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HomeMy WebLinkAbout0065 WHITE MOSS DRIVE l� � �� . . �. �� ,. .. , . �� �� � - � .,, o o a �, . �� ,. n ,, r � � - �., ,. ,n �. �. �� � � � �, ,.. .� - ,. °, �� � a �� ,. .� i. R. �. � ry e� , ^ � � � � �� w � � �, .. � r+ o i � � � �� � .. .. i - � ,. � �, � _ � .M. u � n ' a - ,, ��. `n. � � � .. .,, �� �, '. � ,� r� ;, �.� a' .. �- �� �� •• +Y=' ^1�!"F f�' � a+�wr�Iw�F�+�c'�" �+�.��41R• - -�!1�1 ^�wer'r���'�' T �^ ..mac T.. �TiR,Y - - _ "!f'/"r <_ ?o ,oETHE7 Town of Barnstable *Permit# P '1- EYpire m f r issue dale ' Regulatory Services F 9�A e 9 p,� .u� �� 17Thomas F. Geiler,Director r � � 1 2010 OF e Building Division aRsT Tom Perry, CBO, Building Commissioner R 1r 200 Main Street,Hyannis,MA 02601 www.town.barns table.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �2 1 /�r) I Not Valid without Red X-Press Imprint Map/parcel Number 09 L O " � Property Address 42 !n t r 1 I 1 KResidential Value of Work 16,600. 00 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address-(-Qr r°�( PCn o�•t Y Contractor's Name V—J CC4'1.- (Do rvS�� 4'C T°G �1 Telephone Number S d a q,)? ) IS+f Home Improvement Contractor License#(if applicable) I&a?3,? Construction Supervisor's License#(if applicable) :9() U aWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance] Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows r *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: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc The Commonwealth of Alfassachusetts Department of Industrial Accidents l Lr Office of Investigations I' d00 Washington Street Boston, MA 02111 wivmniass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Applicant Information cc Please Print Le ibl Name (Business/Organization/Individual): il\(Pa 5 tv-1, l�Qi�/I.J C f Ic rU Address: U (,�i Wla City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1. am a employer with V 4. I am a general contractor and 1 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors listed on the attached sheet. 7, ❑ Remodeling 2.❑ I am a sole proprietor or partner- ship and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp.insurance.) required.) 5. 0 We are a corporation and its 10.❑ Electrical repairs or addition 3.❑ I am a homeowner doing all work officers have exercised their I LE] PlUrnbing repairs or addition myself. [No workers' comp. right of exemption per MGL 12.0 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§I 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. 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 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. f Insurance Company Name: tq" u �r r Policy# or Self=ins.Lic.#: (D PI`l w d' Expiration Date: l 9(R) Job Site Address: 105- (1 L I P' Mcsz City/State/Zip: lM,�15 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 fin 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 th DIA for insurance coverage verification. I do hereby cer ' under he p ins and penalties ofperjury that the information provided ove ' trite and correct Si atur Date: ( � tD Phone Official Ilse only. Do not write in this area, to be completer)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 S. Plumbing Inspector 6. Other Contact Person: Phone#: • 1 Y r 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 foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee 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, constriction 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 conunonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance 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-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members 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 permit/license 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 to any business or commercial venture (i.e. a dog license or permit to burn 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 Massachusetts " Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia i �HEroh Town of Barnstable do Regulatory Services ' BA "sT^BM Thomas F. Geiler,Director WUSE F1,3,►q�.