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HomeMy WebLinkAbout0043 HIGH POPPLE ROAD NO._952 1/3 (7RR 0 0 0 0 Town of Barnstable T��°`.` o r3LF oF�HEro Regulatory-Services q'! "':`� 25 p J 3- 0 , Thomas F. C.eiler,Director Building Division w BABNSTABLE, -- y� 6 MASS. Tom Perry, Building Commissioner Div- ArE10) 200 Main Street, Hyannis, MA 02601 avtivw.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: — Permit#: 1 =r� -- HOME OCCUPATION REGISTRATION Dale: �laSl�j ' Nance: K G r�+�' l�b �Z 1' Phone ff:rS_0�r) Address: 43 tjt j k PC ,? fC.o. Village: �-� 3 cz r-^S7 S_ �—� e rw�l-,v� t' l{'I� 4 l.J� L�e cS Name of 1usiness: "hype of Business: Ine_s s Coarc'� INTENT: It is the intent of this section to allow the residents of the`hovvn of Barnstable to operatN a home occupation viitlnin single Family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discencible from outside the clvi,elling: there shall he no increase in noise or odor; no visual altL'Gltlora to the prencises which would suggest anything other than a residential use; no increase in lraflic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following Conditions: • The activity is carved on by(lie permanent resident of'a single fancily residential chvelling unit, located withiic that clwelling unit.. • Such use occupies no more than 400 squaue feet of-space. • There are no external alter-ations to the dwelling which are not customary ill residential buildings, find there is no outside evidence of such use. • No traffic will be generated in excess of norncal residential volunces. • The use does not-involve the production of ofleusive noise, vibration,smoke, dust or other particular matter, Odors, electrical disturbance, heat,glue, huncidity or other objectionable eflects, • There is mo storage or use of toxic or haLar-dOLIS nc�cterials, or thunnaable or explosive materials, in excess of norncal household quantities. • Any need For parking genemted by such use shall be met on the same lot c•orataiuiug the Customary Honre Occupation,auacl not nithin the required Front yard. • There is no exterior storage oi•display of materials or equipment. • There are no c•omrnercial vehicles related to the Customary Horne Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet iu length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Cusloncary Honre Occupation. • IF the.Custoncany Honae Occupation is listed or advertised as a business,the so'cel address shall nol be included. • No person shall be eniployed in the Custona;uy Horne Occupation vvho is awt a penrcarrent resident of the dwelling unit. I, the undersign// "� e��d, have read and agree mill the above restrictions for y hoe occupation I ann registering. Applieani: Wes`" bate: YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $40.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain .the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. DATE S' js- l Fill in please: APPLICANT'S YOUR NAME/CORPORATE NAME are,-, BUSINESS YOUR HOME ADDRESS: 1 r' QJQD .-S-0�-36`i TELEPHONE # Home Telephone Number 3 611-�brsr5� NAME OF NEW BUSINESS w-4,1 e e-SS OR EIN: Have.you been given approval from the building division? YES NO nn ADDRESS OF BUSINESS `13 NZ 1-eorgR 44 MAP/PARCEL NUMBER D5 (l OS When starting a new business there are several things you must do in order to be in compliance.with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO IjAnz R'S O IC MUST COMPLY WITH HOME OCCUPATION This individ al �inf m of ny ermit re iirement that pertain to this type of business. RULES AND REGULATIONS. FAILURE TO 5 nat *' COMPLY MAY RESULT IN FINES, OMMENT ,. '2 i 2. BOARD OF HEALTH This individual hasLbeen ed if the permit requirements that pertain to this type of business. Authorized Signature" COMMENTS: 3. CONSUMER AFFAIRS�IC�N ING�AUTHOIReTy)ingIThis individual has m e icns requirements that pertain to this type of business. Authorized Signature" COMMENTS: t 5. YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1' FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and 200 Main Street Offices at the Licensing counter. wf"`rl,K71F7s"" .