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Home My WebLink About0039 EMERSON WAY ;,__ T �ir�,�•-so,� Vlf�4 ��: �' �..: :. . ,,, _� � ,, � _ ,. r � � _ _ . _ � a:. Qy�F7MET0�f TOWN OF BARNSTABLE ii • ; i BASHSTABL$ i "79��e� 'a war -BUI:LD. I#G INSPECTOR � a' C .�v e ' 4 ,0 APPLICATION FOR PERMIT TO ......:...MFR'>3TC..aTRt1MIREa,..Ma. ......:.:....................................................... -TYPE OF CONSTRUCTION ..x.................Q4.Q..Family.. Dwelling.......' .............................. 1 ................. ...........19.7.3... r � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a"permit according to the following information: Location ...............I,ot .,,..Emerson-Way...,,..Centes:uill.e,..Mass................................................................................ Proposed Use ..............Pr.ivate..Dw.ellirag. ................................................/......... ..................................I......................... Zoning District l PIt9 - �f + r...�(./r.... Fire District ....................................... ...-................................. Name of Owner Saul Freedman Address ...May Street - Worcester= Mass. . ......................................................... ... ............. ........ ................ Name of Builder JETRIC;, 'RUCTtJRE$,,., INC................Address ..IMi.rick Rd.;,, Princeton.,... ass.....,..........,, Name of Architect ..Rus..sell...S...Oatman..........................Address ...al.d..C.alony...Road..-..Pxi.nc.stoa,...1gas,S...... ..5. ............Foundation ......25!...x..�E—Conti.Iwava..Q01P.rAte....... Number of Rooms ............. ....:.............................. Exterior .........Temture..a.-11................................................Roofing ............ Q..A9.P lt.............................................. Floors ...........2..x..8....Kyw ad..-...Cw?pet........................Interior .............V....S......rTypSURI..�?iRerial„Board Heating .......Forced..Hot-Water..................... Plumbing ..........1 ,..Baths............................. Fireplace .......Frae..Standing..............................................Approximate Cost .....SZ..QQQ..QQ......... 1,2 Definitive Plan Approved by Planning Board -------------------_-----------19________, g� U a� Diagram of Lot and Building with Dimensions o057- 7'0 Sr.AG, S// �� 4504W/1-JO, *1 3-7_73 SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 1C1AL'VACCINAT194 SEPTIC SYSTEM MUST BE 1fASSACHUSE'y§ ➢NSTALLED IN COMPLIANCE ,29.00 i, Big® 'WITH ARTICLE I I STATE ;I SANITARY CODE AND TOWN . . REGU rlkl c) So Q - `vc�'h, V 2,1173. U. rto = I hereby agree to conform to all the Ru es aftd Regulations of the To f Barnstable r ardin the above construction. Name, ..... . . . . .. .............. Freedman, Saul 16 No ....... ... Permit for'......one.........stor7 ....... .............. single family dwelling ..........-...................................................................... Locatio5q Emerson W ..... A.................. y.............................Centerville ............................................................................... Owner .............Saul Freedman ..................................................... Type of Construction ........frame............................. ..... .................. ...... ...................................................... Plot ............................ Lot ......... ................ Permit Granted' March 23. ...........19 73 ............... ................ Date of Inspection .......................19 Date Completed ....19 PERMIT. REFUSED ................................................................ 19 .......................!........................................................ ..................................... ......................................... ................................................................................ ............................................................................... Approved ................. ............................... 19 ............................................................................... ............................................................................... AsBuilt Page 1 of 2 TOWN O,F(BARNSTABLE LOCATION- ,3q I+K(:�zAci4 bJ&-f SEWAGE# VILLAGE 1 let it-lLu1 LL.0 ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. cT 1 614 1-1 311 SEPTIC TANK CAPACITY rC��c i�j 1�fE,, 1crC)6kc`T LEACHING FACILITY:(t `ype) �j(�"� (size) NO.OF BEDROOMS 3 OWNER 1 a7l PERMIT DATE: -!