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Town of Barnstable
OF T11E 1p�
r ti Regulatory Services /
Thomas F. Geiler,Director ooc
• RAJWSTABIX.
9� "AM. � Building Division
Art p �A Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-623(
PERMIT# `� FEE: $
SHED REGISTRATION
.120 square feet or less
V1141--e-IC
Location of shed(address) Village
Property owner's name Telephone number
4
Fyn
Size of Shed Map/Parcel# y
cs
Signature Date ICA
Hyannis Main Street Waterfront Historic District? /lh M
Old King's Highway Historic District Commission jurisdiction? �a
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
Q-forms-shedreg
REV:042506
-E= GE ===N ELAL
APPLICANT.' NO IZ/DO YLE TO WM CENTER VILLE
off- �o
4.k F\ ,,,Y4�
dImo¢�p
LOT 9 ARPORT
DECK
HOUSE,
^O
U
LOT 3
166 0"
1
LOT 4 ✓ ��
PSG\S ��v�.✓cam�Y
V S cFH_?d
C
►®vvvee
—rx�-D
FLOOD PANEL. 250001 0016 D FLOOD ZONE. C___ DATED.- 712192
hereby certify that this mortgage inspection plan was prepared fora Plan is For
FIRST HORIZON HOME LOAN CORP. Bank Use Only
he location of the building shown does _-=- fall within a special flood hazard zone. DEED REF. = C 86135
'er taped inspection it appears the location of dwelling does conform to the local by-laws PLAN REF. = 35_5488
❑ effect at the time of const-uction with respect to horizontal dimensional setback requirements — -- --
or is exempt from violation enforcement action under Mass. Ceneral Laws Ch. 40A -Sec. 7 Scale 1 _ —�Q�-- FT
teferenced Deed subject to and with the benefit of all rights, rights of way, easements, reservations —
ind restrictions of record if any there be and insofar as the some are of legal force and effect. Da te.' V27104—
'LEASE A10M The structures on. this inspection were located by tape not instrument and are approximate only. An actual survey is necessary
2r a precise determination of Elie building location and encroachments, if any exist, either way across property lines. This inspection must not
e used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes This
zspection must not be used to locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can
my be accomplished by an accirate instrument survey which may reflect different information than what is shown hereon. This inspection is not
2 be used for any purposes other than mortgage. Yankee Survey accepts no responsibility for damages'resulting from said reliance.
PHONE 508-428-0055 Y� lVk F ��l J T-1 Vp y r0 IV Sy j j j �� �S
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map ' Parcel L�`t �� 3 S _ Permit#
14 Health Division QJr' N-A 16 Date Issued
.
k Conservation Division f / /� ApplicatA Fee
Tax Collector Permit Fee r•
Treasurer_ / ju
l
SEPTfG YSTEM MUST BF
Planning Dept. INSTALLIE IN COMPLIANCE
TITL
Date Definitive Plan Approved by Planning Board H ENVIRON4 NTAL9
DE AND
Historic-OKH Preservation/Hyannis TOWN R GULAftNS'
Project Street Address 3 � e
Village def,-t @e- v 1
Owner _t,'A 4 ivc :5 Address g�S �9 -
Telephone .S o 3 (.2 -
Permit Request / 4 x 2 `� 3 <1 pt, CD a --n wef ( I V Al�
Square feet: 1st floor: existing 1^ proposed If 2- 2nd floor: existing proposed Total n Z
q g�— p p � 9 P P t new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 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 302 Historic House: ❑Yes 2klqo- On Old King's Highway: ❑Yes 8<o
Basement Type: ❑Full ❑Crawl ❑Walkout @-E)ther Y - --'a flC- a& t IA- C A W t
Basement Finished Area(sq.ft.) 6 Basement Unfinished Area(sq.ft) 3 2`f
Number of Baths: Full: existing [ new Half:existing 1l2 new E'
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new�_ First Floor Room Count
Heat Type and Fuel: 21(�as ❑Oil ❑Electric ❑Other
Central Air: ❑Yes W-I16 fireplaces: Existing �_ New 0 Existing wood/coal stove: ❑Yes Q5.No
Detached garage:0 existing ❑new size Pool: ❑existing ❑new size Barn:0 existing ❑new size
Attached garage: 2 existing Cl new size Shed:❑existing ❑new size . Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded Cl
Commercial ❑Yes O'Iq-o If yes,site plan review#
Current Use S Proposed Use
BUILDER INFORMATION
Name- wnenL4her- Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN'TO
r SIGNATU L/ DATE !�D ��/eP
FOR OFFICIAL USE ONLY
• PERMIT NO.
i
DATE ISSUED `
y
MAP/PARCEL NO.