-(►`�� Building Division J Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, ( Art` � ® , as Owner of the subject property � 1 hereby authorize P�r (� 1�.5�t �� ►o tN to act on my behalf, in all matters relative to work authorized by this building permit application for ltilaSs Lr ►--4, rM( lls (Address of Job) gnature of Nner EJate Z Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the- reverse side. Town of ]Barnstable • �f'lHF Tp� , Regulatory Services Thomas F. GeHer,Director BARNSTABLE, • _ Mass. 9� 1639' Building Division Torn Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: • village number street v g "HOMEOWNER": k wor hone#1 name home phone#{ p CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109A.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Thiee-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages_a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when.the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fomn/certification for use in your community. Q:\WPFILES\FORM S\homee,x empLDOC From:Eri:Barrett FaxID:OLDE CAPE COD INSURA Page 2 of 2 Date:6/14/2010 10:04 AAA Pag HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED Y THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN I HE ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. I MPORTANT: 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 and endorsement A statement n this certificate does not confer rights to the certificate holder in lieu of such endorsement. PRODUCER Old Cape Cad Insurance Agency Inc 296 Winter Street Hyannis, MA 2601 COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED Michael Meagher 97 Emerald Street Mdrstons Mills, MA 02W-0000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ao LTR TYPE or wauRmce FOLICYNUMBER POLIOYEFFEC"DATE POLICYEXFIRATION DATE A WORKERSCOMPENSATION D EMPLOYERS'L WBIL rTY LIMITS EPROPRETORI PARTNERS/EXECUTWE OFFICERS ARE: INCL 0 EXCL o 1 6619858 1 11/09/2009 1 11/09/2010 FATuTOKY Lim" OTMER Coverage Appllea to MA Opomflan Ona. CH ACCIDENT 100,00 ISEASE POLICY LIMIT S 500,00 ISEASE-EACH EMPLOYEE 100 00 DESCRIPTION OF OPERATIONSNEHICLEWSPECIAL ITEMS RE:THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR MICHAEL MEAGHER. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANYOF THE ABOVE DESCRIBED POL ICIES BE CANCELLED BEFORETHE BLDG DEPT' EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED INACCORDANCE 200 MAIN ST WIfTETHEPOLICYPROVISIONS. HYANNIS, MA 02601 AUTHORIZED REPRESENTATIVE ✓Iie'LJaYivnca�r��real�� o�✓�Gadauc�uc6e�JW(`. Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR I Registration: 162938 s Expiration: -4/27/2011 Tr# 283438 Type: DBA !' MEAGHER BROTHERS CONSTRUCTION i r MICHAEL MEAGHER.JR. '' 97 EMERALD LN ,,p., 1 MARSTONSMILL.MA 02648, Administrator i 6 09ZZOl :#Jl iawn.�innw ZIOZ/S/l l :u0'jendx3 8b9ZO VW 'SIIIiN SNOJ.SaVW 3NV1 dlV831N3 L6 ar 83HOV3W 13VHOIW -' 00 :01 Palaulsaa 09ZZOl So :asuaai-7 asua�ll JosinJadnS uoll:)na3su00 sl"IT( ►'IS hur. suurlrin;as uIhl!►l9.irr p.nuo8 �Iaic� .iyy►►d.l�r Iu.�tul.mrl,i0° - slL�sny.�r.s'r'lC "�.�" I i License or registration valid for individul use only before the expiration da e. 1f found return to: Board of Building Rations an tandards i One Ashburton F!We Rm 130 Boston,Ma.0,2 ®'g .— -.----N_-valid withou si_— _.----- TOWN'OF BARNSTABLE Permit No. :......31071„ BUILDING DEPARTMENT D°$;� I TOWN OFFICE BUILDING Cash °�tciuv►�� HYANNIS,MASS.02601 X..�,;:z Bond 11 CERTIFICATE OF USE AND OCCUPANCY Issued to GREENBRIER CORP. Address lot #34 65 White Moss Drive, Marstons Mills USE GROUP FIRE GRADING OCCUPANCY LOAD 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. SeptetLber 24 87 CliL ......................... 19................. .. ........................................ Budding Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT _ MAN TOWN OFFICE BUILDING rua �°� .a�9• �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM:' Building Department DATE: • a��/??, a .s An,,Occupancy Permit has been 4issued for the building authorized by Building Permit # ����� .._.. _......._.. _.... ........ ._._......„ .......__ ..._ __ issuedto ................................._...._.......... ..........._ Please release the performance bond. i • TOWN OF BARNSTABLE, MASSACHUSETTS•, I B U I L D IN G• PE R M IT ,may/ A=•031-004-006 DATE August 11 , 1987 PERMITlIF(?. •'I �- 1 APPLICANT Care enbr _ -o rlj_ % ADDRESS n r1C)X ail (I, Lu n i-,e ry i l l e- (NO.) _ (STREET) (CONTR'S LICENSE) NUMBER OF. PERMIT TO fl171 ICI T)WA) I 7 2'1 CY ( ) STORY Si Y)Cf I p t:Iml V )7XnlA� in CfDWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED E1 !� " CONING : i� •' AT (LOCATION)' Lot 434, 65 White mr)F's DrYvi-�, i4argfong Ault I Is b'fSTFiCT (NO.) (STREET) �: • "' J' 'SY' BETWEEN AND ' (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION '] ".P (TYPE) REMARKS: Sewage #87--232 . Bond , AREA OR PERMIT ' VOLUME 1076 sa.. ft:. ESTIMATED COST $ 45,000. 00 FEE $ . 1316-00 (CUBIC/SQUARE FEET) , OWNER Greenbrier Corp. . =' • BUILDING DEPT. 1 ADDRESS P- 0- Box 9iI0Ill CeTlt@I'V'I 11 W BY �. ! THIS PERMIT*CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF,'EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC,- PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM TgE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM, OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBFINAL INSPECTION SSE TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPEC TION�BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 /�o Ore d vex ml 3 HEA NG INS ECTION APPROVALS ENGINEERING DEPARTMENT 1 OTHER 2 (j O- OF $D Q0 BOARD WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE ' TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIR MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION. r "ip der. eM �t T • �YyF a„ 25, t i N. ,. v� �2 e•�. Z. .i 'l 1 f f, e�Ml�� IS wa ca .• � i�z.3 , � Yak� .,,,,�'������t. �" W `"" ' � • A .{'1J1T aL j X�. 2Ti • I CERTIFY THAT THE - � 5� FOUNAR�/O„� � G�Rfj6� FooTini - •,, Sri _ ur ��•y ` ,�. SHOWN ON THIS PLAN IS. 4p�<� "'v, K � LOCATED ON THE GROUND h�� P�u�=a�;���, '������ `►� AS INDICATED LEvv u N0:106;7r`;:yr, DATE' GIS E LAND' SttRVEy LEVY a ELDREDGE ASSOCIATES, tE[d' 'INC. % � ,,.OT G2�,,, ENGINEERS - LANDSCAPE ARCHITECTS �J01"3 °,�.3 2- .. {` * ' PLANNERS— LAND SURVEYORS Dft P Er-. 4 , .Inrnelwe.w.A>aw.r ,f �.� �•' :�,• 889 W MAIN STREET IY ;, 3HrvSr�s��,''ir�ca '' ;*• CENTERVI LLE, M.A. 02632 ., .. SCALE, �o ' T .,S I ;11 sr � l0 7t v� Ur l ��/ -b T i 3 t � 3 jig /82, 3l0 lk L cl�- m F z O/ 44 :I k LEGEND EXISTING SPOT ELEVATION 0 PROPOSED SPOT ELEVATION � H OF EXISTING, CONTOUR ---0--- MAssq PROPOSED CONTOUR 0 0` P A U L Of �Agsr NOTE., THE LOCATION OF ANY UNDERGROUND F A• rn ROSIN SEWERAGE,WELLS, OR OTHER UTILITIES SHOWN ON L E V Y THIS PLAN IS APPROXIMATE ONLY AS DETERMINED No,10050 X FROM RECORDS AND/OR VERBAL INFORMATION. /ST THE CONTRACTOR IS RESPONSIBLE FOR THE VERIFICATION OF THE EXISTING LOCATIONS IN THE FIELD. ISTERED y' r' N I 1 R ANQ {c EVY Ek ELDREDGE ASSOCIATES,INC. D PLOT P N ,. CLIENT 1 ENGINEERS— LANDSCAPE ARCHITECTS JOB' NO./03�_ LaT 3 —A/HiT� Ah a'. F u PLANNERS — LAND SURVEYORS DR.BY ;�;,M IN l 889 WEST MAIN STREET CHKD.Syt 'Po CENTERVILLE, NIA. 02G32 SI ET-1 017 $CAL.E; •/•,Z f -- DATE: - - - �D FT M/N• NOTE /F E/TNER ?"NE SEPTIC TANk OR LEACN/iVG P/T Alre MORE TNA/v /Z"BEL0.4v /O FT, M/N 40o1,9. GRADE,A Z4",0/AM E7-ZR C0NCR.E7--C- COYER �- ScyEouL�.tp S}lALL eE BRnUCaNT TO GRA h�E•�AN ,EXTRA P V.C. P/PE COYERSE I8 IN. P/TCN • J`�EAVy C/�ST /RO/Y CO{�ER Sf/ALL L3E USED e PFR FT !F'/IY Z>/?