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1051 PITCHER'S WAY
i csll - !6 f . op ' �o �. u. �TUME t Town of Barnstable *Permit# Fapires 6 months from issue date Regulatory Services Fee 35. F saxxsr�srs, r� amass Thomas F.Geiler,Director ArED Mpg(' Building Division w_.. 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 - RESIbENTIAL ONLY - `y Not Valid without Red X-Press Imprint Map/parcel Number Property.Address O sf V y 1 GH-�-bL S WR� 14 ieoe -'V S , MPP . t-, lL o t k[2'Residential Value of Work p O _'" mimum fee of$35.00 for work under$6000.00 Owner's Name&A dress Sara CI171bre10 g,qp,�p�y� ®® J As D LL Contractor's Name Telephone Number 410 University Avenue Home Improvement Contractor LicensWft*Wbbl1,°1090 Construction Supervisor's License#(if applicable) G--1 n ge n a gA ❑Workman's Compensation Insurance Check one: JAN 07 2015 ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF SARNSTABLE I have Worker's Compensation Insurance a Insurance Company Name Z�`�'' Sri^E R-C' Corkman's Comp.Policy# �CG .�o q 5 `�$ �. i�\ 1� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 1 ❑ Re-side - #of doors _ ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows I - 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 depwtment 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 j - required. SIGNATURE: . F 'aa�e�it fnrmc\FXPR F.CC rinr . The Commonwealth of Massachusetts j Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeObly Name(Business/Organizafionandivi ' ADT -Address:" 410 University Avenue Westwood, MA 0�, ' City/State/Zip: Phone#: IT `3 55- 51,1 g Are you an employer?Check the appropriate bog: - Type of project(required): 1.E-I am a employer with� 5 4• ❑ I am a general contractor and I 6. ❑New construction - employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet t ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'aomp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11. Plumbing repairs or additions myself. [No workers' comp. c.152, §1(4),and we have no 12. Roof repairs insurance required.]t employees. [No workers' 13 ® Other RL►a rwy-, comp. insurance required.] *Any applicant that checks box 41 must also U out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing.all.work and then lure outside contractors must submit a new affidavit indicating such. lContractors that check this box must-attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation`insrQ•ance for my employees. Below is the policy and job site information. Insurance Company Name: .I.ti ���`E& �t�11(=N:fCftJ Vt4g' Pg Policy#or Self-ins.Lic.#: �`�C° 5 C¢i�% 9% ��L- E irati a Job Site Address: l O City/State/Zip: &A(WffAt�E Attach a copy of the workers' compensation policy 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'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 ce rmder the p pen perjury that the information provided above is true and correct _ tar . Date: !a ►�! ' v Phone 4: Official use only. Do not write in this area,to be completed by city or town official Cify or Town: Permit/License# Issuing Authority(circle one): L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing,Inspector- 6.Other Contact Person: Phone#: DATE(MMODIYYYY) ACO'Lj' C�ERT'IFICA`TE OF LIABILITY INSURANCE Q9fD512D14 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 suclT endorsement(s). PRODUCER CONTACT M - NAME FAX Marsh USA Inc PHONE AIC 1560 Sawgrass Corporate Pkwy,Suite 300 C No Exth Sunrise,FL 33323 E-MAIL ADDRESS INSURERS AFFORDING COVERAGE NAIC# 048953-ADT-GAW-13-14 INSURER A: Zurich American Insurance Company 16535 INSURED ADT,LLC INSURER B:Ame can Zurich Insurance Company 40142 ADT Security Services INSURER C: 1501 Yarn&Rd. INSURER D: Bop Raton,FL 33431 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER;. ATL-003287232-03 REVISION NUMBER:0 THIS dS 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 ALI THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR POLICY EFF T POLICY EX? LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MWDD LIMITS A GENERAL