� DATE: id_ i5- �,-� Z: �" .t j � s ` Fill in please: 7 s APPLICANTS YOUR NAME: . BUSINESS YOUR HOME ADDRESS: TELEPHONE # Home Telephone Number: — o� Z- t. NAME OF NEW BUSIN �-- l PE OF BUSINESS�_, 6 Ill IS THIS A HOME OCCUPATION? YES NO Have you been given approval from the bui ding division? YES NO ADDRESS OF BUSINESS , H 3 4 k' MAP/PARCEL NUMBER Pl oy O O When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has bgen infor d of any permit requirements that pertain to this type of business. Authori ed Signature** MUST COMPLY WITH HOME OCCUPATION COMMENTS: a RULES AND REGULATIONS. FAILURE TO eempiz-y MAY RESULT IN FINES. 2. BOARD OF HEALTH This individual h Veen infogned he permit irements that pertain to this type of business. A orized Signature COMMENTS: Ap Z I C) F-p0 i i 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature COMMENTS: Town of Barnstable ZHE Regulatory Services �F Tp� o Thomas F.Geiler,Director Building Division BAMSTABLE, v� MASS. $ Tom.Perry,Building Commissioner A1f1p�0 200 Main Street, Hyannis,MA 02601 m,ww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: boa-70('94(`�� Fee: -, Permit#: HOME OCCUPATION REGISTRATION Date/1 J �� Name: L -7 Z Phone#: 4 Ll !' — 44" 124W Address: ! Village: r f7 S -e q � Name ofBusiness:H te V t2�0 roe ! !� Type of Busines _ j �) '� <�_e5�4ap/Lot: /d o� INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors, electrical disturbance,heat, glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on,the same lot containing the Customary Heme Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, have read and agree with the above restrictions for my home occupation I am registering. T Applicant: Date: Homeoc.doc Rev.5/30/03 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Maps Parcel "i —Uys (( Permit# �a _ Health Division C 3 72- Date Issued D S Conservation Division 1 o OS �I.;.; 21 F,;Application Fee Tax Collector Permit Fee Treasurer �"— Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address k4 3 W4L i0ao62 eae Village b0Q_S+_ Le Owner ,rL�c�'JP�"� Ha Izrr%r,.,, Address Telephone Lf J U�t TC &�q�g-,,, c Permit Request -A `S _t eP� Square feet: 1 st floor: existin q _1 p oposed 2nd floor: existing proposed Total new Zoning District Vk>T ins St2 Flood Plain �U Groundwater Overlay Project Valuation C Construction Type � SO&-3y�- Lot Size 1 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family Cl Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) � � '�� 9"—Basement Unfinished Area(sq.ft) S Number of Baths: Full: existing a new (1� Half:existing new Number of Bedrooms: existing new 0 - Total Room Count(not including baths): existing new First Floor Room Count '17 Heat Type and Fuel: iWas ❑Oil ❑Electric ❑Other Central Air: ❑Yes iVNo Fireplaces: Existing ✓ New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size d Pools existing ❑new size O Barn:❑existing ❑new size Attached garage:kexisting ❑new size O Shedoexisting ❑new size y Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes (/No If yes, site plan review# Current Use if-%J— _ _ _ Proposed Use DD ,,(- -r ,, II BUILDER INFORMATION Name f`-U� t �7,N'�� Telephone Number �a ���� r i ' Address H3 i, U�n , 2� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 'SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. E DATE ISSUED - MAP/.PARCEL NO. ADDRESS .VILLAGE ' OWNER t DATE OF INSPECTION: FOUNDATION ���b ©/L -Sr-'O S� r2 FRAME INSULATION b FIREPLACE a f. ELECTRICAL: ROUGH FINAL f s PLUMBING: ROUGH FINAL r, 4° GAS: ROUGH FINAL FINAL BUILDING Ole- 5— (f DATE CLOSED OUT f ASSOCIATION PLAN NO. 1 v 1 The Commonwealth of Massachusetts Department of Industrial Accidents 600 YYashing ton Street r` Boston,Mass. 02111 workers' CoMIDensation Insurance Affidavit-General Businesses addrpess���,, //�� .• G city lN'tGt� Y�• "�, L� state Wl a ziv' O�6�yhane# ��-�`�Z `�J W2rk site location full address: L13 I am a sole proprietor and have no one Business Type: []Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office[]Sales(including Real Estate,Autos etc.) ❑I am an em loyer with etn 1 es full& art time . ❑Other ///%///��% 0/i/m,////%�/// �/r0/%%/%///� / / / //%///////%/%/. workers' compensation for my employees working on this job. I am an employer providing •::r Com env name: w bone# " .insurance.co:.: f_.