Paid," $35.00 Project Review Req: Final: Date ' 4/11/2019 Y Plumbing/Gas Rough Plumbing: 3 :Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the`approved construction documents for whiehRthis permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures'shall,,be in compliance with the local zoning by laws and codes. This permit shall be displayed irra location clearly visible from access street or road and shall be maintained open for public iInspection for the entire duration of the Final Gas: work until the completion of the same. i F ,` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bualdmg and Fire Officials are provided on tMs permit. Minimum of Five Call Inspections Required for All Construction Work:( 'w Service: fix " 1.Foundation or Footing 2.Sheathing Inspectionh , Z ^ T w Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior toFrame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,.Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: AII,Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number..... ... ,. .�,.�g� saRxsT�a " ` o on, h Date Issued..............`.,1.. ! ................................... 0 mnM °o 163g. �® APR 0 2019 Building Inspectors Initials... �Fbwi@►'��' �����L� Map/Parcel. /'1� D G 5 ................... TOWNO� 6AW , ................................... .....�............... - S TOWN OF BARNSTABLE EJKPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY MORMATION Address of Project: �o c l I/'c�`o� L n� ✓, G�>� NUMBER STREET VILLAGE Owner's Name: `(�o Se 0 (�;✓Q Phone Number 5-4- y2D_ /g -7 p Email Address: Cell Phone Number S bE_7 3 7_2 g,rL -Project cost Check one Residential Commercial OVIV1VER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CTT IR Owner Signature: S e �-f(Q �Q C' -(Y -�- Date: TYPE OF WORK L�,8"iding Windows (no header change)# ❑ Insulation/Weatherization �-1 Doors (no header change)#____L_ Conunercial Doors require an inspector's review J Roof(not applying more than 1'layer of shingles) f n Construction Debris will be going to CONTRACTOR'S RL' CTOR'S 1LL`V1C OE`Sl`1'J ATION Contractor's name (�c�an �an��sc✓� - � 2�n �J� Lc"�IC-V4 &,II-nJowS Home Improvement Contractors Registration(if applicable)# 17 3 2- 5 (attach copy) Construction Supervisor's License,# 01 S 7 0 7 (attach copy) Email of Contractor QS.jee- 9q5(6 • C bcn Phone number q01_ � Z R -9 goo ALL PROPERTIES THAT HAVE STRUCTURES)6VER 75 YEARS OLD OR IF THE SUBJECT PR®PERTY is.w A H15TORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. r .. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES.* Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number . Cell or Work number I understand my responsibilities under the raves and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction ins p procedures,inspection roced specific inspections and documentation required by 780 p p CMR and the Town of Barnstable. Signature Date PLICANT9S SIGNATURE Signature ° Date All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England'. Rose O'Sullivan .G Legal Name:Southern New England Windows,'LLC 64 Victoria St ���i RI#36079, MA#173245,CT#0634555, Lead Firm#1237 Centerville,MA 02.632 wixoow NE ucEMEwr 10 Res&voir Rd I Smithfield,RI 02917 H:(508)420-1978 Phone:866-563=2235 I fax:401-633-6602 I salesldrenewalsne.com . C:(508)737-2382- Buyer(s) Name: Rose O'Sullivan Contract Date: 03/29/19 Buyer(s)Street Address: 64 Victoria St, Centerville; MA 02632 Primary Telephone Number: (508)420-1978 Secondary Telephone Number:.(508)737-2382 Primary Email: . Secondary Email• Buyer(s)hereby jointly,and severally agrees to.purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in.this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document, the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate'after Contractor has completed all work under this Agreement. ' Total Job Amount: $51684 By signing this Agreement,you acknowledge that the.Balance Due;and the Amount Financed must be made by personal check;bank check,credit card,or cash: Deposit Received: $1;894 Balance Due: $3,790 Estimated Start: Estimated Completion: 6-8.weeks 6-8 weeks Amount Financed: $0 Method of Payment: Cash/Check We schedule installations based on the date:of the signed contract and secondarily on the date in which.we complete the technical measurements.The installation date that. we are providing at this time is only an estimate.We will communicate an official date and time at a later date:Rain and extreme weather are the most common causes for: - delay. Notes: 1/3 paid, 1/3 due at start;l/3 du at compl. Takes paid in Barnstable Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal I changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyers) and Contractor.Buyers)hereby acknowledges that Buyer(s) 1).has.read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and-2)was orally informed of Buyer's right to cancel,this Agreement: NOTICE.TO BUYER;Do:not sign this contract'if blank.