HomeMy WebLinkAbout0059 SCHOOL STREET (4) s�7 �'G,� � u�2
�- - J _-
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map / Parcel LN QO-F. Permit# h ��
Health Division �'I 701"Y N '''F SARNS TABLE Date Issued �f-d-"D3
Conservation Division �3 ��' " ' AMR 3 j PH 2: 3 ) Application Fee
Tax Collector �5( CJ k N L —3�3�0,_3 Permit Fee .41
�0 i DD
Treasurer_
Planning Dept. "
Date Definitive Plan Approved by Planning Board {
Historic-OKH Preservation/Hyannis
Project Street Address _.)C I ACLTTa >A
Village
Owner A Address
Telephone 0
Permit Request
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation ACXO 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: ❑Yes ❑No
Basement Type: ❑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
r 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:
Zoning Board of Appeals Authorization ❑ Appeal,# Recorded❑
Commercial O Yes - ❑No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone NumberO� �a Ic1
l
Address License# 0;)CD ' ' _
w„ Home Improvement Contractor# 1 VI 9 '_
cn
Worker's Compensation# C 00 9 40 1?DD
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Cft
SIGNATURE DATE �-7 (> ��-3
r
FOR OFFICIAL USE ONLY
PER-MIT NO.
DATE ISSUED _
_ A
MAP/PARCEL NO.
ADDRESS VILLAGE .
OWNER `
DATE OF INSPECTION:
FOUNDATION
FRAME `
INSULATION �{
FIREPLACE
ELECTRICAL: ROUGH FINAL '
PLUMBING: ROUGH FINAL, --
GAS: ROUGH FINAL
a
FINAL BUILDING — -.
DATE CLOSED OUT
c, ASSOCIATION PLAN�NO.
i !y
r
,__ 77se Commonwealth of Massachusetts
-y Department of Industrial Accidents `
- _ O177cr cfM7VSZf OV=
•i I 600 Washington Street
Boston,Mast 02111
. Workers com g-rut2t! n T....,m„cg Atfldavif n
lom
tip:
one 1t
❑ I am a «P�8�wo>��� � . •
I am a sole 'c=and have;ne o= is=r
❑ I a=¢as ezagioyerpro5T �Qy�
ata this ob.
Wor3ras for
t�
.... n, -�•firrx:vti. S.M,M}:+:}...-ti"S..x••'!f!47!:w:.::.•;vv;}}!:}xMx\yMp{�>btl•100D%�' n3:'yvf>y/,,,•rQ.; ���•\^ •44}�u n:.+i�i•}n'��M, •r{:?Sr
.. .,, .r}:•\ ,r. .-.,r':.y^;`2 .. ...... ••:.:..•:.}x4:••:s?�.°'.,rye:?nY:xxk:�'Qju}:•::::.:�.....;,e'p..T.::��e.�..',��,t,�. ::•?`"; .3: ?a\\+rHb\:'.-.�'A:.x..•.};;.).?'�.?..b .'i:+:.
ro:\!c;4a:'}:}+d'•.";.;{.<Y.a r,,.� ;...4�•'. •{:lr4 y. ,�}i}4vti,v •:f,.:•ii+::.'••:<:.:.'• xdw.x••.nh.,.;}..,. v .:?^')^,.},ivh\10.'^.. .Ox*:!•}.M - ..it ,\;:,.?•,..,, :• \ :x�:•,Y.,•.
:}�.... :..>+u;;nti:..}..;f•;.•.}5 .,., ro+T.:S,r.,-::r.•? !:}n:�:`'::;.,;.?,.};a\?:;;, •..;�r.,.�::}!atiga:}��.<:.:: .J'rx, >rY>�yf•:22it`•!v6?ri r.,x�:oa,:nt;Z�}. A`G°`:>'•}. ,..?t;::t!c;:",
3coir }.. ^,:.+'�`'•, rc r>xo;'r• .'`r�'t,.�h4:}1-1 like
k�.}rr . a:a::,"`y'-�??�,�:.,,.'..�.« :�KA'+�,}r»,y::.:....;r\ ,.^^i:;:•Fr }�
y*•n:+>}•3,q:f'.2'•L•s>^::\v'.�•. •. .. },•aaf}x+4u.!..•'y:'d}' `c,• f:. v•.v:,fy; wad•.•.�.y,YxE. �* S �t. xv •-•�!•;..`ore?c.c,.,J,',,, ?k: }J>' „,?,�sX'•�tdit:�:..}+;#'S`i::}.`,\\'<cf:r' 'S::Zic?r:.w.:..,
yl'DIII EQ�'11IIII1Cc�yo�E�le�£aX!#?t ;ti:'•;'" rx^v,.. wex4p,:z`a .;tera
^ ,•.•,:��fi;..,.^ r..; }•• .r:4> .,;•;;; x............