UABIUTY GLO 5095899 02 10/01/2014 10/0112015 EACH OCCURRENCE s Z000,000 X COMMERCIAL GENERAL LIABILITY PREMISES DAMAGE Ea oazi D rice $ 1,000,000 CLAIMS-MADE M OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ Z09010D0 GENERAL AGGREGATE $ 4,000,00 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 X POLICY PRO LOC $ B AUTOMOBILE LIABILITY BAP 5095900 02 10/01/2014 1D/0112015 COMBINED SINGLE LIMrT 1,00D,000 a accident $ X ANY AUTO I. BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS. HIRED AUTOS NON-OWNED PReOPPE TT YDAMAGE $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ B WORKERS COMPENSATION WC 5N5897 02(AOS) 10/01/2014 10/01/2015 X wC sTATU- oTH- AND EMPLOYERS'UABIL1rYI TORY LIMITS ER 0D0,000 A YIN WC 5095898 02 W 10101/2D14 10/01015 Z ANY PROPRIETDR/PARTNERIDCECLlTIVE � � EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? � N/A 2,0D0,000 (Mandatory in NH) EL DISEASE-EA EMPLOYE $ If yes,describe under 2,OD0,000 DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMr $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,tf more space is required) CERTIFICATE HOLDER CANCELLATION f ADT LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:TOM LEE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 410 UNIVERSITY AVENUE ACCORDANCE WITH THE POLICY PROVISIONS.. WESTWOOD,MA 02090 AUTHOR®REPRESENTATIVE - of Marsh USA Inc. .-. Manashi Mukherjee ©1998-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 5, :l Iris I I , Will p AP 1S�TtiU' flnpj1l�P. \ \ t G th 'I� 'gN 'I ' _ � � ��,"rdlllh ��•4',�f 41\\w,' � rTh• •al�Vh �����' ' I I I' 'I , .c1 '!°I I}�', ' • , I II��'\, ,y9h y"rt'•1�, vi 1{1� M— , • t\ .{��I v'�j ����1111,: NN(11an17-�^' Ofd�C•rj�� \, •h \ IIGG1111 �'l� , \ I ! !'(r I ' �` '., '1, •�A �-.�' ,dtnSt� �iia!�PtP�'a�r•\• �\ I I _il k !I'' tn �"�'�'1�'l h , !�ii�,"Ad t'•'+�-7•,NiQUI' ' Ip' 1 I 'I " ro'fi n all'"F �I'_S'1ll✓ r h I�� , u A '�01,h'\,'� �' 'hFhllp yp \ r•��„Y.f'•!I ,. pl) I;' i � I 1 ' , .I� •p rl�$UI� r � � `d tl\ ll��Yh+in, �',t fr4��fHNd .r, af.�y�lln'ri'� ,J@�. I r\ II �r.1r!rl,nF�nnmWl ,,YT "w�71 �AWF.T MI r �Ir I' ' 1 1 fi 1 �'1�4T\ ((h � ,• w t�+J ,1,., �.! '�,',r'h a3\, 'I r 1 0'1 I I� • I 1 ' ' � �, r \r '}, `�' .� '• 1 �,,,�I ,,�"� •1 .,rr.,. Irdnh�'11 �,Ir. i1T ' ! I :� I • III , 1 , I I , Y �1 pp IKE Tp� * t * tARNSTABLE. * . 9� '& Town of Barnstable plED MA'S A . . Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.toWn.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section 0 b William E. Cimbrelo as P.O.A. as Owner of the subject property hereby authorize A OW to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) I 12-17-14 I Signature of Owner as P.O.A :for Sara Cimbrelo Date .L Print Name tel. (781) 974-3173 If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on;the reverse side. Q:IWPFTLESTORMSIbuilding permit forms\EXPRESSADe Revised 070110. )1/06/15 06: 19PM EST -> Jeri 5087906230 Pg 2/5 . DURABLE POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS That 1, SARA CIMBRELO, of 1051 Pitcher's Way, Hyannis, Massachusetts, County of Barnstable, Massachusetts, constitute and appoint my son, WILLIAM E. CIMBRELO, l Mad Brook Road, North Brookfield,Massachusetts, as my true and lawful attorney for mein my name, place and stead to act under the following provisions; 1. GENERAL POWERS: To exercise or perform any act, power, duty, right or obligation whatsoever .that I may have or may hereafter acquire relating to any person, matter, transaction or property, real` or personal, tangible or intangible, present, contingent or, expectant, now possessed or hereafter acquired by me, including but without limitation,-the specifically enumerated powers granted below. I further grant to my said attorney full power and authority to do everything necessary in exercising any of the powers herein granted as fully as I might or could do if personally present; 2. POWERS OF COLLECTION,PAYMENT AND ENFORCEMENT:' To demand, sue for, collect, compromise, recover and receive all debts, moneys; property interests, claims and