•:/ . °._<:'_ /�.., j ////.l� LJ ed the independent contractors listed below who have the following workers' I am a sole proprietor and have hir compensation polices: cam an nemeo ... , hone#' :i-(•r.7 insiiranee co. //////// c6mb any 138IIle. hone#'- ` Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 sad/or. one years'imprisonment as well as cfvff penalties is the form of a STOP WORK ORDER and a fine of$100.00 a day against me, I nnderatand.tbat R copy of this statement may be forwarded to the Office of Investigations of the DlAfor coverage verification. I do hereby certij der the ns d nit' o perjury that the information provided above is true and correct C Date Signature `L Print name � �bT Z— -"— Phone# k, official we Only do not write in this area to be completed by city or town official al # ❑Building Department city or town, ❑Licensing Board ❑Selectmen's Office ❑check if immediate response is required [3$ealth Department V.; contact person: phone#; ❑Other (revered Sept 2003) Information and Instructions Massachusetts General Laws'chapter 152 section 25 requires all employers pp tope service workers'de compensation under for their contract employees. As quoted from the"law", an employee is defined as every p Y of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other Iegal 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,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 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,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. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, 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 insurarce 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-'lavl'or if you are required to obtain a workers' compensation policy,please call the D.epartrnent 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 pernit/license number which will lie used as a reference number. The affidavits.maybe returned to . the Department by r-iail or FAX unless other arrangements have been made. The Office of Investigations would like to thank ybu 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 UMn of Imsffg0ons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 �FVE ram, Town of Barnstable °-� Regulatory Services sasxsraHrr, Thomas F.Geiler,Director rsass. 4q,A 039. A�� Building Division QED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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. Type of Work: 5���, es ry o'"'' Estimated Cost ,/ r Address of Work: 4 Owner's Name-.- Date of.Application: JL v,-U- ^u 1 U i I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ERDwner 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 fora a as the agent of the owner: e e Registration No. n OR Date Owner's Name Q:fomis:homeaffrdav FS;Mm -sitElFstateSwIdin Co 0� •" ` en echo :Z3d "'w The Massachusetts State Building Code (780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental.CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall,seeks to utilize a special energy conservation exemption option for "sunroom" additions jo,an existing house (780 CMR, Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size,configuration, orientation,form of construction or percent glazing,but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar- gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructing/installing a"sunroom".It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential- energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.123.1,..requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and energy conservation. Signature of Actual Building Owner Date Print Name Address of Permitted Project Owner Address(if different than project location) Owner's telephone number oF. T Town of Barnstable . Regulatory Services Thomas F.Geiler�Director a�►xxsTesrs, � . NAM 0 3 p.0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma:us - - Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ' Please Print DATE: o JOB LOCATION: fit , number r_ strbet village "HOMEOWNER": 1 C U 6a"A name home phone# work phone# CURRENT MAIL NG ADDRESS: J O get,-- lee",c) 5t— �' �}�.2�e dY►A— OJd.66'r cityhown 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 resvonsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliant 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: Three-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 parrit 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 supetvisor." 