-You are entitled to a copy,of the contract at the time you sign.. YOU,THE BUYER,MAY CANCEL.THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT YOU, OF 04/02/2019 OR THE THIRD BSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER:SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC ' dbai:��ew England ' Buyer� -� Signature of Sales Person Signature Signature L M Kevin Desmarais Rose O'Sullivan Print Name of Sales Person. Print Name Print Name UPDATED: 03/29/19 Page 2 / 11 f s Office of Consumer ,affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, (Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS, LLC Registration: 173245 Expiration: 09118/2020 10 RESERVOIR ROAD SMITHFIELD, RI 02917 Update Address and Return Card. 20M-05,17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Suoolement Card before the expiration date. If found return to: Registration Expiration .Office of Consumer Affairs and Business Regulation 173245 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW ENGLAND WINDOWS.LLC Boston,MA 0211 1 ti s BRIAN DENNISON - 10 RESERVOIR ROAD SMITHFIELD.RI 02917 Undersecretary 9VVt Without signature f Corn monwealth ®r- INlassachusetLz, Division of Professional LlCensUa .hoar of Bu'IdIng Reaulations and "l)Constructor, super"Aso'l l-09570� e� : 09/08/2020 BRIAN ® DENNISON .. 8 BLACKWELU®RIME CHARLTON A.-01 07 ti `Ps�Y Commissioner CIL i The Coinnionwearltft ofMassaehusetts Q - DepartmentoflndustaialAccidents I Congress Street, Suite 100 a Boston,MA,03114--2017 www.nws -ov/dia lVorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PER-NIITT<`YG AUTHORITY. Applicant Information ' 1 Please Print Legibly Name(Business/Or_saniration/Individual): J�__SU(�`�'+t e/'r, JVe o en I Address: o Ser UDl r City/State/Zip:S1q17/'�A eld,I?• 1 ozq 17 Phone k 401—ZZ R-- C/ go(-) Areryan employer"Check the appropriate bo=:LType of project(required): a employer with � employees(frill and/or pan-time).' 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $: Remodeling any capacity.(No workers'comp,insurance required.] 3.[]I am a homeowner doing all work myself.[1 workers'comp.insurance required..]* 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on m 10 Q Building addition Y Property. [will ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.[3 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet 13. Roof repairs These sub-contractors have employees and have workers'comp.insurance.* .6.rl we are a corporation and its officers have exercised their right of exemption per MGL c. 14.r3Other pa4 0 cr 0,3 r 152,§1(4).and we have no employees.[No workers'comp.insurance required.] rC��IG -ei,7 ---1 *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. ;Cantractors 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. Ifthe sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is proWifing workers'compensation insurance for my employees Below is the policy and job site information.. /� Insurance Company Name: 1^ Q l(!— a • o Policy#or Self-ins.Lic.#: fin/C GE .3 15 1? 7 Z.ci 2- Expiration Date: Job Site Address: City/State/Zip: C���e/✓i j��' MA Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the p zindpenaldes of perjury that the information provided above is true and correct Signature: ` Date: Phone#: F Official use only. Do not write in this area,to be completed by city or town off ciaL City or Town. Permit/License# Issuing Authority(circle one): 1.Beard of Health 2.Building Department J.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MMIDDIYYYY) CERTIFICATE OF LIABILIW INSURANCE 12/28/2018 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 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER ONTACT CoBiz Insurance, Inc.