(cy-i 4- COMPLIANCE DATE: u Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) JP, Feet Edge of Wetland and Leaching Facility Of any wetlands exist within t 300 feet of leaching facility) I Feet FURMSBED BY rye h 3:i' YYd 3i, �v " 0 iq I http://issgl2/intranet/propdata/prebuilt.aspx?mappar--188026&seq=1 11/28/2017 Health Master Detail Page 1 of 1 A. Logged In As: TOWN\sousav Health: Master Detail Tuesday, November 28 2017 . Application Center Parcel Lookup Selection Items Reports I Parcel Septic Perc Well Fuel Tank Parcel: 188-026 Location: 39 EMERSON WAY, Centerville Owner: HEINZMANN,CHERYL M Business name: Business phone: Rental property: ❑ Deed restricted:.❑ Number of bedrooms Contaminant released: ❑ Fuel storage tank permit: ❑ I Save Parcel Changes Return to Lookup i Parcel Info Parcel ID: 188-026 Developer lot:LOT 55 Location:39 EMERSON WAY Primary frontage:103 Secondary road: Secondary frontage: village:Centerville Fire district:C-O-MM Town sewer exists at this address: No Road index:0502 Asbuilt Septic Scan: 188026_1 Interactive map Town zone of contribution:AP (Aquifer Protection Overlay District) State zone of contribution:OUT Owner Info Owner: HEINZMANN, CHERYL M Co-Owner: Streeti:39 EMERSON WAY Street2: City:CENTERVILLE State:MA Zip: 02632 Country: Deed date:6/15/2000 Deed reference:C158057 Land In'ffl Acres�-0-23—Use:Single—Fa-m--MD-L=01 7aning�J22I 1 N.ei.ghborhnodL-01Q6 Topography:Level Road:Paved Utilities:Public Water,Gas,Septic- Location: Construction Info Building No Year Bull Gross Area Living Area Bed rooms Bathrooms 1 1974 2484 1200 2 Bedroomsi Full-1 Half Buildings value:$94,200.00 Extra features: $36,200.00 Land value: $130,000.00 11/ R/2017 l�+t„ //ieenl7/intran�t/h�a�tl�l�/1'actrr/ura�thMaCtrrnrfal� aCnX9TT) 1 Rx(1�.� 2 CMI ':DEPARTMENT OF ENVIRONME PROTECTION - 310 15.301` continued.- ` `or to transfer.by - _ - anknt!t 1lispection of the system must occur within two_y to ded that the.debtor. , (h)• �� : _ bankruptcy trustee to buyer or within six months after the transfer,p 15 300 through.' _:; ': •Y ' of there ments contained at 310 CMR• ears- : notifies the buyer in writing 4 An inspection conducted up to three y ection and upgrade;if necessary. s steu i.: 15.305 for izisp ection report is accompanied by y before the time of transfer maybe used if the been Piped atleast once a year during PumPmg recotds.demon'stratingthat the syS thbced at time..: or. _ QeinOwnershi ortheForm-of'OwnershinR'here ductionof new ointtenant(s)g•. n '�- lies iu a nominee trust;into. .- from' introduction of new beneficiary arties where property is transfe;rmg neap.teriant(s)in common,intro of new P g artner is introduced; oint'ownership to nominee orbnsiness tru fo°]ife'or for arwhere eterm of Y ars.is twist for a arty J ownership interest of creation of a legal life estate of 2n inter riot to transfer ' `other than the creator or his yr her spouse;a change in the controltliwnog-yearsP f the s stem must occur withinmust occur o n lion Y ao e c ec .. Ins 'e ins _ th t e•e P - P .. 'o ) transfer,.r,. I a •f - ` ra n; o 0 - :.a co at the time 'ded'•.. - rP "on •vi e cti o • er,tins f n'e ,v trans p• re P e th 'or if weather conditions p 15300 - as soon as weather permits,but in no eventlater than six months ie is notified in writing of the requirements contained at 310 dory that the new party ade,if necessary. In•a nomm. trust through 15.305 for inspection and upgr res onsible for the inspection. �. to add anew be p. er may-be used if the: ..whoever has au ears before the time of transf rem inspection conducted up to. b'Y pumping records demonstrating that the sys inspection report is accomp. Y systemthat time:• . has been pumped at least once a year during usions. Inspection of a system is not required at the time of transfer.°f title pf-the (4)-Exc_�_ circumstances: Anthouty facility served by the system in the following the A roving I e time of transfer and sy'stempmnP�g records demonstrate that (a)'a certificate of comgl ice for a new systemhas been issued by PP i within three pears prior to ear,or: ' pumped at least once durins the third y. • title has signed an enforceable C/ 'the system was pump or the person acquirmg eci the facility to (b) the owner of the facility the s rem or to coup, Pf S a Bement with the Approving Authority to upgrade the following the Mnsfet of title, year, the.subsequent a sanitary'sewer or a shared system within the next two provided that Such agreemeat-has been disclosed to.and is binding