demands-whatsoever, now due or that may hereafter be or become due to me, including the right to institute any legal or equitable action therefore;and to execute and deliver on my behalf and in my name, any and all endorsements, elections, releases, receipts, or discharges for the same; 31 BANKING POWERS: To make, execute, deliver and endorse notes, drafts; checks, certificates of deposits and orders for.the payment of money or other property from or to me in the order of my name; to make deposits or withdrawals on any accounts in banks or other financial institutions on my behalf; 4. POWERS TO ACQUIRE, Q RE, MANAGE, LEASE, SELL AND MORTGAGE: To make, execute and deliver'deeds, releases, conveyances, leases, subleases, mortgages, and contracts of every nature in relation to both real and personal property, including stocks, bonds, options, contracts of indemnity and insurance, on such terms and conditions as my attorney shall 4eeM prgpeT; � 11/06/15 06: 19PM EST -> Jen 5087906230 Pg 3/5 SPECT TO LIFE ENS R—k CE CO.TIt.ACTS: T o have the full a. ��-'th any policies of insurance on my life; or policies on`the life or lives of Others in which I may have an interest, including, but .not limited to, the right irrevocable assignments thereof, t to surrender, to borrow against,or convert any uchpol cues and to change the beneficiaries thereof, or to take any other action with respect Policies as my attorney may deem proper; to said 6. POWERS OVER SAFE DEPOSIT BOXES: To have access to all m` safe whether held in my name alone or jointly with others, - Y deposit boxes, 7. POWERS AS TO SECURITIES: To purchase, sell, transfer or otherwise with all forms of securities; to act as my proxy with power of substitutin to voteall Y Way stoc and other securities in my name in relation to any individual or corporate action; to purchase, accept or exercise rights to s - p e, g subsc ribe for securities relatin utilize or otherwise deal with accounts and securities,broke sthereto, on'my behalf, to create, 8. USE OF FUNDS FOR MY CARE: . In the event of m illness emergency, to incur a y , incapacity or other Pay and satisfy such expenses and ob ligations for m comfort, and care, and obligations of a y rt, benefit nature customarily .sto maril ' y incurred by me, as in his judgment he may consider necessary, desirable or consistent with my wishes; 9. POWER AS TO TAXES:. To prepare, execute and file Federal or State income tax returns and other real and personal property tax returns or statement and gift pa Cher compromise any or all such taxes or apply :for P a Y or Pp Y and collect any refunds due; to make any tax. elections on my behalf of, which ch I.am entitled to make,. . 10. POWER TO EMPLOY AGENTS: To employ, compensate and di my attorney deems appropriate to carry out the acts authorized or contemplated hereunder; 11. POWERS RELATING TO GOVERNMENT ENTITLLn'1ENTS: To d eal all State or, Federal agencies from whom I receive or am entitled to re Federal any and benefits of any description or amount in order to; (1) Prepare and file all documents governmental by such agencies; (2) Apply for any benefits to which I may, be e f fired arrlQ �, Y entitled; (3) Modify Fujts o TqmS Q f ,s}ta } e0tlerr�e �;` (�� �sseTt �►�' ;i . S pi f3' the termination of benefits; (5) Appeal or compromise any 'disputed' c � cam� t o termination thereof; p laim; �'d (6) Effect a )1/06/15 06: 19PM EST -> Jen 5087906230 Pg 4/5 End 12. POWER TO PLACE PRINCIPAL 1N HOSPITAL, NURSING HOME, OR OTHER FACILITY: In the event of my illness or incapacity, to place mein a hospital, nursing home, or any other facility and to enter into contracts or other agreements relating to such placement in any such facilities;.. 