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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map U' Parcel Q Application �
Health Division ^ iZ014 Date Issued (4
Ar-
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _Preservation / Hyannis
Project Street Address 1 f 2 lv m ori4- Dr.
Village 44\0 nk-7IS
Owner �r Nj i1 Address l� zn�erlV
Telephone (77y) -5'73 29/
Permit Request --pQCK Mod o��ca� era1'Ia�J
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 2,000'c Construction Type
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: 0 Yes. ❑ No
t—
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
_
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.'-
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 Pount
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: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
CurrentUse Proposed-Use-
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ��J)qN�®001� Telephone Number
Address �Jr "Ar i LQi7P License #
PlIF-06d I ONO ®I7�7 Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE f�P,N a,l �, DATE
E
FOR OFFICIAL USE ONLY
S - APPLICATION# -
C J
' DATE ISSUED
4 MAP PARCEL NO.
t
ADDRESS VILLAGE
? OWNER
I
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
r
FIREPLACE
' ELECTRICAL: ROUGH FINAL
t
PLUMBING: ROUGH FINAL
,X•
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
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react mag
completed similar renovations.
• Clearly describe the work you wani
for potential contractors. When all cc
same design description, there is mot
bidding process.
• Contact a professional building inc
improvement process, including the
• Before You Hire a Contractor
Before You Hire a Contrac
Selecting a contractor is the most important
should always:
• Interview at least three contract
t • Check with the Office of Consum
sure that the contractor or subcontra
�P state.
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y .
To-xz'-of Barnstable
Regulatory 5eryiCes
• . . r ; sue : .,._. _ •
Thomas `. G-:Uer,Director .
tr o6 9, BuEding Division
Thomas Perry, CBD, Binding Commissioner
200 Main Strcct, Hyannis,IvfA 0260I `
. ' �q.Eown.barnstab]e.ma.tis .
Officcc 508-862-4038 Fax: S08-790-623C
PLAN RFVMW
OWner�r�uh . odYICr Map/Pamd: 307 0.`l3
ProjectAd.dress U2 ��N1o'T �ri✓� Builder- OLOvur
The following items were noted on reviewing:
%) 'r W— i S /Lro,- ��a�r S a f ' ra cruet C/
vs C- PO-5 fis G e 6 Po 5 5
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Reviewed by:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
" . www.massgov/dia
Workers' Compensation lnsurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name pusmess/Org=ation/individualY . ✓a r Gi�
Address: `�] 1 Gr)
City/State/Zip: I���' Phone.#: �' 73 ®2
Are you an employer?Check the appropriate box: Type of project(required):.
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part time).* have hired the sub-contractors 6. ❑New construction .
2.❑ I am a sole proprietor or partner- listed on the'attached sheet: 7. ❑Remodeling
ship and have no employees These sub-contractors have g• El Demolition
working for me in any capacity. employees and have workers'
o workers' co msurance
co insurance.$' 9. Building addition
5. Weaare a corporation and its 10.❑Electrical repairs or additions
3. • I am a homeowner doM* al work officers have exercised their
gl- 11.❑Plumbing repairs or additions
myself [No workers'comp, right of exemption per MGL . 12. Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees.[No workers' 13.C1 Other beck
comp.insurance required.]
Any applicant that checks box#1 must also fill out the section below.showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
#Contractors 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.,
'lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penalties of perjury that the information pro videdlabove is true and correct
Signature .
Phone#: C77y)573 - 0 2V
Official use only. Do not write in this.area,to be completed by city or town official
City or Town- Permit/License#
Issuing Authority(circle one): .
J.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact.Person: - Phone#:
;
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,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, §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 commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of comps ance 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-con6actor(s)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 fo any business or commercial venture
(i.e.a dog license or permit to bum 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:
e Cammmnwealth of massach=tts
DTartmemt of fndustdal Arci eats
Office of fnvestipt ns
600 Washinii Street
BOAGn, MA 02111
Tel. #61 7-727-49-00 ext 406 or 1-977 MASSAFE
Fax#617-727-7749
Revised 11-22-06
w.mass.govldia
I
Town of Barnstable
Regulatory Services
• r
swu MBLE, ► Thomas F.Geiler,Director
MASS.
9`bp i63� ,,••� Building Division
rFD MA'I i
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
lPlease Print
DATE:
JOB LOCATION: I I DU M-04- Dv n/7 Is
number street
"HOMEOWNER": girt190 > 3 02c�/ village
name home phone
/# work phone#
CURRENT MAILING ADDRESS:
M(�F�� /I�Q a17 7
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 109.1.1)
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
require ents.