tic' teminspeetion' (1� ownet(s);or, rehensive local plan of on-site Sep 4•d 1 ,,l @ N f (c) the facility is subject to a comperedby alocal orreYonal govemmeutal approved in venting by the Department and admini. d{� �e plan: A'. .' d oat basis of Proximity • . entity,and the system has been inspected astems tosbe�nptwime a t y comprehensive local plan may prioritize l ry e or size of systems, history °f to water'resources, soil or'geological conditions, ag ' or other relevant-- to frequency of pumping or other routine maintenance ac�y of ecti'n on the basis of; nc factors,and may establish different schedules a ed edequ least nce every seven years by a:' Pro that all systems are insP . such criteria, P the De artnenC,or. System Inspector approved by P - the transfer is of residential•real property between the following relationship's: (�. between current spouses; 2, between Parents*and their children; 3.. bety een full siblings:and to beheld in a revocable or irrevocable 4, where the grantor transfers the real property at least one of the designated beneficiaries is of the first degree Of'• ,. trust,•where • relationship to-the grantor. ,. ' ected riot to any change in the type of establishment,or increase in .(5)' A system shall be insp P served for-which a,buiilding permit design flow,or prior to any expansion of use of the facility stem is a cesspool, Permit from the local building inspector is required..If the sy cant threat or occupancy p •. Q set forth in 310 cMR 15.303 or 15.304(1)or is a significant 4(2),then or if the system rs failingforth in 3 fO to public health,safety,welfare and the change in the type of establishment crease in design ed not ces ool,• ' the system shall be apgr P Prior to anincrease in the deco gnflt°he system shy be flow or expansion of use of the facili a roved capacity, the cesspool or to any system above ahe existing PP es the foo rint of a banding with no increase in u ailed in accordance with the standards applicable new construction. Whenever an P structure which ch g addition to an existing 39 Emerson Way Centerville Davis,Lillian 1/5/199S Mideape 39 Emerson Way Centerville Davis 12/15/199S RoWnson Septic 39 Emerson Way Centerville Davis 12/21/1999 Midcspe Septic 39 Emerson Way Centerville Heinzmann,Cheryl- 11/2/2005 Wind River Septic 39 Emerson Way Centerville Hehuzcnann 3/30/2007 Wind River Septic 39 Emerson Way Centerville HeinzMan 1/7/2008 Wind River Septic 39 Emerson Way Centerville Heiuzman 7/31/2010 Wind River Septic . 39 Emerson Way Centerville Martiue2 6/27/2011 Wind River Septic 39 Emerson Way Centerville Heinemann,Cheryl 1/9/2012 Wind River 5epti 39 Emerson Way Centerville He iuzmann;Cheryl 1/9/2012 Wind River Septic 39 Emerson Way . Centerville Heiazman 7/13/2012 Wind River Septic 39 Emerson Way Centerville Heiuzman 7/16/2012 Wind River Septic 39 Emerson Way Centerville Heiuzsnarui-Cheryl 5/30/2013 Wind River Septic 39 Emerson Way Centerville Heinzmann 3/10/2014 Wind River Septic 39 Emerson Way Centerville Heiu inann 7/22/2014- Wind River Septic 39 Emerson Way- Centerville Heinzman 3/3/2015 Bortoldli Sentic Wad IKE Town of Barnstable *Permit Expires 6 t nths from i ire date PERMIT Regulatory Services Fee • snxivsrna�, MARS. Thomas F.Geiler,Director 0 F rl i AT163:9: _ Building Division l� �1��4� j ��ST �-�Tom Perry,CBO, Building Commissioner 111 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1 oz.(S' Property Address . 3 Q A/ e 02, 'Residential Value of Work. Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name 1U ae ,o— (!:�47 A,) r. !„Z.0 Telephone NumberS2�d%2-B® Home Improvement Contractor License#(if applicable) Az Construction Supervisor's License#(if applicable) GS j"dS rorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am.the Homeowner rave Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#_ k✓`CC SDo 5 S��D�aoC 7 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) (nRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ 1 cement W' do s/doors/sliders:U-Value (maximum .35)#of windows ere required: Is ance of this rmit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. * *Note: Property O ner must sign Property Owner Letter of Permission. A copy of t e Home Improvement Contractors License&Construction Supervisors License is uired. SIGNATU C:\Users\decollik\AppData\Local\Microsoft\Wi dows\Temporary Internet Files\Content.0utlook\DDV87AAZ\EXPRESS.doc Revised 072110 Massachusetts - Department lit' Public Safet,N "Board of Buildin�l, Re!.tdations and Standards Construction Supervisor