x.•::;,. :•4^•.•.,., 'v-:;!•.}x r.bka),•••f.\Yw+Fy�'.of ,,,.:x",},:!%��c•. ,,,., GL.,. t;>g� K�Ya fi ..!•!•-. ..: .fir:..To-,.,�",r.'xtefilt,.�:>r::.,?.....
-..,�.:'•;wY.;}..t4n Hf,,Cyr\, frff?m,!y;�`.•,.. 4.RS`�p,W`�,�^�.,,.X.
•':3..,... .f. ,..c. :S::C:•`�?%aY!K .t
rxiI.:}::'\iC{:.-.:ir.•,•..,f�'e+a ."oc�hC ',..: .'.�+{:?i;`•6ie, '� ew•l+W,G,• +^:ti .!!!q.t!h•• \:xr,\rw..fi?.. •C:e>.srx n]:•
i.i�jyrSo^x:; .a?r$. y { a }, y v. :,cZ b^,r.,•.
•:••`:.x,!•..x%:•id. ''rd.. {f'}ey". ;,}',:::,✓.a<g 'n"a::�1:..x•,'„ry.'r•"^'C:k`L\v,.}�i"~nv:.•.1TOy
}�vn�•J.•n•�.... .w, ft .. ..�,'�'�r,�P�,.:'F�PA:`��a•.en\:^.;\y{,v,^w\•,•,.:.,i.:{.}., ..
.J}rrp•:•'�.:'v4Z '. h`:Y.`'7.�:: �y �>!a a!pv�a> :Or'.•}:iv:
... '.Ji.•>r v• ; .;.:.. vfiY} 4+ y x'.;-...�C:^,T' .. ••' ±p}r%n)' FRO�i{�C1 \�J.,�Y `,`f��`RWhkv+K x;,0.,:.;:.•.
,.}.:;:f;�$:ov.{+vr�+�:nan,.,'"S}, .. �Mw a,#`•�:�t�;.\` +:�;k,. ...!li.. �:.!. �> :�t. .R,:�${a'§��`.`',`�:a}rk:)Tri?3v`2>•::
�t>: .}.W.4•,•x y'+:4x3•. �?%�•,'�' y� ^';`''`h3'^'FS.•>•;�a�+.Sf> •+fi;::G?'•••�>."?�'K�c;�i�{•�+.aeu,os,::.. „ "�.5 :."•.1+..- ts;::^'.�>.;;�;.;i
.k, .r.
r'
::�iG}}'}ta,^,+,.;,:�+,K4 fr G.by.3y;•:rSi� �e��,•'yy�•";!v'4.u}'.:^..`:i•.y;.,' C�a.a.a:4:of.:h,:{}•.•. �,aw..,\;...::�;�.» .� ..:•����`�12�ti";ra'C,.
•!,:•..!•:{.::�:rt :�k+..?+'�fv.", `e" 9.�^e'�?..�.:R•ra"c..3t{�':�"T'•.•,�OTy�.d:`r�'.$•`.�.nC�e:eg�0;•;u+:.•.u�K�a•�`.3.
.,:.v'-. .v. ,,.n:.n:. :n:.,.}i�.,4.�cCaWi}�0.�7'G4'�.- Q� ,v. }.};.•?i^.,.!;.�..
••4:•:;, .: r. ,• v?.. ; .. A.x?;•i''vPa }2,2}'if,G.'Z'"•^.AD•+ n \`.'kti' M1•d Y•:�}
..'e.c-Mw� '.FY.'' '' ^SFg'nv l^,•f^::"7.!i"::TS:V. :}:3.a.'.. .r:�:K''.bc• +�?.;,.fi .f
! a. rn al 3�w a f,; .),r x�., ft7 ^„ �d µcm a?A>Z.: ! .• ::
n�• 'a'^iZ;?'�•xy.h :{;::'::;f�;;ty:+�„;;.!:.;.;•7"•>y,�.Yv ;.`f. �,M., •
.,4�..; .x�;i:�?'• ',:y .•}+a�'r" -' '•�'' �?a. .:7{4}.: ..:T.{r."? •,.r??:4.. .;tPr. •k .ic
I am a sde prep,EmeM III=•,or h=mwnr-r Ono tmd hm hired the wauadcxs listed below Who
- have • ; .. _... ._ . .�s�:�,:;..•,t:-:!... _ •
r.`.