/VEN/A Y' 2% nl iN. CONCR - 7 *OE COVER CLEAN .5*AN-0 Q • _ 9 L1Qu/D LEVEL r�►^ - - - 2*LAYER P/PE i 1�_ GAL. ' • • • • • • •• r eo 0 o OF IB :v M/N.olTeN D/ST. 0 0 4 WA5HEO S70iYE %4"Pox SEPTIC TANfC • 4 • • • • • • • • • ,t° • + I BOX o • • B • • • • • + . n� • D:• off34 EPTH/• of + • •o WASHED STONE I /i� O �� s • + • • • • • • • • p ••y PRECA5 T SE,EPACrE' /��x/•O o Po P/7 OR 4WIVIV. INV40KT &LEVATIONS. ?/7 CAPP47N� �D' 'C�P© d — INYERT AT BUILDING 403, 13 FT. 6l=•T D/AM. L INLET SEPTIC 7 4NK I ¢� FT, L _, IB FT. PIAM- C SEE TABUL.�1T/Oitr� OUTLET SEPT/C TANK/D,3•o F7.' INLET OISTR/B!!T/ON BOX,��� SECTl4N CIA- 0 GRDuNo N!�►TEF� TABLE C/TLETD/STR/BtIT/ON BOX/oZ• 2-6 F7 /NLET.LEACHING /c"/T I�FT .S'E�fJAGE OlSPOSA d. SYSTEM -rA,6411- IT10,V LEACH/Na F'/T v/MENsION A 9 7 FT. DESIGN CK/TER/A SCALE : %s" a / - o p/17.E/YS/oN $ FT. i /Vl/MBER OF BEDROOMS 3 D/MENS/ON C�Fr. GARBAGE D/SPO S.4L�//�//r/✓o�✓ SOIL LOG Solt 7165T TOTAL E-'FrIMAr"ED FLOW .3i3D GA4.1DAV SO/L Te57- A/ SOIL 725S7702 NUMBER OF 44CACN/NTi p/TS l !^ELEY./07 d"EL4rY, DATE DF SOIL 7'EST (42 S/OE LEACHING PER P/T 15/ SQZ PT. / ��Ji RE'SULTS ivITNESSED dY T 1-wC-h 6-W 6oTTOMLFi+ICN/NG PER P/T Ll'?—so. FT. `3v'`�O �FRCOLAT/ON RA-rw r Iy//V�/INCN 7"0TA4. LEACH/NG AREA SQ, -FT. /'-40" CL-A`i PENCOL4 p/ON RA7,E jk2 NJ/N1INCH RESERl�ELEftCH/NGA�4EA�SQ. FT. � . P_ 2 J( kOFMq 9��=�` ssgo / PAUV yG A rn E v Y. LEVY & ELDREDGE ASSOCIATES. INC. IGo.10050 O 4 �� �1 -. EG. 889 WEST MAIN STREET CENTERVILLE,MASSACHUSETTS 0263 FSS�0 � NO GROUNP YY,47&R ENCOV 7.- CL/.E F{, .CI�/�/F� DiITF g ./3 Bj C:RO uND PV.47'',--.oP A7- E L.HV JOB No. 1Q3y SHEET:2 OF Z ! • f n�I�+Yrw•-^'•"'"'� - .s.r..r..�..!'raw.'v"rr _._ -a 3.�_�.-.�=•... v-—.-- .� Assessor's offioe (lst floor): 00 y- '`�9C SYSTEM MUST BE *1HE J. 0 /...... �o�..Assessor's map and .lot num er . ... .... � 1)( "��_�.LLE® 111i COMPLIANCE e�Q� �`�� Board of Health Ord floor): VITI'I TITLE 5 Sewage Permit number .... ................ �,. —MENTAL COD � � A 3�1� t BAUST0ALE. Engineering Department (3rd floor): 64 �o r a �y C p y� ae Ci (0,<��J- AI Y•� 9�'iCam' O i6}q 000 House number .......................................... ........................ 1 i°�teypVa` APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00•.2:00 P.M. only; TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............. i. 4 .......... .............. TYPE OF CONSTRUCTION ........................1 ol!::! I ......, /TM .................................................... 4 .....191 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: nformation: 0 Location .......4 ..3. ......t (•rj/,.(.6......../M � ...... Proposed Use .....: .......... Zoning District ....... DD.. ............................................,4�.� ..........Fire District•...... ...... � n Nome of Owner .:1 ./•- .!ti1.L?.K�l .....1.._..OLf..Address '... ..,& ... ,1C.. ���... AZ-/LII.jS... Name of Builder ....��� ...........................................Address .......�54►V.Ll .......................................:.................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms , 1 /� ....... .........................................................Foundation .... ,�.Cl�.�.......�..r.U..!4J....e 2,e. T�i........ Exterior ..... . ....Roofing .........1j.5F1/.7.0?.L ......Z ........................ Floors ... . ....I.,;,.. . . .. 6..1••.............................Interior .........:�F?.C.t✓�j�-�r�................................ 471 rieating � �..... >.. ......... c .............................Plumbing .........�� ... �yj ..................................... Fireplace .............46. .......................... ................................... ..Q . Approximate Cost............. . / ............................:. \ Definitive Plan Approved by Planning Board -----l__6-f __---!_/_t____19 Are .1...v..f��!. i../..../.:!. Diagram of Lot and Building with Dimensions Fe i,... .........SUBJECT TO APPROVAL OF BOARD OF HEALTH /c' ? fA /zt� 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 .. .... Construction Supervisor's License ....... 