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 Supervisor;,Section 2.1 S) 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 formlcertification for use in your comnnunity. Q:fomrs:bomeexempt I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l S Parcel Permit# Health Division7� o �? Date Issued az Conservation Division Fed. ✓ Tax Collector SEPTIC SYSTEM'! MUST BE Treasurer INSTALLED IN COMPLIANCE Planning Depi. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Village Owner i�,t�,y , /7S' G Z .� Address 3 Telephone Permit Request b G/??�� 7n/® . 11OI�� �6�7G%/f7GS Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost o? Zoning District Flood Plain Groundwater Overlay Construction Type Uidz5.2) Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family 2 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ElU Yes No On Old King's Highway: ❑Yes ®'I J�o Basement Type: 2"Full ❑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: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:lH existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes I(No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name -54,4 ADD&-Al Telephone Number _.TDB ,7-2—�f Address /D 2D License# L-, )*� lwa2 /;Z?ZA 42 6',3, Home Improvement Contractor# /Z.6 70/ Worker's Compensation# s'�7X 9 9115 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE , ,Q—GfsTL117 DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED t % MAP/PARCEL NO. ► , ADDRESS - VILLAGE { OWNER ! i DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE , ELECTRICAL: ROUGH z FINAL ' PLUMBING: ROUGH FINAL = GAS: 'ROUGH j ` _ FINAL FINAL BUILDING _ � m n 4 � C , ' DATE CLOSED OUT "I m ASSOCIATION PLAN NO.;« cj `•� �� M , I ... , , I -�T-.ki--.,I.-...�-..,.-"I,�*.,;..­L"�,-"".-,�'-�,,,I­,.:%.:�,.�..mI.:..,-.:.:���a��,..._�.:",­,'-....-.....,--.­.*--.--'*.,�,.�-:..'..--�,-.1�-­.iI..:..:'*.-,-.;�,&&.:.'..---::.­..,.:��.­:'::-.*..4.,...i,.....-.-.�,.,�..�-,.�".............--..i...--.r-.-_,.I..:._*-..-:--"�-.....-..,�.--.-�-.*%::-`.............-...-i.:....:".,,��......-.-.:_­�.�,.P..­:,.......,..".l�..........................,.�'..,,.*'..",-i.---:.-.�.-�.:",_�-.-.---,�-1....,--.,-.!.,.*;"-­. .....�._-...-.­...--.,-­,0,.---,�,�.................................::..;;:,---_...'L..,..-.--�,. ,..­.:*',:.,.­W­.:.:-.:;.�,..i_..:�.:_....:.w.,.-.'...-.�.,:....-�%.:...:......'-��;-­��.:.:.-.:.­.:A..;-.;..:*­�..,*:----.­.�:...:...1...�.C.:',..I:----'....­...�.:,,—�..,..�..!.-.:.�...:_�......:._.....-.,.�..`-.1.;:,�...-....-..�.::.:..._..:'-,..�*'-.........:I::"-..�--.....:1:.-:�:.-.a— ......i:....',.�,�.-..."I.:.-.pA..:.�.Y:.-.b....�......::'-w-..-:.p--:�-,..._S.,.1..:-,�-i....%....'..,.-.�,....*-1.�g...1...-.:�..--.�...:.o.-�.:I......-:-:.ffi-?,�...--.Y,.5--.-,L....�:.._......:i..'.—:...�-g--,...I.C.w.­� "-�...".':..'..',�.-..�".­-.,-......,.i.­.-:­..:.1.."�a'...I":.,`.-..-.:b.:.--...:.,:..'...."...,-.'..-.....­...d.'"...:.......:,.:-:--�.,..-."....,-�.M.3...,`..:.,..q:-..'.O.....--,.�A..",'.'.-.,::..�:.'-.­-...:'::..�:",...I..E..-::..,.:.:.-:...e'�.."...9.S-.....�ml'..:...b-.�-::.....--.1:..�.-...'_,..v.'..---�.,-..:...:.*.:­".'....,i.....t:-...'*­.....�::i.q'::...,:.I4...-�.,--�:*,'....:....�.t;..�.­..p-.....-.......:*:...C......,.",.-:..-:.�a,....-;.-..�"..h.�'........�.�.A�­.,O-....-.....'..---.':._.,1*,...t..I.-...'.,..,.:.I:" 11­ _- 11 l. . :.. , . .:....:.... .s_ :: ......:.,. , r _ . , ..... . ... : ... - g. t9 i. :.. ... ._... ;.: ::.,,. . . . 8 Sri N''''t :..... a-. . . . :. ,......,—:'..: ,:.. ....... - .. _ a.: .".:..,..::...., ... ,. 1 . pax .... .. .. .......... . ...... ... ,,... :. ... .: ..... .. .... ........ . .... .... .. .. .. _ .... .. .. .. .. 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The Town of Barnstable AMM 1 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. 