ADDRESS• VILLAGE '
OWNER
f
DATE OF INSPECTION:
1
FOUNDATIONa�
FRAME
i
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
in
GAS: ROUGH IA ' ? FINAL
FINAL BUILDING _� t!!`'rL�(o'• 1(er a6C �ldb
r, rtt
F
rn l I ^+. •-
DATE CLOSED OUT . va
a
ASSOCIATION PLAN;NO. }
a
-, The CommonwealtkofMassachusetts r.
l Department of Industrial Accidents
_ �0ffiW$WM
600 Washington Street
x� Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit-General Businesses
y-•r//rrii iii r ii raraii rill ,�///////%/, �� /////� , .. .r � ���/�///. ���//� .......
/�
address:
ci
(� state: Zip- hone#
work site location fall address
❑ 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 to er with On to ees(full& art time,. then / /���%�%
// %W%V%////////////%//%//�%/%/////%% NO
I am employer providing-workers' compensation for myemployees working on this job`
COMPenv.
name: t'
wt'
'•p•_ .. •t•'
uJ+••
•f,
77
'ess:
addr
ti,r• \ bone#:"
city:
ce eb //
�' ///
urea •./•
s
/%/////// . / / / // ./ / // / /////y///.W
❑ I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices:
coinren n'sime:
address: �E�'' •• '":���•
hone#'
sit.
:,�::. dlicv:#
r
insurance co. •' // • //' ... / /%//// /.r// ///l/// / /- ,/ r /////•/ •. // %////%////%/%%�% -
company flame,
ciiv:: w hone#:
C.
_ :ice'•'• .•o7icv�#+.�,i' - - �.
/
Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminalpenaltiea of a fine up to$1,500.00 and/or
one years'Imprisonment as well a+civiIpenalties in the form of a_STOP WORK ORDER and a Fine of$100.00 a day against me; I nnderatand that s _-
copy of this statement may be forwarded to the Otfice of Invesdgatioas of the DlAfor coverage verification.
I do hereby certify under the pains and penal ' of per ury that information provided above itye �r -
Si a --� Date /
e
Print name Phone# j
,S `
official we only i o not write in this area to be completed by city or town official
Buildin De artment
city or town. permit/license# ❑ g p
_ _ ❑Liceasiag Board
response is required ed CI Office
❑check if immediate p once q []Health Department ,
contaetperson•
phone#; ❑Other
1 (revised Sept20M)
All
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
on in the service another under an contract
e law' an employee is defined as every ems Y
employees. As quoted from the P
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 section 25 also states that every state or local licensing agft
ency 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 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.,
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 per"n itflicense number which will be used as a reference number. The affidavits maybe returned to
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you 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
off n of ImsdQstlons
600 Washington Street
' Boston,Ma. 02111
fan#: (617)727-7749
phone#: (617) 727-4900 ext:406
f
RESIDENTIAL BUILDING PERMT FEES
APPLICATION FEE
New Buildings $100.00
Residential Addition $50.00
Alterations/Renovations $50.00
Building permit Amendment $25.00
FEE VALUE WORKSIMET
NEW LIVING SPACE qq
g`f square feet x$96/sq.foot=
o x.0041= 151, 14 •
plus from below(if applicable)
4
ALTERATIONSMENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot= x.0041=
plus frombelow(if applicable)
GAGES(attached&detached)
square feet x$32/sq.ft._ x,0041=
ACCESSORY STRUCTURE>120 sq.ft.
• >120 sf--500 sf� 4— $35.00 �
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf-1500 sf 100.00
>1500 sf-Same as new building permit: x,0041=
square feet x$96/sq.foot=
STAND ALONE PEMTS
Open Porch (number)x$30.00=
. • .
Deck x$30.00=
(number)
Fireplace/Chimney x$25.00
(number)
Inground Swimming Pool
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable) permit Fee
Projcost
Rev:063004
�F'it HE ram, Town of Barnstable
w
Regulatory Services
13AMSrAsr.'s. Thomas F.Geiler,Director
9 MAN. �*
�A i639. A1` Building Division
TFD 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:
Ze1,0 Estimated Cost
Address of Work:
Owner's Name:
Date of Application: �/d
I hereby certify that:
Registration is not required for the following reason(s):
OWork 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 of the owner:
Date Contractor Name Registration No.