1. . . ..... ,-GREENBRIER CORP. No,..3!.Q.71... Permit for ..11 Story .............................. Sing.�f�..... Dwelling ........... ..... .............................. Location , Lot #34., 65 White Moss Drive' ...................... ......................................... Marstons Mills ............................................................................ Owner ....Greenbrier...Corp........................... .. .... .. .... .. .. .... .. .. . Type of,Constructionrame F ­ . ...........::.......................... ............ .................................................................. Plot ............... ............ Lot ................................ August ll , - 87 Permit Granted ........................................19 Date of Inspection ....................................19 Date Cm 7 I ted ...... .- 5. ....... .......19 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parc I ` ® ,r Permit# (Health Division + � j ; NW rDate Issued /Conservation Division ? l� 3 Fee 404? ,/fax Collec // � SEPTIC SYSTE11 MUST BE INSTALLED IN COMPLIANCE /Treasurer _ �'�Z'-1 WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND (f TOWN REGULATIONSDate Definitive Plan Approved by Planning Board Historic-OKHPreservation/Hyannis Project Street Address a Village > Owner L,: L"II—e—y1 a— Ply el-6 Address _ nQ S &0 Telephone o — 0 7 Permit Request l� Fo �aZ �� �i✓�� Square feet: 1st floor: existing proposed 2nd floor: existing proposed ® Total new Estimated Project Cost Y6�d Zoning District Flood Plain Groundwater Overlay Construction Type o 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 HNo Basement Type: b Full kf Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) © Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: & Gas ❑Oil ❑Electric ❑Other # Central Air: 0 Yes ❑No Fireplaces: Existing New 00 Existing wood/coal stove: ❑Yes (b/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 l7 No If yes,site plan review# Current Use Proposed Use x BUILDER INFORMATION 7 g Name 1e1� wi4Telephone Number � �+ / L / Address 51/>g ��6 n f i License# LS CkLI Y Il.7 Qi;4 Z? Home Improvement Contractor# Worker's Compensation# V C d;L— 3115 0a o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO' 4Pn&t q6 . A.�.n SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED , r' MAP/PARCEL NO. - �., ADDRESS VILLAGE OWNER f DATE OF INSPECTI , 1 k, FOUNDATION r / Tc ; FRAME ��1 INSULATION FIREPLACE ' 1 ELECTRICAL: ROUGH tin FINAL 'PLUMBING: ROUGH z-- }= FINAL �^ GAS: ROUGH = FINAL FINAL BUILDING �- m 0 .5 , i •.. I ' DATE CLOSED OUT !I ASSOCIATION PLAN NO.*:� . e rf own of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 ' Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre'=existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. =i w T e of Work: AJ,991-1-'/VY7 Estimated Cost Address of Work: 6 5— GC.Jh l k- /`��S' /mil _ 17)"S-k/ZS ///i/k /wner's Namer,Jr a e ��(,& /s Date of Application: J.,�:&q I hereby certify that: Registration is not required for the following reason(s): i Work excluded by law Job Under S1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. // d�N41 O / / C u< om Date Contractef Name Registration No. OR Date , Owner's Name q:forms:Affidav , �- _ - The Commonwealth of Massachusetts zj !'� Department of Industrial Accidents ii.{ •L N. . 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit IN 011111111MR11VAR " name: / — /Llouatio�n-: �S��t/1lZG/f e-' JV/7 phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity ME ❑ I am an employer providing workers' compensation for my employees working on this job. comnnny name: address: ::... .. city: phone#- insurance co. oiicy# ❑ I am a sole propria`t6r, genera!contractor. or ho eowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: com any name: r address: / :.;. . city (/ hone#- ..: 4` insornnce ce. company name- ......... address: city- phone M insurance co. ::: o icv# :;<;•;.;:.;:;: ::::::: ::;: %//%%/%/ Failure to secure coverage m requited under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains enalti rjury that the information provided above is true and ��correct 9 Signa Date Print name Phone# oMcial use only do not write in this area to be completed by city or town official city or town: permit/license# ]OBuilding Departmentensing Board❑check if immediate mponse is required ctmen's Officelth Departrnentcontact person: phone#; er (revum 9/95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any coati- 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 foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: trustee 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa: 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, 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 insurance requirements of this chapter have been presented to the contracting authority. F'.. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and ..supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns 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 permMicense number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Massachusetts Department of Industrial Accidents OInce of Investigations 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406, 409 or 375 • Tabla•1ia1b Fewer P&e PaelcaM for Oae and Two•Famdly Rmd=MW Budding Sewed with Form Fuel MAXIMUM N111"NUM _ Glaring Glaring Ceiling WAU Floor Baarawt Slabg Afm'(%) V valud Rry hw' Rrvahm" Wvand Wall FIB ===yy pro Rrvaluae Rriwud 3"1 to 6500 Readaf;De6eee Dam Q 1ZY. 0.40 3E 13 19 1 10 6 Normal R 12% M2 30 19 19 -10 6 Nom:al S I2•b 0.30 3E 13 19 10 6 ES AFUE T IS% 0.36 3E 13 2s WA WA Normai U 13% 0A6 3E 19 19 10 6 No mai V 15% 0.44 3E 13 25 WA WA IS AFVE W iS% 0.32 30 19 19 10 6 85 AFUE FAA 18% 0.32 3E 13 2i WA WA Norma! 12% 0.42 3E 19 2S WA WA Normal tE•iL 0.42 3E 13 19 10 6 90AFVE IV/. 1 030 30 .19 19 10 6 90 AFVE 1. ADDRESS OF PROPERTY: v 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3 3 3 --39✓ 3. SQUARE FOOTAGE OF ALL GLAZING. 7o,5 a 4. %GLAZING AREA(#3 DIVIDED BY#2): dX/) 6 S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a Footnotes to Table J5.11b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the grossii wall arm,acpressed as a percentage.Up to 1%of the total glazing area may be excluded from the Uwalue requirement. For example,3 ft=of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. The ceiling R values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness-over the exterior walls without compression, R 30 insulation may be substituted for R 38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. `Wall R values represent the sum of the wall cavity insulation plus insulating sheathing(if used). Do not in exterior siding,structural sheathing,and interior drywall.For example,an R-19-requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-flame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned aawispaces,basements, or garages).Floors over outside air must meet the ceiling requiremeam The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. The R-value requirements:am for unheated slabs.Add an additional R Z for heated slabs. •If the building utilizes electric resistance heating use compliance approach 3,4,or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a ROTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available,include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more area with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to the R value requirement for that component. Glazing or door components comply if the area weighted average U. value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 . t �T1e 4 Plo.,vnazuiea o�;l�aa�acll ude�Gt DEPARTMENT OF PUBLIC SAFETY a . CONSIRUCTIW SUPERVISOR LICENSE ` Nuaber__- == Expires: MICHpEI:==�QEtUGQt: �� 568 SANTUfiT_<R0- f COTUIT, MA 02635 E OMf IMPROVEMEN4 U TRACTOR Y.F Y.