13. POWERS WITH RESPECT TO RETIREMENT PLANS: To establish, contribute to, cash in, and/or liquidate any so-called retirement plan for my benefit, including, but not limited to, Individual Retirement Accounts, Keogh Plans, and any other form of pension and employee benefit plans; to change beneficiaries of my account on any such plan, designating such beneficiary as my attorney determines to be consistent with my -wishes; to borrow against or withdraw from my plan accounts on such terms as my attorney determines to be consistent with my wishes; to select any form of payment option or to modify options I may have selected; to accept any benefits or lump sum,payments on my behalf and to "roll over" any such benefits on my behalf; to be appointed as "Representative.Payee" from any private pension or public benefit entitlement plan or program; 14. POWER TO CREATE AND TRANSFER ASSETS TO INTER VIVOS TRUST: To create, amend or terminate one or more trusts, partnerships, corporations, co- tenancies or any other form of ownership for the purpose of dealing with,any property or property interest of any nature that I may have or hereafter acquire, under such terms and with such provisions as my attorney-in-fact deems to be in my best interests and in the best inteests of my family; my attorney-in-fact may be a remAinderman, partner, shareholder or beneficiary of any entity connected with any transfer and the fact that my attorney-in-fact shall have any interest or capacity shall not affect the validity thereof nor,by itself,constitute a breach of the fiduciary.duty owed by my`attomey-in-fact hereunder; to transfer any or all property, tangible, intangible or real, in which I may have any interest, into a trust or trusts, whether created by me or by my attorney-in-fact in my behalf and whether or not such trusts were created before or after the execution of this durable power of attorney, and to transfer any .such properties to any other form of entity. or ownership, including any form of co- tenancy; 15. To give gifts such monies, real or personal property, both real and personal, either outright or }n �pi, o; fq� �}e 4ealt�, gducag9p n*ntip m�q �t pp01'l, 4f such p�l•�A s, as }ri Lhe 12, opinion of my attorney-in-fact, would be the donees 1 might choose, including my attorney- in-fact, having in mind the resources, both public and private, available for my care after G�� )1/06/15 06: 19PM EST -> Jen 5087906230 Pg 5/5 of _ DI-�_3I31L1T�' O'R INCOIMPETENCE: This power of attorney in the skid WILLIAM E. C DLBRELO shall not be affected by my subsequent disability or incapacity; 18. THIRD PARTY REL"LANCE:-ANY PARTY DEALING WITH MY SAID ATTORNEY HEREUNDER, MAY RELY ABSOLUTELY ON THE AUTHORITY GRANTED HEREIN AND NEED NOT LOOK TO THE APPLICATION OF ANY PROCEEDS NOR THE AUTHORITY OF MY SAID ATTORNEY AS TO ANY ACTION TAKEN UNDER THIS DOCUMENT. IN THIS REGARD; NO PERSON WHO MAY IN GOOD FAITH ACT IN RELIANCE UPON THE REPRESENTATIONS OF MY. ATTORNEY QK THE AUTHORITY GRANTED HEREUNDER SHALL INCUR ANY 'LIABILITY TO ME OR TO MY ESTATE AS A RESULT OF SAID ACT. I FURTHER DIRECT THAT MY ASSETS, WHEN SUBJECT TO THIS POWER OF ATTORNEY,NOT BE SUBJECT TO SUPERVISED ADMINISTRATION.. IN WITNESS WHEREOF,.I have executed this Durable,Power of Attorney this 20`h day of October,2008: --SARA C MBRELO COMMONWEALTH OF MASSACHUSETTS Barnstable,ss. October 20,ZOOS On this 20" day of October, 2008, before me, the undersigned notary public, personally appeared SARA CIMBRELO, and who proved to me through satisfactory evidence of identification, which is a `.current Massachusetts Driver's license, and who signed the preceding durable power of attorney before me, and who acknowledged that she signed it as her free and voluntarily act for its stated purpose. MICHAEL L.LAVENDER Norpry PUCIiG COMMONWEALTH OF W6VSACI4U6M6 Michael L. Lavender,Notary Public d,Commilon EIP1101/oDbmtor16.1001 My commission expires: 9/18/09 { r SMOKE'DE TEGTQR , t 1 S' RE)VIEWE , i DACE DING DEPT.'- i.. 6ARN5TABLE BU { Y - ' RE'DEPARTMENT - _�►1t _ ! - ! - ' r ...FI i I BOTH SIGNATURES ARE REQUIRED F®R , i } 41 i __ _ _1. __ _ _ _-- _____� ._ _ 1 " _ _ ' ✓� __ ` 1 C- , • � ` i { r r � � t a, •t I � s r r I n _ t , }--�---*— i (__.__I,—„' � !—�—.-+__ ��_ }_ _y i—_fir _. � i -------i_�..T - _.i. � - _ �- — •� — ---'— —� I k } S ! r L F t , , t : , r , -._.t_.___.____.- _'•-..