6 26 0
Date Owner's Name
}
Q:forms.homeaffidav
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
3 peg 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: %D I a(o l 0 LF .
JOB LOCATION: G. 3v f l e 'L IQB '� e1_e�•. � v (;1. e
number street village
"H ME0WN1H : °9 N��S IJ r,y rL' Ja 5 -31-2.
name q home phone# work phone#
CURRENT MAILING ADDRESS: /s r o'Yj ✓9 ''" S °� S G"'�✓` c
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.
DEFINTITON 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 compliancy with the State Building Code and other
applicable codes,bylaws,roles 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
re ements. 7 ,
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 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 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 bomeowner 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 form/certification for use in your community.
t Q:forms.homeexempt
' • t 4
•If
6
t
7 ., % TIC ELAN 7
ORT-GAGE LLSPEC /V
APPLICANT• NOTZ/D0YLE TOWN. CENTERVILLE
o
i
LOT 9 �� . ARPORT
ti0 DECK
HO USE
O � b
y
t � A
LOT 3
166.O,Z .
e , A
LOT 4`, v� of 0,S��
c
Qc=
tJ.
poy'E
~ D� • �lp L
FLOOD PANEL: 250001 0016 D FLOOD ZONE 'C"__ DATED. 712192
I hereby certify that `his mortgage inspection plan was prepared for: Plan is For
FIRST HORIZON HOME LOAN CORP. Bank Use only
The location of the build',rng shown does _NQZ_ fall yvithin a special flood hazard zone. DEED REF = CC 6135__
Per taped inspection it appears the location of dwelling does ------ conform to the local by-lams PLAN REF 35548E
in effect at the time of corstruction with respect to horizontal dimensional setback requirements — -----
or is exempt from violation enforcement action under Mass. General Laws Ch. 40A -Sec. 7 Scale I' = —��—_ FT
Referenced Deed subject to and with the benefit of all rights, rights of way, easements, reservations p /
and restrictions of record, it any there be and insofar as the same are of legal force and effect. Da to 27104__
IPLEASE NOTE The structures on this inspection were located by tape not instrument and are approximate only. An actual survey is necessary
for a precise determination o: the building location and encroachments, if any exist, either way across property lines. This inspection must not
be used for recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan purposes. This
inspection must not be used ro locate property lines. Verification of building locations, property line dimensions, fences or lot configuration can
only be accomplished by an a-curate instrument survey which may reflect different information than what is shown hereon. This inspection is not
to be used for any purposes ether than mortgage. Sankee Survey accepts no responsibility for damages resulting from said reliance.
PIfONE 508-428-0055 A AX/4 j j V l Y ro Al 1 ��l r AIT
BC CALCO 2003 DESIGN REPORT - US Friday,March 18,200512:38.-
Double 1-3/4" 8-1/2" ERSA-LAM@ 3100 SP* File Name: BC CALC Project:RB01
Job Name: Fuller d Description:
Address: 63 Fuller Rd.�" Specifier: Botellow Lumber Co.Inc.
City State,Zip:Centerville,Ma, Designer: None
Customer: Jerry Reardon Company: 4. Xi
Code reports: ICBO 5512,NER 629 Misc: ,
12 s `+ 5
1 'le
Standard Load-25 psf 115 psf Tributary 12-OMO Anzy
,. NggA, gm ,tt..urtL' .t r 4- y kg '7 e c 'ss, - ,rr., •.
y.,• -a .�'kr .:` �K��. t2r w °' ...r}j 01 AC^ R' '.; `safnF: Ykmc•�'. �°vv. •vr �+" 4a
BO
6.1�.:.
2005 lbs LL 2005 lbs LL
1115 lbs DL 1115 lbs" L
Total Horizontal Length-09-02-00
General Data Load Summaryt
Version: US Imperial ID Description Load Type Ref. Start End Type Value Thb. Dur.
S Standard Load Unf.Area Left 00-00-00 09-02-00 Live 25 psf 12-00-00 115% '
Member Type: Roof Beam Dead 15 psf 12-00-00 90%
Number of Spans: 1 1 ceiling load. Unf.Area Left 00-00-00 09-02-00 lave 25 psf 05-06-00 100% .:
Left Cantilever: No Dead 10 psf 05-06-00 90%
Right Cantilever: No
Controls Summary ;
Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location .