License License: CS 69058 ,• RICHARD S TUPPER 79 B MID-TECH DR WEST YARMOUTH,.MA 02673 ��- - Expiration: 12/31/2012- t'annmi"44,114-1- Tr#: 8340 Officc`6Y�o 8 f 'lf�Yr�ilr"i it License or registration valid for individul use only _= HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ,121845 Type: Office of Consumer Affairs and Business Regulation .' Expiration: 6/19/2012 Individual 10 Par RYJaxa- i e 5170 �Bostan;NIA 02116 D TUPPER RICHARD TUPPER r 29 Roberta Drive W.YARMOUTH,MA-02613 Undersecretar Y Not valid witho signature V i ACOR CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) �M 03/08/2011 PRODUCER (S08)997-6061 FAX (508)990-2731 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO,RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INSURED Tupper Construction Co LLC INSURERA: Arbella Protection Insurance INSURER B: AEIC 27 Roberta Drive INSURERC: CNA Surety West Yarmouth,-MA 02673 INSURER D: INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I R DD'LT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR DATE MMIDD/YYYY DATE MM/DD/YYYY LIMITS GENERAL LIABILITY 8S00008743 11/01/2010 11/01/2011 EACH OCCURRENCE $ 1,000,000. PCOM MERCIAL GENERAL LIABILITY DAMAGE TO RENT PREMISES Ea occurrence $ 100,OOCLAIMS MADE FKOCCUR MED EXP(Any one person) $ 5,OOO A - PERSONAL&ADV INJURY $ - 1,000,OQ GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $. 2,000,00( POLICY PRO LOC JECT AUTOMOBILE LIABILITY 56662400002 12/01/2010 12/01/2011 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY $ A . X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) INC GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ AND EMPLOYERS' YERS'LIABILITY IONILIT WCCSOOS S93012007 10/03/2010 10/03/2011 X TORY LIMITS ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV Y/N RICHARD TUPPER IS E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? (Mandatory In NH) LUDED FOR WC COVERAGE E.L.DISEASE-EA EMPLOYE $ 500 OO If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 onT for theft of 71068813 02/28/2011 02/28/2012 Limit of $10,000 C ney &/or property. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE.EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. For Informational Purposes Only AUTHORIZED REPRESENTATIVE Krista Hartford ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ;t __ ,�)_TUPPER CONSTRUCTION CO.LLc 79B Mid-Tech Drive West Yarmouth; MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#121845 License#069058 Date: May 3l,2011 Attn:Building Department I hereby authorize Tupper Construction Co.,LLC to pull the permits necessary to complete the project described on the attached permit application form. Thank you, Owner's Signature Print Owner's Name: Joel Martinez. av Street Address: 39 Emerson Way,Centerville,MA 02632 f The Commonwealth of Mk.ssachnsetts Dep artmenl of Indusdraal a ccidents Office of Inmtagadons 600 Washingtan..S&mt Boston,M54 02111 w►v.massgovldia Workers'.Compensation Insu muee Affidavit-,,BuflderslCo ckwslEle teicciaus/Phimbers . Applicant Infarmatiou Please Print I:ebly . Name(lsesslOrgaatrahanllndividwll: TuaO�e� �lid'7�YUG �,� �p Z Z° ' Address; o�?_6 7-3 City/statrjzip kl, a Phone Are you an employes?Check the apprapriste box: Type of project(required). 1"L 1 am a employer.with . 4" ❑ I am a feral contractor and I employees(full azDdfar pme). have hired the sub-contractoas 6" ❑New oonstrut on 2.❑ I am a sole prop6etor ar partner- listed on the attached sheet 7. D Rermtodeliag shop and,have no employees These sob-contractors have 8..El Demolition wonting for me:in any capacity employees and have wadws' [No wasloers"comp.insurancecomp.insuranmlBudding addition required"] 5. ❑ We are a corporation and its 10"D Electncal.repaiss or additions 3 ❑ I am a homeowner doing all wont offioers have exercised their I1"0 Pliunbing repairs or additions myself[No workers'cmw- right of exemption per MOL 12"❑Roof repairs ins,mmt:e raj I c..152,§1(4);andwe hMMno employees.