3-rX Type of Work:e3 956y x,1tVj3Otys Estimated Cost 0Z-p— 5-0 Address of Work: y3 6 7Gds' ID . ' Owner's Name: LLZyy�,�.J Date of Application: I hereby certify that: Registration is not required for the following reason(s): 0 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. el Date c� Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts - _ Department of Industrial Accidents exce 0110YOS99affOIIS 600 Washington Street Boston,Mass. 02111 _ Workers' Com ensation Insurance Affidavit name:- imgen: t32 phone# city ❑ I am a homeowner peiforming all work myself: ❑ I am a sole rietor and have no one workingin ca acity %%////%%/%%%% %%//////�y////////%//////%%////%%///%///%%%%% ///%//// ////%%%///%/%/%%%%%////%/%%/%/d//%%%��%/////%%%//////%///////%��%%/%%/////////////%%%//%/�i I am an 1 ding workers'compensation for my employees worlang on this job. P m an nam ftatare ................... <oe .............. ::.:::.::. ........ :..... ci :o ;:.>:.>;' ;:;:.::.:::::......... ::..:. .............. .............. alicv.# :.:..::.:.:,:::..,......,::.::.:::.:.:::::.:.:.::::.:.:. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have thee followin workers' co ensation olices: P...................... :::::.:_::::.::.::.:::.:.::::.. :::::.::::....................................:........................,....,,,.:,x ..:............ 2.`8me >E2s? ''`a i ''"i�???? '?? i.. . i i.i ?? ?`'i:.i<;::?:;'i>:::: isii`>::isi:.......... :: is '' '``': ' com an n i`ii.....ti({i iiii:.::::.iiii:iiii :?ii'r ii ii i:ii:i;isii:t<i:}:i}i::i<iyi:::'v:jii;';:::......is<iii?Y<i:iiii Ji:i:ii{iiii:iii iii iiiiii ii iiii:v i?}:i:i}:iii:•iii:v>•iiiiiii:?^iiiTii::•iiii}ii:4iiiii ;Y.ir•wv•.;y:::}..:{.;;:.:•?v::: ?;....ii::n•::4:vv:i ... .. .........t....... j;:;.;: ?:>:ii:;:};:;:;.::;i:;:;:;i: �... is i.`?i:isi:?:i s is i i:i%>i i;i:;iyi;ii:iii::"i f;vxtititi' >ldtlTCS m.� :..,.:::::..:::::::::..........:::.::::::..::.:::.::::::. ... hone :::r:+:•i:•:r:::::::•::::?;•;::;?•;:::::::»:%;%::>:�>z«:>::;;:;i:;i:::is:;;:> :>:::;:>::>:>:i:�i::i ii:::'::.'i:is<.�;;:>��-is:>:<<-:>.::>:>:s:<_::::•;:•::._:•-::•::.:;•;::::::•::::::•.�:::...,:::.:;;::;::.:.................... ..............4..... ...........r.....,.......v.....v:.. ::: :.::.......... r.r....... : XX :.::.i:.:.............. .:::?......: ;;........................... s ``ddres aX. It :17 '' "ha 'iTi vviti•i:iiii X. :','•rii i:;::ii:':`i iii..... > ii\..+ .iT i?iii'i... x::n..:•..;:::...;;•isi:;v:•.^ii:4i'v`i:•iiiii:•iv.v:v:?w::iiii::ii:ii^i:;:}}::::::iii:?4}i.�i:::::::...:::::�:v:.•....v::: ................,..:•-n•:::w::::.v::::::::::•:::.ii' v: ?:•iiii:??•iii:?�:^i:??�i:C;�iii!!:!::iiiiv:.':::::::::::::::::Y'-iii::•iiii::_.,:;,................:............r.....::::._:::: Ol i i?ii:•:>.:iii?::::•::::.:•::: :: :..... a�araecis c Failure to aeeure coverage as required under Section 2SA of MGL 152 can Ind to the impositloa of criminal penalties of a Hue rap to 51,500.00 and/or oae years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Hue of$100.00 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 a paint penults of perju tat the i rmation provided above is trw•and correct Signature '� Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town. permit/license# ❑Buflding Department ❑Licentinng Board ❑checkif immediate response is required ❑select�en's Office _ ❑Health Department contact person: phone#; Other (�evi�ed 9195 PW i FAX NO. Jan. 27 19% 10:05AM P2 FROM kU„ c;Er�i iFiCATt OF. LIABILITY INSURANCE : _ DATE(M ' ,'`' ' 09/22/199999 %ODUCER (508)6S5-OS22 FAX (508ASS- 3 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION 885 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE :rl i n Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND.EXTEND OR 33 West Central Street ALTER THE COVERAGE AFFORDED 9Y THE POLICIES BELOW. �ti ck, MA 01760 COMPANIES AFFORDING COVERAGE COMPANY CNA Insurance Companies A In: -St. Paul Insurance COMPANY SIraED SNE Products, Inc. d/b/a g Four Seasons SunroomS MANY 600 Plain Street C Marshfield. MA 02050 COMPANY D )VERAGES :._ :.__. TMIS IS TO CERTIFY THAT THE=V jCiES OF INSURANCE LUSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NormTHSTANOING ANY REOU AFMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERT!F!CATE MAY 9G!SSUED CR MAY PERTAIN.THE INSURANCC_AFFORCED BY T a POLICIES 7ESCRIBEC HERE!.