•�i..�,`
theft�Ilowsag .^\....,,..: �.:<{ r „ �:ay
,•. :o-.•c^-{ + .•"'"�,'R'!.},;c:.yn.r,,�,..,.n „-,..••;;,�:;^;•.!.• s,}:•>aw! er..': r:f:}•..aaC£�r>r.`a••>• ..e S,. T f'?;::•rw'G..s ,<•'i•.'• :a?:'. r."`•';:' lr•:r
::g: G "t 4• :5 .> w:. +.•`xa:+• " `:. F '.xtv:;n.r,v#, .ati :.a'K. ayr' y r l:,.•{..}._
,r.::a �?x2a...}.r:. f:• :!•. ^n.r•�: n,S :+n. "�`" r x.�v?� :�
''.3 }•}f'f,'4,:y+T}}},'v^<r':"•4'.f-?£`•'v:,+.:�`^; :>?k''•�5 '`%5.•'`.' <£S:f�+v ixS:•.,•}:t;t}•.fF" x:.:a;> x!ggxf. .ti?>i:%a•,f' '!•'•M1X• a'1�•w•x,.f,,ri}n„vt. .yr,,+;\y, ac}b'pT.!.;.;.,
m:!w;�,,f„ ,,.:t.+.;:iv. r. .. .. t, +d...rA ,,,•. ;y.,r }>c>,:•`7!'•x!,..� ..• r�•`kx{W..+�{. �.:.m S ..ram•ta::4••.,.
-.+'^Pi::{:Y.C�vC�M.3}M.X{+\.• 3f}: �•Y{n. '�.v.4:C•.:r.}I�.. •r.. iv,.r:•rl:Y:{•:.w.. :.
wn
;•!•!"..++..'xt.Tc,:ai+.!»^�:c,^w.,:,:a.!w$,'o>�+?aS"i9�'2}a•'.?aR,s,�>\ww,'.'0.a?A? L!+!a*., ;a,!a••
. •..rv:. .a
.^ymk M.". v
E v a yMP
4ffa S w•.. �•.••:•:.,.:},.
.<..
Vi
,••:•:4'T•i+{v:.{•::n•v:01,11
;. v v-r, ..
• �•"g.,uxs:032v7; i2 ;?.\ •..•}`tt'p'• +"�. g
: - v.::f{.; 'Y�,�':. '",y.'
p
., �jjr` •, ay'.•,CAB11,
!x - :.v?: •.,x}..,.
T'SlfCtr'C�-:�. .
/g�n-I ,� ,.. r::;:: ... „'k:?::.;, % _y�,:�:,,x,.f;.,:r r:••ti..vp.ey.....•:: .:..`".... ,... X !�1.� ;vFM fi.•,•>'•,f•',.^;.
RORON
i'^��,f gar
. .. r4::2• :•' ` ••
k}sp•{ ":
li y.laiYS.S}4
.,r. f�bfAyixS•�.Ci}`a17.9'S'GfI�..K.~`lY�'3•.+i
:
•'�s x^�r w: ^d; .:fhe�r?ioYrx.'� q»
.:..2,fx"#?:?';. + :r.••. "� d'}{.rx«.,,,..,,,} ..,.•»,,,,,�,r• �6Z.XJr.>sM
f:'•``;.••?."4x••!:.>., ,� w)eaa3J'•. ;roc.. x. . o••:. ,.... w\k.'4,A a\.-•aS' ;m+�'�•,�lw'.$aw-Y�'t i
...,.•,,,..,:.::�,;r ,: `.: ,?r':.�o-Y•+,<•.};, tt tip`%`"if•?::a,•• .••yi ;;�'�+ >:x. x G' .,.".A•\a•:•. ryy`.k•M}n w. ti0T7:fQr.•f
ycf.E:.}.}�,.T:.f.1.G{•1.;•;a.:.;•;• ..v,. .:}• a Ca.•• Y.`.•.. ':i`: r,2t ^n�. :r. »..:. ...a.!.rT"j+!i•:•:r:•>n:•1.4:fir\•,,,t:.a..},t.; },.0 xox'-\:;�• f. frv`ti?µ ?`;`,,;n�`:.`•v:!4••: ?:: J:.....•-•,.T}yDO',.....Y.. ,•.•?,:', ••+``
i!.+. .. ,,...:R{.`.k{!ri •#•i•.:::..�4.}•:.:,,.-xC}! ... .. ..... ..::,:. .\y.2.%;'ai,.a'rc y,',..•'R'.✓ !, •'.C''";`tf}}r....».