- CO NAME: 1401 Lawrence St., Ste. 1200 PHCN o Ext: 303-988-0446 ac No:303-988-0804 Denver CO 80202 A OREss: COMail@cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURERB:FlremenS Insurance Company of WA,D.C. 21784 Southem New England Windows, LLC. dba Renewal by Andersen of Southern New England INSURER C: Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:787175890 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 CLAIMS. IL RR TYPE OF INSURANCE ADDL SUBR . POLICY NUMBER MMiDDY/YYYY MM/LDDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 111/2019 111/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE a PREMISES Ea or curr OCCUR A G D e nce $300,000 MED EXP(Any one person) $10.00D PERSONAL&ADV INJURY .$1,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY❑JECT LOC PRODUCTS-COMPIOP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/1/2019 1I112020 COMBINED SINGLE LIMIT $ Ea accident 1 000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Pet accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per acc dent $ $ A X UMBRELLA LIAB X OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,00D,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $15,000,000 DEO X RETENTION$ $ B WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 X STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑N N I A (Mandatory in NH)If es, E.L.DISEASE-EA EMPLOYE $1,000,090 y describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1.000,000 C Pollution Uability 7930073340000 1/1/2019 1I1/2020 Each Occurrence $2,000,000 Gaims Mada Policy Aggregate $2,000,000 Retroactive Date 0 612 012 01 3 Deductible $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Assessor's map and lot number ,�`� � !17� Sewage Permit number .....(3.�................... l ...... F y�[ n Z BA13STABLE, i ✓.................................... ......... .. :oo Mb 9 a♦� House number ...............# o AOI TOWN OF yBARNSTABLE- _ - BUILDING INSPECTOR �h l APPLICATION FOR PERMIT TO ...1e L'C ......................... / ................. ................`...f......................... TYPE OF CONSTRUCTION ........ �g .......................................................................:.................... ....... .................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby pplies for a permit according � t he f Ilowing information: GT VCLocation ...w..... .............. .... © .... .......................... ................... Proposed Use S,n lrP. . . l ....... f k 1..,................. Zoning District .. .7...� �� �a ........Fire,District �-`'�11v�l../ .. i.............................(J « . . ... g �s Name of Owner �Lrr 1���/.............. .. ...Address ,`... �`.....+...... .......... /�.�.... . Name of Builder W� .............Address..�....... . . ................ .........:............................................ . . .... ..... Nameof Architect ..................................................................Address .............................................:. Number of Rooms ....................... . ........................................Foundation .. /.0 ..l'?`` ��"` ��' ..... Exterior �(.4.LY IFQfI .. lJ� �h �k(...`.`. ......Roofing ..... .... .f1u/. l�r/t ..........<............... ......... 1 ............`.... / .V. y. l Floors �Y d. ...Interior : . %.. ............ ..................................................... Heating?-5... /... ........4.. . .......................... ...Plumbing' ...�..1`�.p(���!-......�...��..`.:. !. f...................... F Sf9 a .............Approximate Cost ....................... .................................. ........._ Definitive Plan Approved by Planning Board ________________________________19-------- . Areas ......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH lit OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS. I hereby agree to conform to all the Rules and Regulations of the To' n of BcSrnstable regarding the above construction. Name ........ C,tf ... ...� ................ ............................. Construction upervisor's License .................. ................ t �' COOLIDGE HOMES A=148-65 a No .25364 .. permit for ,One Story ._ .............. .......... Family Dwelling t 36A 64 Victoria Street Location 9.......................................................... ................ ..le.................................. Owner ...Goolidge..Homes ............................. Type of Construction .,Frame ............................... ................................................................................ Plot ........................ Lot ................................ Permit Granted .....August...l.f............19 83 Date of Inspection ....................................19 Date Completed ......................................19 1 k --% 25364 •"p,,>� TOWN OF BARNSTABLE permit No.' ---------------------- a $ non Budding Inspector cash r --------------—------------- pasts �eVAR OCCUPANCY PERMIT Bond r Issued to CUo.P, dge H©mu 1�n ddress— Wiring Inspector /L.+��, .-�- Inspection date Plumbing Inspector/ry Inspection date Gas Inspector O � Inspection date rJJcj,7,P p,, Engineering Department Inspection date IC r,871 Board of Health ���'L- � �. - fInspection date / THIS PERMIT WILLINO;T 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. 13 Building Inspector i i f � 1 t 1' p • , to' i. 21 �� gyp • f� s �� � i f3�. Ste• � , GCECiY CG7'�F Y 7:A�b'?7- 7",t�+E + EJlLZ7�•c/4 .�s.hsSGY�/�/ O.V 3°'f"//� .0'4�7.v f S .G Q�'�i 7"L�i3 O..✓ TidE ,r- By_ Z0!mac/ � IAJ )e " 1#gsessor's map and lot number V OF THE t0 . Pe number ..... ............. ...............}.....,. .. .:'......Sewage P �.. COM. li sl 14 q�°" e3 Z BAEB9T�LE, i Housenumber ....................... .................:........................... �� FKTAL COS '�O M639• •� ;• vwvmc �k RA �� � RFD MAY TOWN OF BARD '" TABLE B,UILDIHG INSPECTOR 01, APPLICATION FOR PERMIT T C..fyf1..�T. �`C.. ...'"t�flf��h /C...����! l�.`. �/�� ........... ..... - TYPE OF CONSTRUCTION ........1 © ...........1` C�s........................................:....:.......... ................................. �' .. .z.............19..?� , t TO THE INSPECTOR OF BUILDINGS: The undersigg e'd hereby 9ppliq .for a permit according to he f llloowingli formation: Location ...!�`' ...........................� UGd✓(�... ...: eF..U�.` .. !. ..:.�........ .f ........ ......... ...... ... 0 Proposed Use .... !.n-v./C..... �ar�. I l ....... ......�1 M.. a � .FireDistrictZonin9 District / �:.!.����lL e Address N . :...Name of Owner © . .C. 4" ........:.................. ( .�:5•...... � FD Name of Builder '^e W(� � � ........................Address .................................................................................... .............. ... .... . ............... Nameof Architect ..............................:.... ..............................Address .................................. :............................................... Sf ..........Foundation .......�!'i-!�`.. .. ............................U1 �"�... Number of Rooms :.........�:........ . .............................• . Exterior . ..�..................�lk'/.�... .. .....: ............... ....... .. . .Roofing ..... .. ..:... .. .....................•... { ee Floors1 Y ...... .. ...... .. ...�©.......................................:Interior . .�.......l.�..... I��C.`.C...................................... Heatingn 'I ' 1 ..!�..... .................. �17� � ��'t/ .........:..............Plumbing �P.. e f ' /� pp . .... I.�...,.�.. ...(.... .......... A roximate Cost .............:..Fireplace 0/4 1.�/K:IC1` �c Jm pP 1. Cc® Definitive Plan Approved. by Planning Board ___----------------------------19_______. Area / . Diagram of Lot and Building with Dimensions Fee . � . SUBJECT TO APPROVAL OF BOARD OF HEALTH �® )L)o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To n of B rnstable regarding the above construction. . Name ........... 4. .. .................................................. Construction u ervisor's Lice ..... .............. ;COOLIDGE HOMES ,4 25364 Permit for One Story r• V .......S.ingle Fam11y...DW21],•ing.............. Location Lot 36A, 64 Victoria•.•,5•treet Centerville .................. ................................ jet Owner Coolidge...Homes.....:.................. Type of Construction Frame ................................................ .......................... +� Plot Lot .......... u� - August' a, 83td .. 19Permit�Grane : f Date ofrinspection ................................." .19 r' Date C mplete W ........................1a y V &� i tA , - .X "'fr^.T• ,h ~,4/ ..' ��n � Sidi! - r m