[No workers' 13:❑Other comp.iasarance respired. *Anyapplicaul that checks tax#1 also filloutthe section below dwwinglea wwkewappen policyWti�,b 1 Homeawn4rs who sub=91-of A-9-i1catmS they are doing all wa&and£hen hue outside c mt wwrs—srscftnt a new.afdavit mdic=g sash:. .:Contractors Chat cbect this boa mast attached m addimnnal sheet showtog the nme of Ste suh~a inba mas and state whethRr or not those entities have employees..If the svl:taatractars have employee%.they mustpittvide than workers'comp:policym-ber" I am an employer that ispmvidirrg workers'.Caarpansehsn insurance for ily ewqz[ayw& Below is.Alfa aad ab s*e p�cJ', ) informagm Insurance Company Name: Policy#or Self ins:Lic_#: Ii✓C G ��d d/-? z Fatiaation Date: /p 3 // . Job Site Address:•2??eis tei^�s �'41Y GityfStatel 'x Attach a copy of the workers'compensation policy-declaration page(showing the policy number and expiration date).. Failure to s veiage as required under Section 25A off MGL c: 152-can lead to the imposition of criminal penalties of a- fine u o$1,54 "00 Avor one-year imprisonment,ors well as civil penalties in the form,of a STOP WORK ORDER said a fine ofafto$250: a day a " the violator. Be advised that a copy of this statement maybe famarded to the Office of Inve of the DIA insurance coverage verffication" LIdo ed"W&andar tk pains andpenabies ofpedstty;that the information provided above is tree and correct Date: rio - Pltane Oj ff Wal use only. Do I&writs in this area,ta be Couiplated by city or town a iciat City or Town: . Permitl license yssaing Authority(circle one): I.Board of Health I Building Department 3.City/romr Clerk 4.Electrical_Insppctor- S.:Plumbing Emspector 6.Other Contact Person: Phone#. f TH E T0� �Q o TOWN OF BARNSTABLE i i BARNSTABLE. i 6 q o w �•�� BUILDING INSPECTOR .�, av°" '. APPLICATION FOR PERMIT TO ......./.... . ...... a.�L.l-.��" Ly................................ TYPEOF CONSTRUCTION ....................................................................................................... ............................. ................... 'S ...............1929 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ................0..� ...........� ............... .. 'L.I�� .�C, . ........ C1! .............. '.. ..�1................ .e.4 ProposedUse ......... ..^.....�.L..f............... �c-.L. ....................................................... ......... .............. ZoningDistrict ........./R.. ...... ........................Fire District .... ........................................° ......... ........................ Name of Owner .. ........ ................................Q2�r:�.. ...?��..:�.�`.�IA�.dl..�ddress ..��..�� ...�!��./...... Name of Builder .... /..' .�....... ��. ?f. � .Address ...... .. .��' .... , -............... Name of Architect ....................Address ........... .............................................. ......................................................................... Number of Rooms % ............�<01-)Pt4�? .....................................Foundation ..........1....-.�,,.:.�................................................. Pell Exterior ........4�0.4 T?........ e.G.":',,r. ............Roofing ......... .... . ! ..�................................... ..... ..... J �r Floors .......... ........................................................Interior ..............=.:... .4�./.'�........................ Heating ........... 1 .................................................Plumbing ..: .......1 y .. Fireplace ...................... ...........................................................A roximate Cost ✓ Uc�C/ pp ................ .. ................................ ....... .... Definitive Plan Approved by Planning Board ---------------_-__-----------19--------. Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 . d r � � NJ. ; ao� WW V W ? d _ 1� W CL j O O O- LO Z Q: N 5. Uj 00 Cl- ULn j Q ¢ }© w aQ : }�. 0 w t,- Z -� 0-, I hereby agree to conform to all the Rules and Regulations of VTow4,Bc, table regarding the above construction. Name .... �....................... � �,`~�` � Forbes Investors Realty -^~.. . , No -.1-54//5'.. Permit for ......... ....... ' v- ^ . , ........... .................. l�", / Lwcp,v�n -^�.�-��e�ae�+�.-n�............................ / Centerville . ^^-----'^--'-`~-'`-'-~^^'^-----'-- ' ' Forbes Investors Realty l:r"s+ ' ' Owner ---.-..----~--..---.��....-.�.�- ` frame ^ � Type of Construction .......................................... � , . ` --..-.-..-.....-.,.-.~.--.-.-....._-... ' � Plot ............................ Lot ................................ ' Permit Granted ...... . 72 --' '--� �. Date of Inspection- ....-------lg Date [omo��a6 -------------lA ' \ � oe '_-.� REFUSED U ' --�` ' i l . � ^r^ wv �� ~ � ' - ~--'--' K �' » !___.:*�..=�x .� ........................................... . " i � � ------..---.x-_---_-..---.---'---- ---'---'------''--'-'--'---'-'---~-' � Approved | ................................................. 19 ________,_._______,_,,__,,,,,_. 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