-._._-�-._,._._--_--_---__-,_. _.:.._._' .- L__._i._-- - -. ..__-�. �_- - .__' - __..' _. _ .--ems_-.—..... t { d } 1 `. Y l� i S 4,i . A4 .. _ 7- - - 7-7 <. TOWN OF BARNSTABLE 19189 5/6/77 `` •°, � Permit No. ----------------------- t NA"IT"a a Building Inspector cash °" OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first:having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to C & F Builders Address Box EE Falmouth, MA 02541 lot 1122 1051 Pitcher's Way, Hyannis Wiring Inspector c.•'A/ J� ,ep"-.�'f Inspection date .�.,4;,,19 Plumbing Inspectorfi�� Inspection date u Gas Inspector Inspection date Engineering Department V114 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. <... ......... .. ... Building Inspector I ai• �. TOWN OF BARNSTABLE Permit No. ------------------------ 1 S...nAK . Building Inspector cash .E70• �o rr►. OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issuid to C F W.,1. d,-ro Address Sox EE 17;Omouth, I;A 0251,,2. lot 122 1.051 P t,chor-'ti ::^y, I•IyutLrl.o Wiring Inspector �= '� _-i 4 Inspection date Plumbing Inspector Inspection date r Gas Inspector Inspection date Engineering Department 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. ........................... �r.�........., 19....f .......................................................,•..-"'.:... : _............. ._........ ! 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TYPE OF CONSTRUCTION .........sS./ ler......1-714A.M.-Y.......�Q/"1........................................... - TO"THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according .to the following information: Location ..... 1 .k.� .. ... .AY.............Hy r .... ..:.............................................................. ProposedUse .........!7..0 A..V.-..........................................................:...................................................................................... /.Zoning District ........ ..........................................:.....Fire District ....... �7/�//1/. 5.,....../�.�5'�...................... Name of Owner ......................Address ...FAL.Afoz??7..J#026,4 0..... ,-AILS' Name of Builder 'pS?` .! P.. .. !Pa� �4",QG?�-�� Qddress .r�l............... !QCP.....s.?.n .�9N...�/4SQ Name of Architect .../4CD!Q ....h .a . .......................Address ...... '!���!� �1.�`'. -...+ ................... Number of Rooms .. r .......................................Foundation ...1F�V.dfao.....GAD'grrrveA.c. ............... Exierior ..........................14............................................� ...;Roofing .. �1.!7 ......J.................... ! '............................... Floors CrA .................................Interior ... .................. P Heating ... ' �•� .......................................Plumbing .................... ............................................................ r P / . Fireplace ............./Q.I'. •�t'...................................................Ap Definitive Plan App proximate Cost ...............y�.4 ................................. . roved by Planning Board _______________________________19________: Area ......... 4P....`. ... Diagram of Lot and Building with Dimensions Fee ............:................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH yo 0o 10 IN 1G x �° - - • �00 $cALC, No' WAY F hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , Name 4�,- ...... :......6�^� • Frost Cape Cod, Inc. 19189 one story ............. Permit for .................................... single family dwelling . ...........:..........I.......................................................... Location............P.i.tchers.. , .Way. . .. . ...... ....... .. . .. Hyaniiis . . .............................................................:................. ,Frost Cape Cod, Inc. Owner. ................................................................. V Type;of'Construction ..................frame;....................... ............................................................................... Plot ... ......................... Lot ............