`I!S SUE.9CT TO ALL re-e.a ?'4S. EXCLUSIONS AND CONDITIONS CF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED eY PAID CLAIMS. POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS I TYPE OF INSURANCE GATE(IIDm 1 LATE tMMlDOhY) GENERAL AGGREGATE -'1 2,000,O00 i GENERAL LIAIULIry PRWUM_COMPIOP AGG = 2.000,0001 X COMME510AL GENERAL LIABILITY --- _ - CLAWS MADE X 0=';1 08/01/1999 08/01/2000 SON'-aaAovinJURv- -= 1,000,OOr.! 1080042480 EACH OCCURRENCE s 1,000,.3 CI OWNER'S 6 CONTRACTOR'S PRO- "-" • •-• FIRE DAMAGE(Any am fim) S —100,000- Eo EXP(w;;,one _ 10.0001 AUTOM001LE LIABILITY COMBWGD SMGLE LIMIT = ANY_JTC . . __.... sl.",vNF.0:.VTOS BODILY INJURY = (Per oe+son) SC::E';;L0_uTOS nIR i.:.ITQ) BODILY INJURY _ (Per acadmi tl\::•:::':Nt�AUTOS PROPERTY DAMAGE _ AUTO ONLY-!A ACCIDENT = GAP.AGE L:ABILI'Y - OTHER THAN AUTO ONLY: aN\•':ifv EACH ACCIDENT S AGGREGATE S EACH OCCURRENCE s 2.000.00Gi i . ;s• CORM TO BE ASSIGNED 08/01/1999 08/01/2000 AGGREGATE = 2.000.0001 s rHttt T+AN UMBRELLA FORM TORr UNUTS ER• WORKERS CCMPENSATION AND EMPLOYERTUABIUTY 08/13/1999 08/13/2000 ELEAc+�Ccd DE'N'_ = 100,000 $4 7X 994 S EL DISEASE-POLICY LIMIT = S00,000 TI,E?�OFRIEYOw X :NCI - PAR.::E:,$i SXF.CJTIVE EL DISEASE.EA EMPLOYEE S 100.000 OFF,;i RS ARE. EXCL OTHER RIPTION OF oPERATIONSILOCAroNSIVEHICLESISPECIAL ITEMS • Seasons Solar Products Corp. and Four Seasons Marketing Corp. are named as additional insured with Ire -0 the general liability. day notice of cancellation on Workers Comp. 10 day notice for non-pay on General Liab b Umbrella TIFICATE HOLDER CANCELLATION _ . ._. . .:....... .. ..: .---• ~ _ 3NOULD ANY OF THE ABOVE DESCRIBED P'oUaE4 BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 300 OAV$W4.r►@N NOTICC TO VM CE WW"TE HOLDER►ARMO TO TI1U LFPY. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUOA WH an LIABIUYV Four Seasons Harkazin9 Corp. OFMYKIND UPON THE COMPANY.ITS AGENTSORREPRESENTATIVES. SODS veterans Memorial Highway AUTHOAItEO REPRESENTATIVEs- Holbrook. NY 11711 Rosemary Fulham/57MS BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 052649 Birthdate: 1111 V1940 Esprres: 11/112000 Tr,no: 9331 Restricted to: 1G WALTER A SLABODEN _ 10 SALT RIVER RD (.�w•a.r" ' E FALMOUTH. MA 02534 Administrator �1�e ' anv�raftwe .a z Y Z AHOME IMPROVEMENT cUNTRAc'rORS REGISTRAI-ION I „ 3oard of BuildingReyutations and Standards One Ashhui-ton Place - Room 1301 Boston, Massachusetts 02108 I HOME IMPROVEMENI- C(.)NTRAcrOR � Reclistration 1.26701 Expiration 07/08/00 I•ype - PRIVATE CORPORATION 84.9 ....o...lu��G..�r6 HONE IMPROVEMENT CONTRACTOR Registration 126?01 SNF PROD(.)CTS-/FOUR SEASONS SUNROOMc TYPO - PRIVATE CORPORA1i0H -10SEEPH D . PLWW Sr, Expiration 07!08100 L4 600 I3I..AIrJ ,,i o MARSI-It=TEI_I? MA 020F_•0 SITE PRUDUCISlfOUR SEASONS SUN N JOSEPH D. RUSSO e1-WPLAIM ST AMINISMAMR HARSHF IELD MA 02010 m m D 3 r Ass gssors snap and lot number ....../..j� / �:/(�.. SEPTIC SYSTEM MUST .,O`TMEto� Sewage Permit number ..,,/,�'t.�d..�,c. ,.."�t_7l"_____�___.... , IIVSTe4LLED IN COMPLIANCE �WITH TITLE 5 3AW.STLU House number ENVIRAii{fll1FRlTAL CODE + rasa p0 t639. TON N REGuLATlQ-,'`.;_. �crara� TOWN 7OF ,BARNSTABLE BUILDING "INSPECTOR APPLICATION FOR_ PERMIT TO t, G.................�y1-�J�.f�:u.....�............ I�1..G.!1!t.&,Ad Z?..... TYPE OF CONSTRUCTION ........................II,I ... 1�'../..1.^Jc `!� rl (/J............................ 444 ................. 1'�lL... ...19..�77 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ..... f? ?. ..-�1....... d .{. Y11......zrJ.............. f�1Gl� fTkL.�c�...�k.�� .................. ProposedUse ............... ....... a ................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. t Name of Owner .c;1ni. '.►!�k6........c>-&...z-xb4..........Address � .. .T7�w...F.. Name of Builder'-14,00A.A.�� ������.. C�.Address .Z ?.....�^l q.�Q. �? ... .:... .. . ,Al1 4, s... Nameof Architect .......... �—...:.........................................Address .....................................:.............................................. Numberof Rooms ..............` ..............................:.......Foundation .............................................................................. Exterior ....................../v Roofing ........... ......................................................... Floors !"..� ......................................Interior ................................................................................... n Heating :...:..................:./lJ .............................Plumbing .............................................. X Fireplace ....................................................'