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HomeMy WebLinkAbout0378 ELLIOTT ROAD r 9 fa k�7 6 0 . a i JJ 'i i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 BUILDING D �� -'� / ✓ �,J O Map Parcel Application # Health Division AUG 1 9 2016 Date Issued Conservation Division N IT, Application Fee Planning Dept. XE Permit Fee U5- Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address 37 t c J�� Village e-AC r,1v!it Owner Address Ste' L Telephone gi t-S I V - 5Y-G) Permit Request Call,-1,),r .6 Jj hr Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ` c,t� 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 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 ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER). Name Telephone Number Mike McCarthy Construction Address PO Box 52 License # Nest Dennis, MA 02670 Cell (508) 280-6964 Home Improvement Contractor# CSL-58633 HIC-169393 Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO blk . " SIGNATURE r` /` DATE FOR OFFICIAL USE ONLY APPLICATION # ' D4TE ISSUED a MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Z004 �-- 53q— 9Sp� X4JW rA=. m Rtcltxrd V Sc:ilt,LDirectoi e6gq Tom F*M3.iildiri,6.Cbminiisfouer ` IUU;hlaiu S(i�i t.4y inriis;'liA Q266.1 stitisiF•.fq�>n.b arn5tahlc_niaus Ofli(:G: 50g-`86240_8 t lyat .508-790 6210' PropE'.3'I C)-%ai:er .us-t Coral Icrc'axa�l 5 sra'I"lis.Seitz Qs1: f ;sxrA B� tcc z: . e 7r ,oeAl i"-� WL c.✓I� nS C1r�7�t=-r�T`�1�`'Sub]ecr_�] � y ltcr�l�r•2u>he?raze•��a.,.a:1. _ � to act`oi�ntr5r'�ebalf,,,: M Pil' amrs.rclal�vc io wo=k.authnz zedby'ffimis buldin7 persut app cft..'nlor: • 3 ? w , lLn _ o _ c611ervile :Pool fchccs and,ilsz zi s a tAe iesponr ib nf, h a pl�carii:`P'otls Are n. t:ta he-,M-1 e .Qr:u re icnrt iiis k-d,anc� f P>natzu�or0-,up r. -8 s1�&turn, - p"Ic uit Punt Nary dame — _r ,Piw;C ~ , Date' i Q:r-OF AS:OW'lNF.RPE"Y.Isst.OIe.Wi S t i I � Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement *tractor Registration: Registration: 169393 Type: Individual =-" Expiration: 6/16/2017 Tr# 264961 MICHAEL MCCARTHY ' -=--�- ,.t MICHAEL MCCARTHY ; Y.k P.O. BOX 52 �: I WEST DENNIS, MA 02670 1 Update Address and return card.Mark reason for change. SCA 1 t, 20M-05n1 [l Address n Renewal Employment ❑ Lost Card ,f� �e�payrunaa�aulealC�i o�C%�Cvaac�iareCts , �\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: UE,VRegistration: : �9393 Type: Office of Consumer Affairs and Business Regulation xpiratiotr_—AW2Q;a>7 Individual 10 Park Plaza-Suite 5170 �C Boston,MA 02116 MICHAEL MCCARtH y MICHAEL MCCARTOb W 6 RANGLEY LN. ` SOUTH DENNIS,MA 0A60' Undersecretary Not id with oft signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-058633 Construction Supervisor MICHAEL J MCCARTHY. 3 P.O.BOX 62 , WEST DENNIS MA 02fiT0 ^^^ l� Expiration: Commissioner 04/10/2018 I The Commonwealth ofMassachirsetts = Department of YntlustrialAecidents 1 Congress Street,Sitite 100 Boston,MA 02114-2017 www massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO.BE FILED WITH THE PERMITTING AUTAORITY.. Applicant Information Please Print Le ibl Name(Business/OrganizatiorAndividu, ): Mike McCarthy Construction Box 52 Address: west Dennis, MA 02670 Cell 08) 280-6964 City/State/Zip: a#UIC-1 9393 Are you an employer?Check the appropriate box: Type of project(required): l.[glam a employer with !�_ employees(full and/orpart-time).+ 7. ❑New construction 1[]I am a sole propriclor or partnership and have no employees working forme in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.O I am a homeowner doing all work myself.[No workers'comp,insurance required.]t 9. El Demolition ' 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.Q I am a general contractor and i have hired the sub-contractors listed on the attached sheet. re These sub-contractors have employees and have workers'comp.insurance.l 12.❑Roof pairs 6.❑We are a corporation and its officers have exercised their right of exemption per MCL c. 14.[ /OtheC WC.f 152,§1(4),and we have no employees.(No workers'comp.insurance'required.] 