Tributary: 12-00=Q0 Moment 7151 ft-lbs 55.0% 115% 3 1 -Internal
Neg.Moment 0 ft-lbs n/a 100%
End Shear 2638 Ibs 39.9% 115% 3 1 _Left
Total Load Defl. U364(0.302") 49.4% 3 1
Live Load: 25 psf Live Load Defl. U567(0.194") 42.3% 3 1
Dead Load: 15 psf Max Defi. 0.302" 30.2% 3 1
Partition Load: 0 psf
Duration: 115 Notes
Disclosure Design meets Code minimum(U180)Total load deflection criteria.
The completeness and accuracy of Design meets Code minimum(U240)Live load deflection criteria.
the input must be verifieda anyone Design meets arbitrary(1")Maximum load deflection criteria.
who would rely a the output Minimum bearing length for BO is 1-1/2".
Minimum bearing length for B1 is 1-1/2".
evidence of suitability for a Member Slope=0,consider drainage.
particular application. The output •Cut from:1 3/4"x 91/2"VERSA-LAM®3100 SP
above is based upon building Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing
code-accepted design properties
and analysis methods. Installation Connection Diagram
of engineered wood
productsducts must be in accordance Consult project design professional of record or BOISE technical representative for connection design with the current Installation Guide Member has no side loads.
and the applicable building codes. Connectors are:16d Sinker Nails
To obtain an Installation Guide or if
you have any questions,please call a=2"•
(800)232-0788 before beginning b=3„ b d—
product installation. c=2-1/4" ~—
BC CALCO,BC FRAMERS,BCIS,
d=12" . 8
BC RIM BOARD1m BC OSB RIM t
BOARD- BOISE GLULAM- � C
VERSA-LAMO,VERSA-RIM®,
VERSA-RIM PLUSO,
VERSArSTRAND-, `
VERSA-STUDS,ALLJOISTS and 4
AJSTm are trademarks of
Boise Cascade Corporation.
}
Page 1 of 1
*THE
TOWN OF BARNSTABLE
DARNST' AILE,
039.
0 VO BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ......I/ ... .. .......
TYPE OF CONSTRUCTION ............
................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...... .......... f
................................
ProposedUse ........."14 .........................................................................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
r.
f Owner ... .141" f ...........Addres -S?
.... ........
Name-a .............. ....... s .................................. ..
Name-of Builder .... ........................................Address ................404 ..............................................
Nameof Architect ......I/ . ......................................Address ..................e4i,... . ................................................
Number of Rooms .........9......................................................Foundation ........
Exterior A,
11 .
(......00. .. ..Roofing ......... .. .V
V
Floors .........................................................Interior ....... .... ................................
. ................. ........
Heating ....One 4" ............11�.. ........e�WV61:
........ ................Plumbing ........I......... ...... .................
Fireplace ....... Z.........................................................Approximatf. Cost ...
...
V... .........................................
(
Difinitive Plan Approved by Planning Board -------------------------------19---------
Diagram of Lot and Building with Dimensions 'CEO
1 3 5-3
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... . ....... .........
| �4�_~.---^_" �`^�
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one
No — nnh
.�����.. Permit ----.—..�����.--' �
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.----.~.---_---._.-=---.--.—.,. \
�o�
Loco�on"�— .Bood._._______._._ /
Centerville
'
—.—.—.---.~="-`'==..=.—.—..-------'
Owner .........Win. ................-----.. /
�
Type of Construction .........ftARIP...................... `
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—^~~--^—^^~^~--'---'^^^--'''-----''
�
Plot .------.--.. Lot �q .^ '
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Permit Grantedune 7 72
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(
um/e of Inspection '
�
uu*^ Completed ./ '
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PERMIT REFUSED } �
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...............
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. E
IMPORTANT - UPGRADE REQUIRED
STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS REVIEWED
SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN f t®
ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. I �Y
NOTE: A SATE PERMIT IS REQUIRED Ft3R THE B N LE UILDING DEPT. DATE
INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL
PERMIT DOES NOT SATISFY THIS REQUIREMENT.
G
FIRE DEPARTMENT DATE
BOTH SIGNATURES ARE REQUIRED FOR PERMITTING
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