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UPC 12543
HASTINGS, N1N
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Assessor's map and lot numb .✓.a..l.J.. .L.11..1J.... �� �/"1 �G � �� /
SEPTIC SYSTEM MUST BE
INSTALLED IN COMPLIANCE
Sewage Permit ntj Jrber ....... 7 ....... WITH ARTICLE 11 `PAT
'1 SANITARY CODE AND ` OWN
y�i?HEr��y r Xn TOWN OF BARN '�'RLE
"b q � BUILDING I INSPECTOR
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APPLICATION FOR PERMIT TO •/
TYPE OF CONSTkLICTION ....l . *4..°�.. ... ... ......`.......................................................................................
.........19. Y2,
The undersigned hereby applies for a permit according to the following information:
.� ASS
Location ........ cs7—
...............................4.�... il�... ......... ..�. ��Ylcrr.�!............
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ProposedUse ........... (!'� `<.!N ....................... ......................... ...........................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of OwnerW �tl V Zi� U l/rt% S sVNis
................ .................................................Address ...` .......... ......................../..:....... ....,V1,...
Name of Builder / CR ...�^' 11it !!.�!�.&'( ..Address .P.`.'i'f.'...&Fev.....`S/�.�''�C7,�f� t�........../ 1.
Nomeof Architect ..........:.........................................................Address .............................. ...................................................
Number of Rooms ................J.. ...............................................Foundation .......�.�v....�....f.........C....u..N....c..H....�...7.A..........................
Exterior ... .��!!. '�,$ .. Wrc✓... r^!.5......Roofing S {
Floors d445/ yl�&X - ,Interior S��a'(P�d��
. .Heating 1/v / ..../.¢/h/(s�-.�..............................Plumbing .........: .........................% ......F.l... ...s1�...:....
Fireplace ...... ..................................................Approximate Cost :,r..�C.A4 -
.................. ................ .................................
Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ..... �.1 �. ...: ..................
Diagram of Lot and Building with Dimensions Fee � / �"s
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......... .......................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree_to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
•• construction.
Name ...Al- .... . ......... . .... ......... .................
,
Souza, Edward
Plot
PERMIT REFUSED
19
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