#22 .......... .......... May 6 77 Permit Granted .......... . :.... ...........'..........19 6/7- Date of Inspection . .............—,........19 .Date Completed I.Zi..../7 ...............19 -77 -,PERMIT REFUSED ................................................................. 19 ............................................................................... ltlrLl- 0 . ............................................................................... W414 11Me7lAl ............................................................................... A/a . ............ .......... Approved ................................................ 19 .................:............................................................. ..................... ......................................................... i � _. - � .,. ...�.-.. �. � - ..:may r.,+ � ,. � _ .. .. �..�.x�... � _ ...-.. C..�K�:.YJ4,. .`•,.��� _ .n.-, s4ssessor's map and lot number ....... ............................... . o� d Sewage Permit number ..:..............................:......................... / V "yofT"ETo�y . TOWN OF -BARNSTABLE • ti B9SH9TAML " O 6 9 DU:ILDI,NG INSPECTOR Om ` , c�}.I.'..'`'�.��? ',r��?...�ivr............................................ APPLICATION FOR�PERMIT TO .:.. {' TYPE OF CONSTRUCTION {� *�� �* ' �"' ! � `� ' ......... /. ..........'........I. . ..................................................................... ..TO THE INSPECTOR OF BUILDINGS:. t The undersigned hereby applies for a permit according to, the following information: Location .................................................... ................. >'. ........................................................................................................ ell Proposed Use & - ................................. ..7�............................................................... Zoning District `' ••••••••A��!f• .....A..Am.....:..................................................Fire District ...:.VY,�.......,... o � � Name of Owner a �Qrs<" "C�1A e' n I9 '"�/C Address .. � F+ *r v�'x�l .�.. . t-r t 4�lJ ri . .. Name of Builder ....:�•� it ....... .......... ....................F.. - ........ ` 1 Name of Architect C gPco.- A- ... ..�:.................... i ........ U..`.....�'r................f.. .Address ...........!`....!................�................... Number of Rooms � yr f o PC 0 -f ^ ............._.................... ........ ...Foundatio .. ......'.............................................................. Lr � ARL3 <. -`.',f .b lr`7 ld[ r �}° r Al%.- S 1. 1 Al!?A.�"' Exterior ....... .......................................................... .....Roofings....=��?�... .......... �•... Floors ....... Interior ... .�V by A�..�......... ' '. .r. . .............. :......................... Heating � .Plumbing ....................:................ 1 C ,`. IT ..................Approximate Cost ....... Fireplace ................................................................ ..... ............................................. � ,/ Definitive Plan Approved by Planning Board _______________________________19--------. Area {�.�.�!...,..•�� .r.. .. Diagram of Lot and Building with Dimensions Fee .........k- (v................. SUBJECT TO APPROVAL OF BOARD OF HEALTH C UO F 4 • a 52t' � 1 0 S A L c, • a � / r c I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .~r -- --------- u one a��r� 'No ---v�m�--JPemni/ for ------------ � singlefamily dwelling -----------'-------------^— _^ | /�«�\P1tcberp���� ' ' Location �!�-----.�. --' . s C� . ,^o"` Cape ' ~_.~. me Type of [b . - 000 ------'' '— ^' ' P_ ------. . . - ' ' - -- of Inspection_ ---- . . Date Completed = . ^ . ' --' ..........I.. . . .. ..... .. ......././.!A7..r........... � . - � . ---- ......................................... —~.--..—.. . ' / , .--...---^—................................................... . � � Approved .............................................. 19 ' ^ ��������������������,�''��,�` ---------------------^^^—'~^^ ���� `