. ¢LL?CSS?'• .. ...,;..:,:::...:.•r::4r.q•!:+ax•>ax+,;i.,}Y: }•::T}�.- ..y:,'.^•':Cv;?lq. • ;,?'•'y'n,Wi;'.iYtt••:'•:r,',;•,, a}y ^ •.;';;�•i::`g4:S! :'';"
..-• ^,';x,:..,v •:•?:h4.-y x? 3F::4yiYr :.r..,,y;•?r:;}:..,cn'<.-ri.;.:`.r.'.+:^gr :•T.,.,.x.. \,,,},2 Y'!+'•'r.!•:rlf 0:c\r.�s,:�'•7.{;..:a lr,.;Yv r,r, ;r .<qt :..;;2,,;yr,.,,.••.•:r,...
+y}:•WK+i.U+fn...\¢? S`C!Y Yit •fir;?..x:, nv.
:yr..,• .,. .?X•>:..::: a3'f.••:5•�T•::. t•.;r,:{:�}r}x,.;{:;•:;,.:...• .;.n..: '•.yg:f3;!!.},'.xw�,,Y3$c£y�,�.�a,°�C }w:a': .,,y,!!c. <'C:•rw,••r}g'{,�..::{� .r:.kySA>},}r,•:2:C� •v\:a'c�r,.y,+,�:.}•::::�;
.:....,...3>•.}Su"ir.•,;:: v.+! ..k ...}`•...L.•T.x"•r.: f!}• L2'�'rS'�'•R!2• w, �.n�.iby��++� a,. >1• \ :
,16':ax•}•fn•A .4 •. ria%s•�`,'�ff;t{}`,•.`';'rrKx;,..a. k,T:;�h}� i•� R7r':'Pp:ua+. ^raY•.•} :. arr ,vrx?J::4:yh..........
•. ..:•:,.;.$•}Y,',;.:�:}»:"t.•::,,;•..:.+.�.c!9k:.•..�o-''TF'r.7�?:c:?!•.'tx#H. ,{Sv:?�,,•:.a?•}>Mx•::::?,r'>........w??.3Sifn:?
w ,. we...:...{ ,,.••yam}h:>?�.�.>.y.,�!e: : ?c93 ::. ........ ...(Y�! 3 �\Ye O 2
r^v.G44'v�,i'.: •4•;.�v.!!•}};!+-,h!>X,.T.:-•: ,. a -,..}{:• ""'},al,�.r v •r,�.:.r.
• ,:..:r,:r:r.:.!'"•.•-1•^^�y..5'ia�r,••o}.•«.?}•:d•:.'':S? .,/0:.,:1.,.}, .y.!.},.:{a�.�: .ac{.�.. Z•.wR..•>,', +:%x.V)k:?•e+� ... Jry+. F, ,\w•;;.:{f,•,.,,.^.,w„aSxa»�x} Y+;u:::•':.:a
v.,. .•...!,•e...• ,,.., .Y�r}{;er.'a ,;y. iK�iaa���f° tty''
�£�,'�R;?•„ w�Y;xS>o3;.xvC;.�:nc>....Y!i??tii,•`k'A.3e
.9?��.!zJ,�;ecy>?:^.b>'�`T'+::m...;�r�r�. S{..•.:. ::. }ww�:axeea':\y'd�a(.�cc➢%e�a�:�7Spp0( 3�FAJ .
•xvr•^:�•.•:O-x:,v�.•.' ?r••,^wK fn:yr xv+,:w..,,;,.x••+,v!ax?,:•:is T3:•}!^ ...w•.I•..K
gaib:re m saenss ev+�s*t+as dta�th0i ota am up to SUSQM aadlor tmdsr8eetim2SAotMGLIS=ee,l�ea�itet�a� P�
that a
aoe T��� st weII as dtQ pmaltiea to tha form of a STOP WQSS OBDFS toad a�dS10tt.Q0•da7 a�m+�I •
mp7 of thL ttitemssd mat ba[orwt�ricd to flat t7IDee otIamtt=attam otiha DlAfar.�p .