� z] 4 q r egtsGration' 0554.8 , KyUBA p. r: EzQir._ation: 7/i7/00 to , S1.F�.Y.0.vt vo' . f Y 9 I `AGE CRAFT BUILDING X REMO :SANT' OTUIt MA 02635 �1w ,5 3 I iOF 4j T lrlhCanc Fool- 6 r ' r•+7' r . 17 f t r J Rt of �a i ut'19Z :343 G t( R.IfY fc1�t ` r !i, qrour,J I' - f � Namon sL-,d C.*)"On•-i", to I e a� 1ir r'j_ 1 n� � , a t ..•+ ! 1. c% 4���G' 4,;ia 11rT]f'irl�et r �.�v SGI�s�Ck �,.�•.f:"-� ,!£-1'lt�i 'jG I 1 .:,stirgj r„ '�..,aws �1 ctv"stnx"tii7 , of is exerri7. f,'O,r, vtClaticin eff;'4V fr*,lt 7+ an 5r'ovr dbxk rn,!all!Yyll"lin a 1 Zo ne L3T a r£'�I lti4itta G {rA l) i ark Dry, ��t R•rS' :� iS ff� :y h 11Y "�s 6--S! K f. f S.. fV - ���.s.y 'f-L 1 •' ," u 11'x yx. r s 0cti a Ca' n r d i r.! 02,!r„r r t ;m.�I 7s re r„f...3.r n,.:;.. . .n ,,:�., .c; n+ .,, wrFtqu• �.. S`. [rr"drt*zxo,rK Pa> .x�.x..c +rte ^eH �a+ri r�:7u C �( �b � •v""w .�_, �.,t rt'�� 1.1!��14ArtdYfi Mt fx=Rr v+e.v4 ,-ti s.u � �—:�-f:3 n�.R•ai.. Y -ti �l.: ,c.� f a.!;- • �� -,cy�t;^.;*rj Assessor's offioe Ost 'floor): 7 1 E Assessor's map and lot num er ...... ....Aw. ... Board of Health (3rd floor): Sewage Permit number .... ......... ....................... 33AM39TABLE. WARR ,Engineering Department (3rd 'floor) e 11 03 Housenumber ..........................................w5......................... APPLICATIONS PROCESSED 8:30-9:30 A.M. and '1:00-2:00 P.M. only --tTOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONS FOR PERMIT TO .......... .......................r_�- ............. TYPE OF CONSTRUCTION .......... .. ............................ ...................... ..).................. .............................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ............M... OKZ::.�..... Location ....... ... 4...... M-t�. ...... . ..4S........... ....Proposed Use ................ ................................................................................................. ... . ........ Zoning District ........t .. ...................Fire District ...... .......M/6 �5 . ............ Name of Owner ...C e.....Ciao- Address ... ...12xf,.� 4C Name of Builder .... C...........................................Address ........15eltyl.q./r........................................................ Nameof Architect ..................................................................Address .................................................................................... In Number of Rooms Foundation....... •....................................................... ...7��a.f.D .. ..... ......... &Aj!�7 ...... (7Z.A Exterior ......(/,) ....Roofing .... .......................... Floors ...Ulk'. . ............................Interior ............................................ Heatin ........g .................................... . .....'.1. . .............................Plumbing ......... Fireplace ..... ...... ....,.Approximate Cost ............................... Definitive Plan Approved by Planning Board -------- 19 Area ............................................ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 3z k 24 C/-7�Y6 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 .................. ..... ........................ Construction Supervisor's License ....... GREENBRIER CORP. , A=031-004-00"6 03°l - oo � " • � � 7 _ No ..31.Q71.. Permit for ...112......S,tor.Y........... Si.n.gI.e...F.dm ly..Pwp.i.1.i ng.......... Location L.Qt....UA........6.5...Wh.�,t. .... .o .. Drive ................ ......................... Owner ....Gx�.�xlbr. e. ..C4rP....................... Type of Construction ...........Fr.amp.................. ..... Plot ........................... Lot ................................ Permit Granted August 11 , 19 87 Date of Inspection ....................................19 Date Completed :.....................................19 t 1 i 1 ) - � _...�- -- - -w.w.r_rr...w....f.•r.w...._......w...�_..wv-rw..rw ��� � F �; Air OAA p b t et f2 0 - 3673 Ail-,l � � f 1 N 2 � r1 � i , zo Ile 1�d _ 1