'Any applicant that checks box#I must also fill out the seclion.below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating[hey are doing all work and then hue outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheep showing the name of the sub-contractors-and slate whether or not those entities have employees. If the sub-contractors have employees,They mutt proyide their workers'romp policy number. I am an employer that is providi►tg workers'compensation insurance jor my employees. Below is the policy and job site information. /� M Insurance Company Name: A_'/ I Policy#or Self-ins.Lie.M VW(-- 70-1 Expiration Date: )2 J1 r i Job Site Address: City/State/Zip: Attach a copy of the worlcers'.compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c:152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. .1 do hereby certify under t a' s enalties ofperjury that the information provided above is true and correct Signature: Date: Phone#: Soo, a�.^c re'r r Official use only. Do not write in this area,to be completed by city or town ojfrcial City or Town: PermitlLicense# 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#: TE 2/071 ,4co O � CERTIFICATE OF LIABILITY INSURANCE °A 1D°'YY"Y' 2/07/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:..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 an endorsement. A statement on this cerbfcate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01962-001 WPM Bryden&Sullivan Ins Agcy of Dennis Inc ?&Ezt, (508)398-6060 No,; (508)394-2267 PO Box 1497 ; So Dennis,MA 02660 INSURERISI AFFQRDINGCOVERAGE NAIC# INSURER A A.I.M.Mutual Insurance Company33758 INSURED INSURER B• Michael McCarthy Construction Inc P 0 Box 52 INSURER West Dennis, MA 02670 INSURER E: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING 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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS. ILTR TYPE OF INSURANCE 1 SR POLICY NUMBER MNUD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED P I Ee $ CLAIMS-MADE1-1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ EN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ OLICY E OC AUTOMOBILE LIABILITY C OMBINED'SINGLE LIMIT $ accident)Me ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS + NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE AGGREGATE $ yyO�D(�ERDg�p�p�R�EgTpEN�TpIONN$ yy�gTp7U TH $ ` AND EMPLOYERS LIABILITY X TORY LIMBS OER Y/N E.L.EACH ACCIDENT $ 1,000,000.00 A AONYIgpRMETOR/PARTNSFjI�(ECUTNEa NIA VWC-100-6017666-2015A 12/15/2015 12/15/2016 (Mandatory In NH) EXCLU to E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 WCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule;B more space Is required) CERTIFICATE HOLDER CANCELLATION Cape Light Compact PO Box 427 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Barnstable,MA 02630 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) The ACORD.name and logo are registered marks of ACORD Town of Barnstable �'ME ~C Regulatory Services f . Richard V.Scali,Director ` MAS& Building Division AA i01f1639.39�A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us t7 Y ' yq 5 Office: 508-862-4038 Fax: 508-790-6230, PERMIT#�Q/S� a.�( 1 FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less- Location of shed(address) Village Property owner's name Telephone number r7 /`// Size of Shed Map/parcel# F r 71, 5i Signature Date Hyannis Main Street Waterfront Historic District? AJ d Old King's Highway Historic District Commission jurisdiction? I 4::�) You must file with Old King's Highway Conservation Commission(signature is required) Sign-off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. _ PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN I Q-forms-shedreg REV:040914 .3a Fq CHAFtfi. �Qif o BAXTERlp y�w h. 4 G/STg�`� l h y�N URti ��/ CLOT_e,4A Al TN.4T 7- �x ��✓ .fN4Wit/f,/E�2EGL!/ SCA t i ,eE4�r•2EMENTS of 7,41, ' ww.v ct� Aic/O /S L OCA TES W1,rV1..,V 7 4 FLOGtalZ-4141 /� - .'//�,�✓�OS/z��r Z7� GATE: Tf,�/S P.C.4�/S.�/oT B.4SEO D.v .4�t/ .eEG/STE.2El� LSO S��✓�Yb� � //V$'J- UiiiENT,s'!/.e�EY THE asTE.2✓/,CL� MASS. D�FS'E'TS.Sh�i✓�Y Sr,lov� .t/oT 9� AO.��/Cf�i�� G"�//�5.4�/.1� Town of Barnstable *Permit# 5 Expires 6 months from issue date ► * 'tI snxxsTas Regulatory Services Fee VV 9c� , ; �00q Thomas F.Geiler,Director Building Division Peter F.DiMatteo, Building Commissioner 200 Main Street, Hyannis,MA 02601 PRESS PERMIT Office: 508-862-4038 JAN 7 Fax: 508-790-6230 ���� EXPRESS PERNUT APPLICATION - RESIDENTIR BARNsTAE3LE Not,Valid without Red X-Press Imprint Map/parcel Number ��7l/// 4/j �� N Property Address esidential Value of Work Owner's Name&Address�4 az/ Contractor's Name 4Telephone Number 6e Home Improvement C tractor LZ/nse It(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑Jram the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# L?