.`.. ..................Approximate Cost 1.5.0... .... .......... ... .. .. Definitive Plan Approved by Planning Board __________ 19---_----- Area ...le, tL. c? Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH S�t✓ C���l �lT > FLA 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. Nam ............ ...........................o................ p3 0 ;� 0 o (�'BRION, JM4ES N,qo�..............2 54 9 4... Permit for ....Swi.M.MiRci...P.921 ....... .. .... . .......A.c c.e.s s.o.rY....to Dwelling................ . .. .... .. .... .. .... ...­15 43 P49 -effr Road Location ........ (3 Owner James......O.'.........Bri......on................................ ....... .. Type of Construction .Frame ............................... .. .. .............................................. ................................ Plot ............................ Lot ................................ ........... Permit ;Granted ... Sept. 1. . 19 83 .......................... Date of Inspection .:.................... ..............1-9 Date Completed ............ �- P...........19 S nr 1 C I 1114 L 10 p O p N J Il N O N C 0 d r d p O, p - Q 0 Q l9 "� 10 o a•a to Z N ° o, Q) o,90 _ RI 0 .re ,00'SZZ 7 d; ¢ O 9 a to N 4 0 ° °' 6 h � u Q' N J r �.13Z o fo a•-Gll w %'I N n .o 2I O 19OD. OO SNOISN3 W 1 v I In to ej 17 ° i9 O Z V - to H J_ZS•', N t7;a 1 ly W 1 1%-•1 -d 0 3 ltylS 3 i C- - 7 ypi l0. TOWN OF BARNSTABL. i BASHSTSDL$ o�9a�e� BUILDI,I1IG INSPECTOR �� APPLICATION FOR PERMIT TO ......../.. . /�. ............... .....:::.......... TYPE OF CONSTRUCTION ........................................................... ...................... .... ..... ............19-2— TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1. Location .................... /-146-�. . .. ..... ..!..... ,.h., ... ; ........................ Proposed Use ...�. . .......................................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .. ..... ..4��.. !7.t.1.1....���. .. ...Address 2,Af.?, .. ...A...0{......... Name of Builder. 4 ...1. .. ........... ...... . ..Address .,.`. 1� ...... � .=. i�.. ' '' / Name of Architect./?!'!'ll.. . .tv-1,14.4.tTYri,A .....Address ... d . ...... .!./ �............. Number of Rooms ................. ..............................................Foundation ......... :....... Exterior ..�L �, ... 1R1�,/.....................................Roofin Gt/J / Floors U.1/!.".. ......lnterior .. .... ............................................ . ``.......Plumbing .. Heating .................. s Fireplace ................../.............................................................Approximate Cost ...........C?�..�.U..�........... ......................... Definitive Plan Approved by Planning Board ______ S______19 2� j,000e. Diagram of Lot and Building with Dimensi s SUBJECT TO APPROVAL OF BOARD OF HEALTH I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam9,;� OV.eAdf'..0. �n- Glendon Developers, Inc. ' ,. r , fv�� ....1635�.. Permit for one story k ............. ` single family .dwelling I H1gh Location West Barnstable ......................................................... .................... r Glendon Developers, . Inc. Owner t ' frame • r Type of Construction -74 ............................................................. #5 F Plot ........... Lot t; r {{k Permit Granted ......`.'J-11M .:...........19 731= 411100- Date of Inspection ..,.... . . Date Completed ..........................19 K. P i ItEfUSED ; '7 ...................... ..........6..C-0...% . 19 ........................................................... ........ - ... {4 - ...........................................................................:... f- + ............................................................................... .. Approved . :,' � ° .e; ° e 19 , • �, ° ............... .. .... . . ..... � Is �z N po � �� 0••� n )A 4 Assessor's map and! lot number ...... � �. ...::,...V..ftf...... `� c THE c Sewage. Permit number .... � i HASa9TLU i Housenumber .......................................................:.......:......... rasa t6 q. ON J TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ?'L�J��'... T.......... l i�r� �t� t��J,v ,,, �='vL ..I./.... .. . .... TYPE OF CONSTRUCTION ............................. IU.'.6�..