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
StateBuilding 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 personas 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 caret amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
�ZHE r Town of Barnstable
Regulatory Services
9BAMg Thomas F.Geiler,Director
Ar i63q. A10
FDMa+ 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
Property Own r Must
Complete and Sig This Section
If Usin Builder
I, �I �0 1 , as Owner of the subject
l property
hereby authorize to act on my behalf,
in all matters relative to work autho ' ed by this building permit.
Address o Job)
**Pool fences/datrs are the res onsibility of the applicant. Pools
are not to be fillzed before fen a is installed and all final
inspections are d and accepted.
Signature of Own Signature of A licant
Print Name Print Name .
Date
Q:FORM&OWNERPERMISSIONPOOLS 6/2012
APPLICANT: DOYLE �} a TOWN 'w.HYANNIS
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FLOOD PANEL: `250001 -0006 D FLOOD ZONE: "C -DATE MAP,REVISED: 07/02/1992
I HEREBY CERTIFY THAT THIS MORTGAGE•INSPECTION PLAN HAS BEEN PREPARED FOR: DATE:- 04/14YO9 :rr SCALE: ,1 = 3Of
STEVEN J. PIZZUTI ..DEED .REF: 13328-198 PLAN. REF. " 49-133
THE LOCATION OF THE DWELLING SHOWN DOES NOT.FALL WITHIN fA SPECIAL.FLOOD HAZARD ZONE.. -
PER TAPED INSPECTION .THE DWELLING APPEARS-TO CONFORM TO THE LOCAL ZONING BYLAWS IN EFFECT THE STRUCTURES SHOWN ON'THIS MORTGAGE INSPECTION PLAN ARE LOCATED BY TAPE SURVEY
AT THE TIME.OF CONSTRUCTION WITH RESPECT TO HORIZONTAL DIMENSIONAL SETBACK REQUIREMENTS ONLY. NO INSTRUMENT SURVEY WAS'PERFORMED-AND-LOCATIONS SHOWN..ARE APPROXIMATE. _
OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER-MA GENERAL LAWS'CHAPTER 40A ' AN INSTRUMENT SURVEY IS NECESARY-FOR PRECISE DETERMINATIOk-OF:BUILDING LOCATIONS
SECTION 7. REFERENCE DEED�SUBJECT TO AND WITH THE BENEFlT,OF ALL RIGHTS,rRIGHTS OF WAY, AND ENCROACHMENTS, IF ANY EXIST, EITHER WAY ACROSS PROPERTY LINES. YANKEE,LANR,-
�2 k
EASEMENTS, RESERVATIONS AND RESTRICTIONS OF RECORD, IF ANY THERE SHALL,BE,AND INSOFAR " SURVEY COMPANY INC. SHALL NOT BE HELD LIABLE FOR DAMAGES'RESULTING-FROM. ANY USE
AS THE SAME ARE OF LEGAL FORCE.AND EFFECT. '- OF THIS PLAN FOR'PURPOSESOTHER THAN,MORTGAGE INSPECTION.
TELEPHONE: 508-428-0055 YANKEE -,LAND SURVEY COMPANY,- INC
40 Indusrtry',Roa( ,tMarstons -Mills;-.MA 02648
FAX: 508-420-5553 -
yankeesurvey@c'6mcastnet` wwW.yankeesu"rvey."comt 80240 SH
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Building Department
ComplainVInquiry Report "
Date: 1o2 Rec'd by: Assessoes No:
Complaint Name:
Location
Address:.
Originator Name• ✓��Uer h'�i� -
Street: / .������ ✓���i yw P -
Vttlage: /4i, r, State:
Telephone:WE - M'/')�� ci D l�33
Complaint 0 i e 6 /1 Q i /�
Description:
Inquiry
Description:
For Olticc Use Only
Inspector's �-- � � S
Action/Comments Date-- Inspector.
\4 TI ,-is T-4 CT_(6�
Follow up
Action ' cftJ 1Z
A
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Additional Info.Attached �rpo ,j L`` � LL W J 'lam � l v= �� �L
Copy Distribution: Mike-Deparmreat File
Yellow-Inspecmr
pink-Inspector Metum to Office:llanagrr)
iHE Town of Barnstabletn °�
p l
Regulatory Services
M Thomas F.Geiler,Director
BARNSTPABLE, Building Division
y ntnss.