/[i Permit Request(check box) �J Re-roof(stripping old shingles) /❑, Re-roof(not stripping..Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature 7 ® ° ��17 �E �:Forms:expmtrg Revised121901 Assessor's ma and lot number .....�.r� ... .y�..�..... ___p k.,.,.. _.. �FTHEtO Sewage Permit number .........................................G'?`�........ S d Z HAW TAXLE, i Hduse number .........................: �"....a/�'�'!�'I!-;i............ . 9ooM639 i D YPY f TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ..% ...................' "P �.. 4. s. ......... TYPE OF CONSTRUCTION- .............. ..LUr30 42.......!c.r'119.....P......................................................................... s wg o�3 ........19.FY TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f& a permit according to the following information: .LG T y/ e'LG�a7 /P � �P�T fii Location .........................................................................................................�:�......c..�......................................................... ProposedUse ........... �/��'.... i9/�Jic .... G. ................................................................................................. Zoning District ........................................................Fire District ... 'l! r 0-s7. n >9- Name of Owner ��.���� UN 71�157 �Q yd� e'F-u7e%'alC6 ...........................,tea.......................Address ....................:............... ............................................. Nameof Builder ....................................................................Address ................................................................................... # Name-of Architect - t,_,. .: ......................Address .................................................................................... E U , Number of Rooms ....$................. R.S..... dti .....................Founaon .,tom ..2P d... Q'u vS`l i��'�v.S ��S,O�l9C 7` Exterior %................................................................Roofing ........... ........................................................................ r Floors .In .....<.C.l, .. Heating14 ...................Plumbing ........... ............... .... ...... ........ .................................. Fi eplace 9,1/" G &4Oe-h Approximate. Cost ��d�,OGYJ j Definitive Plan Approved by Planning Board ________________________________19________. Area a... '30�.... .................................. Diagram, of Lot and Building with Dimensions Fee /07= SUBJECT TO APPROVAL OF BOARD OF HEALTH. n�Y 0 r j• 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 ..........................� � k DAVID BUILDING'TRUST A=227-141 17- No for ... ... ......... r -St x 5)ry Single Fair4y, ling. ..p��jj�li2q ...............Single ....... ....... .............. Location . ..... d........ /-0t-- d Cen-tervillp............... ..................................... .. ........ Owner ....David-Building .............................—:11:14t...... .......... Type of Construction .....Fralm........................... ................................................. ............................. Plot ............................ Lot ................................ Permit Granted ........Decelbex..3.1........19 84 Date of Inspection .....................................19 Date Completed ......................................19 CO L '�o•TM�r TOWN OF BARNSTABLE Permit No. 27363 { . = Building Inspector Cash wa ` OCCUPANCY PERMIT Bond Issued to David Building Trust Address lot #41 378 Elliott Road, Centerville Wiring Inspector ! Inspection date Plumbing Inspector' Inspection date Gas Inspector ;tr�N r Inspection date --- Engineering Department Inspection date Board of Health 4 Inspection date _ it 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. Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT ! seBaSTAU : TOWN OFFICE BUILDING = rua HYANNIS, MASS.,02601 �o ror►� �`�- MEMO TO: Town Clerk FROM: Building Department y DATE: 02 to �✓� Jq P-'t)� An Occupancy Permit has been issued for the building authorized BuildingPermit #...............ez..f... 6—7........... ........................ ............ ............................................................................... issued to U/L/,•, .r .f�.v. ...... ... .1:..._ .. . �1.......��` ...... `?J.. ....... .Z/d// Please release the performance bond. r.i V Al s " HICHAh f`1�\✓) o BAXTE . n} O c �id.4 c,tj wirwQ g cE,eTi�/Eo o,�or &LAB / cE2 r/.may THAT TAr z5k-&�77�,✓r� f'NOWit/" 'se,= v�ois�JPL YS W/rH SC.4 L �•' >' OATS ����-� ANC SETBA Cf� i ,2�4vi.2EME.VTs' of T�/E 7--wW-V of /S it/o T �� L OCA TEG W�T/i//�/ TyE FLoaaP�,a/•t! ,�-�_:�✓3.�.3os�6 /�G GATE://- �.: XTE,2E.VYE /Ile s Tom//,S P.L.4�//S NoT BASEO DN Ate(/ .C?EG/STEREO L �L� SU.e✓�Yb� /N.S`r.2viE.�/T',$'v,�✓6Y€ Tf/E QSTE.21i/.CL� O�'.SSETS,sy✓y Svt� .t/oT B� A�.o.�. `l :s ?.. f' '',. .ri.:k"" ;3'. i k h.3 ix x ' cif a43A,4# .. �z *'g-,r-s:4 �, a� fir._•-- -.�.. 'As' ssor s map •and lot number'. .. ../....:... .... �f THE Sewage Permit, number .....�: y 7 `t r,7 o� 0 c. .. ........ ' -INSTALLED BABHSTABLE, Houle number' ....... .. .�� Q.. ll �, r. M O 1639 �.�.t �t'i 9 ..• � �i ;1 'EO MPY TOWN OFF RAAR=N�S.,,`PTABLE,*j BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...:: /ai (o. %'a.:G ...../'`a�P 1.:: f� ......... • ,;. , LC/*O a;TYPE,,OF CONSTRUCTION,..... ... .. ......... .......r..} ......... ......... .... ..... ... .............. . ..............�r.... .19. ,TO THE INSPECTOR OF .BUILDINGS:' ? n The undersigned hereby applies for a permit according to;.the following information: Location ....'C�'.� y/:.... LG/67 !e U� '®� .. .......................... .....................:.. .............................. ..• ProposedUse ........ G y/ lyG/i'l.P .................... .............:...........................,......................... Zoning. District �,fji..= BST . .......................................................:........ ........Fire District ...C•�:.................................................................... Na_me of Owner / .. UJGQ�/. .:. ?/c/S? Address ' �Bol %r!/f ::. ....... Name of Builder ........................................... ...................Address ........: . .......................:.................................... Name of Architect Address .......... . ...................................................................... Number of•Rooms .... .. . ......B .S. :.... .. ::.,. '....Foundation OU ... ... ....................................... Exterior .,W �J9/ ci c! �S ..:..........Roofing ....... i®��•9GT:.......................................... ..... .................... ............................... Floors ....Interior ......h.y�'`�•L L •�� T Heating ... .f .......................{�:...................... ....::PIumbing•....... � .... . .............9 ................. p. M Yk Fireplace ..BIiC� Approximate. Cost ,...... ......................................... .................... x Definitive Plan 'Approved by Planning Board ____________ ______19_______, Area .........................fX . ...:. ...; Diagram of Lot and Building with Dimensions w: Fee ........ . .. SUBJPCT TO APPROVAL OF BOARD OF HEALTH. • 1 F • �I r OCCUPANCY PERMITS.REQUI RED'FOR'NEW yDWELLINGS I hereby agree`to conform to all .the Rul ' ',and, Regulations of the Town of Barnstable regarding the above construction. Nam ............ • �� Construction Su ervisor's License .... M DAVID BUILDING TRUST ; 27363 One Story �F No Permit for ........ ........................ }+ Single Family Dwelling ..................... I......................................................... Location ..Lot 41►.....318 Elliot_Road........ Centerville -' .� I� ...,.............David•Buildin....�st.. .......... �: .." �� -• � =� � , Owner ............................................. ............... Type of Constructions .. Frame...... ................ . e /.•-...A............................... * a - y.` i h .•.r = l - H Plot ........................... Lot ........................... Permit Granted ....December 31...................:19 84 ' Date of.Inspection ................ ......... .....19 'p Date"Comp) ted ....?'.�� .. 1 "Vow F=: '