(`... . '.. ...................... ?r �.............. .................. ................: r 1,,? ��„?...19.:il's TO THE INSPECTOR OF BUILDINGS: The undersigned /hereby applies for a permit according Jo the following information: Il )I Location ........ .'G/...... w.t .!7, .......... Tom............ ................... Proposed Use 1 J l� �►!t !.l .l ........ �v�-:- .......... .. ................. p ... ..... . ZoningDistrict .......(.................................................................Fire District�./............................................................................. .,.J Name of Owner . A)W....'�.......v.�"? 1Z1,�t)...........Address Name of Builder'�'�bvt�E la 7 r .Address .Z`�..... r.r .�,.�.n.v ... �.... !A�fPAs4-,.t. Nameof Architect ................. .............................................Address .................................................................................... ter--- Number of Rooms ......Foundation ........... . Exlerior <. f. �v�..................................................Roofing .................................................................................... Floors Y......�.. ..................................:...Interior .................................................................................... .................. Heating ......................................... ..Ae Ai2 .........................Plumbing .................I.................................................................. Fireplace ................................................ !?4..................:Approximate Cost...... t'..... r ��/............ ........... Definitive Plan Approved by Planning Board ------------__—__________19____:__. Area .. ... ?.—......... � .. Diagram of Lot and Building with Dimensions Fee U5........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Af 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. a Name .........:..................................................:'.................... �� .. 0 k� O'BRION, JAMES A=105-5 No . 94..... Permit for ..§wimm.in.g...Pool Ac�.�.��.qry_..to Dwelling ............. ........................ ---Location he--49-t-t -Road. .......................... .................. ....................... Owner .....James OlBrion ............................................................ Type of Construction ........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ..,,,Se t......1.1................19 83 Date of Inspection .....................................19 Date Completed .......................................19 Tli •l •1 � ' �' �. i r�""_ �� l .. •.._.. _-. _-. -.... .-.- _.._" - .ram' ��,�_"�-r '�� 10 l o c' � 8.z 70 01 . 00 mbar In P/�Qt?Oscy AP 7- - ( :, sign 4 L_L 77RA I 10 No vy.n 7�2 L ly ` J F'�ERCOLA .7...e. ' Q \�. \ ► \ fvi A 'r' 2 w, vv,. I=> 3 8E1� 7 7 7 0 4 '5 P3, I. ➢�. 113. f 1� ----------- 'opTP14 _ 2X 12 •j I� �E ��J �•�Iput �I 1 IIII I .�i I 3 I '� rjR'�l lnl l� Grrrv,n�L. . 5 fngl I. '-_ sT-1 i. 9 � !i 1 rt�•� 3 g3 1-�2 I X G° ff �' � I ►. , 7 v 5: nNy �I 1 i Gout:Sic(+, 4 I 6, (lPNC-. S< 4 D w a g snq 1�E_L•,.J%..�•-1� c�snlG. T�I_2 _�-_I..L!_ N-��-.S.I_D.� �:_1...,=V_��.1_4�.!.. _.� `rtuI - CIUNc.. Qj'fDIAM C��D 1� N a y2C-F, a7 G I �I J ' .1.�jlO_fz.SG fA � /o,µ5R �•2 w 1, w tirTUf �'7"� _ ,lI G _ y IS"v.NY.I—jm�18 L�" O �4 t� lz e� \ 42-1 I -CIE. �I.ol-�14- M.M.1± 3 0 APPROVED BY: ' :� •: �,Y,SR�1.4 _._:.5:._..=111,. W�5 �•.+ - __—__—. J. SCALE: = I Q DRAWN By p�c y — S T(2 V G T V 2.� 2`X 12. 'S �4A:H-D4-A-kLN/— I DATE: lj` /8 �1�7 N. G • e�i n �� l nnis IV1A DRAWING NUMBER H a BARRYJONES HENRY ARTIST/DESIGNER f i 1 k O'' err �1 "` L_L 7-RA C G:: OF 7-iL...L '0 O GS' ' ' r NO w r '2Z,V�oLnrT��>=� i `y J ` SERV,CiT"10 /`I PIT ` '. - - - - - - --7`-> PE R C O L A I-I O N RATS 0 //j A 'r' 2 4, -7 V1/. W. l�E AE K ) /V � 1 ` 3 ,BCDFc3C)AAs <i&' ! OJc-P© - 3�0 J O0 3f» pj> x 0. SO sp. cr r-�n. ',MSO,F g N V E L.._L E L-L-- i ) �'A C/L/ T/ES i I I L O 7 _ Jf /G H p O le)�7'L F R O.,4 D /;r xi V i �. It�'La t 7�'J" j / Z ' � (-.E"A A/ U:A 51-i r-R e C,01?,s 7- -W 1 C- L- 1 A A,) W• F'>� K 1 ,� P, E N 11V G N.4 w'1 l LI ---- -- _— -, . L A Al ------- --I _ *-/a , c.. 13 7 v_ e� t?r ,. -Z S '_L �, ( 4 ,c'�.`' R Rya F Q,, APPR O V c=-L7 BY ! \ __-_. _^_!� -7' 7-0 C'A J U N �' 20, 1+�73 � l 2O