I do hartby and pendda of padury thmt�e u °rn °+�PT°n Qb°vs is she Unaeorrrd
Date —C-3
Pii name V lit? T
at
Ofacw mt only 8a•nnt wrtta in thls u=to ba c=pkled by do or taws uldrw
city or tuM ❑U=xint Beard
ehscJciii�udt+teresPons°tatnimrsd ❑HeslthDep+r��
plm!t — ❑otbL r
eoaiad person: ' .
(�Crwa 9193 FIAI
I
. . . . . . • see • . ./. •.
•
• • •• - • • • • e -• • to • • •• • •r. •
I. •• .•
• •• go• •.• • r. •••.1.1 •• e• •.. ••�. -.•• a ee • .\•.el • • • e• I• •
1• • inI -8 • ff•
.r•. a e • •. •• • •.:L L • • • -.feu • et wa • •�•.••_• •• • .•1 .,at• •
• r • Y 1 • J• • : 1 • 1 1 1 . - 1 • •
1
• • • e1 • 1 I 1 • • 1 • • • • e • / J. • I I f••Ir I I 1 •
1 • t • • • • - f 1 - • 1 • 11 • - • • • 1 1 • r • '
6I111e1•1• • e •• 1 • Il f• 1•«: t•• 1•le • { ..•Itw •tt1• .It r•111• 1.1 •• •.1 • et •
••. • •.1• •
eee
•letl• • 1 e/ et •• a•• �••e• ••e wpa •1 eH
Mt.•••w •- •�wf • •�w11�• • • •Htl■
e•
eU ••r H e .••• • •• • roe• .•••u ••
Its a 1• • •1••••.I• t.•H w •H w. .1•• •/•1• el•01•w •1•_ le/ rw •••rrU •1 \\ •1 .••
1 fr11/•�• • •
• •••-•ft •/ 1•11 • w•w1\a f/ r•If••••1•✓.0•1• •1 11 It .•I• r••w _ .
e as•. • 1 1• • e ..uH•�• u a we uqku IYI a U.. e• -1• • r•••r/
• \ •�r•Iet1 •1 •
—••e �• • ••r. n •••I•.•w •na•�•• .•••,t •• •
�Sjjjjjj���j����jjj!/// j/��/�j�j�jjjjjj�j�jjj��������j/j�
• I r -' 1
.81• • uu�• .._.• • • • w• ••1�••\ e • • •
�� •. .e • ••enu • -
by
• ill • 1 u u �•/ u • i• • • w■ •i a•u e.
•f_ • uw-1
• , . ii . 1 •.•Q•N ••. 1NQ1.w •.
•••.Ie1 • Q • t7 • e.1 • .t••w••wH► e •.we e•r.•
_e • w•ee
w•-.•••N ••glee • ••1•• • •f ••••w .1•eye e• e• • • e•
1 R •• •• a ••:• • •1 - {
• ' •. ••••••1 •• .+ •••ie 1• r •1•eef•.1
• of ■• . •
1 . . ••• 1 / e • • •
. . . • • • 11 1 . • 1 . 1
�pIME Town of Barnstable
Regulatory Services
` a�KAM
Mnss. Thomas F.Geiler,Director Ul
i639. �`�� in Division
T Bid
Fo�� g
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.
r
Type of Work: 1 Estimated Cost U 0 00
Address of Work:
Owner's Name:
Date of Application: 3`�JC�—C
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent o the owner:
Date Colfactor Nam Registration No.
OR
Date Owner's Name
I
i
91te
oar o ui in,-q egu a ions
One Ashburton Place, F�m 1301
Boston, Ma 02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 12/11/1962
Number: CS 056192 -ExpL Tres-12/11/2004—� Restricted To: 1G
GUY L RUFO
10 OLD TOWN RD
HYANNIS, MA 02601
Tr.no: 7004
Keep top for receipt and change of address notification.
Board of Building Regulations and Standards
One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement-C pitractor Registration
! 4 Registration: 119952
j
< Type: Individual
Expiration: 09/24/2003-
GUY L. RUFO
GUY RUFO - -- - --
10 OLD TOWN RD. ------
HYANNIS, MA 02601 ,' :' - ---- - -----
Update Address and return card.Mark reason for change.