1639• �0 Tom Perry,Building Commissioner
�TF pr a 200 Main Street,Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
June 20,2006
Mr. &Mrs. Todd Hebert
650 Old Strawberry Hill Road
Centerville,Ma 02632
Re: Violation of Chapter 240 Section 63 -Signs in Residential Areas
Map 273 Parcel 205,Hyannis—Zone RC-1
Dear Mr. &Mrs.Hebert:
This office recently received a complaint regarding an illegal sign posted in front of your
property located at the corner of Old Strawberry Hill Road and Phinney's Lane. I have spoken to
Robert Bastille(aka The Yard Guy) concerning this sign on numerous occasions. During our
last conversation he agreed to permanently remove the sign on or before Tuesday,June 13`h.
As it was determined that the offending sign remained past the agreed deadline, a removal order
was issued to Structures &Grounds on June 15''. This office was notified again this morning
that the sign was reposted in the same location,this time with an attached securing device to
prevent removal. Subsequently, Structures and Grounds was once again dispatched with
instructions to retrieve the sign..
I am writing to you because Mr. Bastille previously acknowledged a financial arrangement with
you in exchange for the privilege of posting his sign in front of your property. You should be
aware that the subject area has been definitively determined to be town property. If Mr.Bastille
continues to repost his sign at this location,we will be forced to issue you a citation of up to
$300.00 per day in accordance with the provisions under the Barnstable Zoning Code-Chapter
240 Section 123.
Please take immediate action to remedy this situation. You may contact me directly at 508-862-
4027 in order to discuss this matter. Your full cooperation is anticipated.
ncerely,
Robin C. Giangregorio
Zoning Enforcement Officer
J:\Complaint]nv Reports\Yazd Guy Dlegal Sign to Property Owner Hebert.doc
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r DIRTwORKS 508-240 5541 Furniture,Junk Removal, edyma @ Lic.#40613.508 287 22�I SHEA S I:ANDSCAPE � w '' Insured.Domenic 394-4496
t Sat.&Sun.Service TOOT Semi retired,licensed buildin € xs..• Yard Clean-ups, Full Lawn Stone Walls, Brick Steps and ,, may,
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Y pE_xpress.com contractor, 45 years expen d Care,Patios Great Rates: !� .1,
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MIKE'S DUMP RUNS Cape. John 508 759 3444 Low Pressure-Great Prices . Unique Outdoor Living . Impeccable Masonry. Steps, on wallpapering & panting � @
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CONTAI
ERVICE D REACH 918 1 S.readers every week / For Di.
FREE listing on www..barnstablepattiot.com / For Lin,
IRECTORTE-mail: sd@b.
Town of Barnstable
Approved Regulatory Services
,
pp g y S vices
Fee . �J - °`P Thomas F.Geiler,Director "
Building Division
Peter F.DiMatteo,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-8624038 Fax: 508-790-6230
/ Home Occupation Registration
Date: �,�
Name: �--
Phone#: 7 ��—�c�
Address: 11.2 Z)/^D,,J &I Village: ?VIAn.17 is*
Name of Business: rd �G4
Type of Business: 10;fE 4 Map/Lo t:(4>0 2— o 9,
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 P
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 Home 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.
Applicant: �Y : Date: O C
Homeoc.doc
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I
of Val', N
The Town of Barnstable
q'"RMASS.M
Department of Health Safety and Environmental Services
039. A`` Building Division
ED Mp'l
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
TOWN OF BARNSTABLE Perrnit:,5VQ°y
SOLID FUEL STOVE PERMIT Date:
Fee:
Owner: p�e,�f l�� Phone:_
Address: t ��in�i� �j. Village:
Map/Parcel: V Q 7 Q 7 Date:
Stove
A. New �e�
B. Type: ` ` Radiant/Circulating
C. Manufacturer: v lb Lab. No.
D. Model No.:—
Chimi1ey
. Ne 1 E-x� (If existing,please note date of last cleaning
B. Flue Size 6 " re(�,cl
VI
C. Are other appliances attached to Flue? N d
D. Pre-fab Type and Manufacturer MS'Q I �; (t'l e ct I Ye f�,s
E. Masonry: Lined/Unlined
Hearth
A. Materials: 4jqptoj4A
B. Sub Floor Construction:
Installer
Name:s f'�.� ,,, Cii;m4e,6e Sw e. Address:
Phone:
Location of Installation:
APPROVED BY:
Please make checks payable to the Town of Barnstable
*This constitutes an official stove permit after inspection,photographed, and approved by the
Building Inspector °
Stove.doc