F-1 Address 11 Renewal F", Employment i-; Lost Card
AIM eomlm���
Department of Public Safety
One Ashburton Place, Rm 1301
Boston, Ma 02108-1618
License: HOISTING ENGINEER LICENSE Birthdate: 12/11/1962
Number:.HE 070937 Expires: 12/11/2002. Restricted To: 2B
GUY L RUFO
2 OLD TOWN RD
HYANNIS, MA 02601
Tr.no: 10141
Keep top for receipt and change of address notification.
°FIMHEr° Town of Barnstable
Regulatory Services
]BARNNSSTABLE,$" Thomas F.Geiler,Director
039.
.,A`e Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must Complete and Sign This Section If Using A
Builder
as Owner of the subject property
hereby authorize �� �/ /�a;t=-d to act on my behalf,
in all matters relative— to authorized bythis building permit application for(address of
job)
14-Clii!S4 9k 151tt, 5 lec-A
SljnTtLiie of Owne ate
Print ame
0
0 _
3
J N
3 ul o�c
�� Q 3
Ito
w
ce
me
w
0 W V.. OC
O W -c
W
00
ul Z
• � x
0
CP
oc
� � W
3 a
J W
zQ
v�
q � III
X09)laJ}I13 O 310d 1H9n 4 •sdow m slosAM elgolswog to umol EOOZAd woq poz41Blp eieM Scull Immd ',001=n 1 io el0x o la 'dow eql uo .1 ws peDiolue *1333 06—MNI l
spiopuol5 bmro)V doyy louo4oN leew al peddow eiaM uoyoleBen puo'AydwDodol'nulewluold ueymodro) spelgo lonsAyd of sdlywo4olei lonuo lueseidei lau op slyf to spiopuolS A3wm)d opq Iouo4oN ov QZ 0
a3M01 a 310d ALlllln o 0039 Aq sgdwBoloyd Ioueo 6961 woq paleidialul MOM u04oleBee puo Aydm6odol•Auo wo)gomeS•M puo'suo4oiol enq Sou em Ae41•seuopunoq Auedmd 3o l9ew 1ON Aow puo dow elox 00 L 1
sewol eql Aq sgdoiDoloyd loueo S661 woq peleidielul eieM(Semloel epow-Uow)S)l4ewluold :s3)snos viva suoplueseidu)IydwO Aluo eio seull le»od eql:31ON** u}o lueweBiolue uo sl dow slyl'ilUN* 1333 NI:3105 033NINd M
NIVaO MO1S ® H91S 0 1 1 N n S W 3 1 5 A S N 0 1 1 V W 11 O i N 1 1 H d v a O O al 0 S 1 B V 1 S N b V 8 i O N M 0 1
310d 9VIi &10 isod 0IL z
i,
31OHNVW ® 3AlVA 6 (1 �W,1
1NUCIAH r - _ I L
s3ld/A300
3an1)nals/9NIOling 0 L9
A)30/H)aod
100d 9NIWWIMS Q (/
Alof3NO1S LzE a,nW
A)Val OVOa lltla
11VM9NINIV13H T
3)N3i —XX-
11VM3NOIS coo _-
NOI1VA31310d5 6 b;; -- ---_ —X 65 #
6ZOA9N uo pesoq uo4one13 �— -
3NI1 anOlNO)100101 0; I
V
3N11 anO1N0)100i Z
L
a3GWnN 3snOH—am 0981#
a3ewnN 13)SVd
#dVW —011 dvw
**3Nn 13)HVd —�
llVal/HlVd - — — — —
H)lla 39VNina — —
1019 0311Vd —�
1o19NIANa — ���__ 6
AVM3Ala0 —�
anoa lala
s3lVM i0 3903 —•• •—
UPHSNVW � , �� �5 # LZ£ dnW
S33a1 sn0a3iIN0)30 3903 A A A A 1
Aa3SanN a0 OaVH)a0 L � D� \�
HSnbg 10 3903 --•-----
S33a1 Sn0n01)30 i0 3903N
AVMSIV33ssn0)i109
dowouoloeddo unso wAs olou: -" - - -- -------------"---
II. I q II 310N 31db n»d as ,10 N Ad W 5 3 N 17 A-LN J d 0 N d �0 N 0 1.Ld�0,-1
aN393� MUMS