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Home My WebLink About0080 HELMSMAN DRIVE Y, .O e� ,Ism n ' t°c�c - u c o . o TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I .I Parcel f�l TABLE A 61.. O � � 6 MRINS Application # Health Division =f:a Date Issued //lam Conservation Division Application Fee 1570 Planning Dept. U.. .„„ Permit Fee (35 •o0 Date Definitive Plan Approved by Planning Board ' r) Historic - OKH _ Preservation/ Hyannis Project Street Address La Village CS:nAll v,)IA Owner c�,� ►., G�n�_`;� Address Y1. Telephone SA -`�`3�-�aL12 Permit Request 0_+�� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total 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 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 P® Box 52 License # West 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 SIGNATURE DATE A �,— FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER z r j DATE OF INSPECTION: FOUNDATION FRAME } INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Town of;13arnstable ° �2egul tort'., Services • e'` a Ricliarct V.5cali,,Dir�clot: i639. BWIWI' D�MsWii Tom Perry, "Commissioner 200 Main.Street,Hyannis;MA 02601 .towd.barnstab[eanaaus Office: 508-862-4038 Fax: 508 790-6230 r .. Prwertv:Owner Must " Cojaap�eft,a;&smgn'I' Section lf:Usb 1 .BuiIder p4a r T ' � � `° it C41� ��° _ ., ,as Q�vner.o£the subiec�r prop�ny herebpatuhori2e '. fV to act.an mybehalf,: in aU matters relative to,worl authorized by this 8wldingpermit application 6r. ��=.. .,(Address"crf�ob)" • • • ��#� " ''-Pool fences and alarms are'rfie respo1'isi lz yof the'applidant.:ft are �o`t to be rf filled or ut i ed more:°fence'is installed and all final. inspections are;petforM4.And,accepter, %gnatum ofignaivre of Applicant F'xi�r Name; Q FORMS:OIVN>:1't?EV 4MSIONPOOLS; Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supenisor License: CS-058633 MICHAEL J MCC AR PO BOX 52 W DENIMS MA 0267 ell Expiration Commissioner 04/10/2016 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C-64=actor Registration Registration: 169393 Type: Individual Expiratio /2017 Tr# 264961 7 MICHAEL MCCARTHY MICHAEL MCCARTHY e P.O. BOX 52 K - WEST DENNIS, MA 02670 -- ----- Update Ad ess and return card.Mark reason for change. Address Renewal [_ Employment Lost Card 20M-OSl11 �\ The Commonwealth of Massachuseffs Department of InthistrialAcchlents 1 Congress Street,Suite 100 Boston,AIA 02114-2017 ' wlvlv.massgov/dia ]Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plrimbers. TO BE FILED WITH THE P)R114ITTING AUTHORITY. Applicant Information lease Print Legibly Name(Business/Organization/individual): Mike c ay _ �0 Be"11 Address: West Dennis, MA 02670 e - City/State/Zip: C'46964 -5$lliUM#: HIC-169393 A71'. an employer?Check th�propriate box: Type of project(required): a employer with employees(full and/or part-time).* 7. ❑New construction 2.Q 1 am a sole proprietor or partnership and have no employees working for me in $• ❑Remodeling any capacity.[No workers'comp.insurance required.] In lam a homeowner doing all work myself.[No workers'comp,insurance required.]► �• El Demolition 4. I am a homeowner and will be hiring contractors to conduct all work on m property. 10❑Building addition ❑ g Y P perty. Twill ensure that all contractors either have workers'compensation insurance or are sole I L]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and 1 have hired the sub-conhactors listed on the attached sheet. These sub-contractors have employees and have workers'comp,insumnce.1 13.❑Roof repairs 6Q we are a corporation and its officers have exercised their right of exemption per MGL c. 14•901her 152,§1(4),and we have no employees.[No workers'comp:insurance required.] *Any applicant that checks box#I 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. tContractors that check this box must attached 9n 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. lain an employer that is providing)Porkers'compensation insurance for my employees. Below is lire policy and Job site information.Insurance Company Name:_ AT/p '�[ //�j +,i 'Tr, Policy#or Self-ins.Lie.#: Expiration Date: Q I _ )IN— Job Site Address (� • b" )1"NN+'1 L City/State/Zip: Attach a copy of the workers'compensation polic declaration page(showing tl)e policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine tip 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. f do hereby certify un it al s and alties fl ity that the:information provider/above is trite and correct. Si nature: Date: T— Phone#: 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): 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMPAGE A.I.M. Mutual Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 26158 POLICY NO. I VWC-100-6017656-20146 PRIOR NO. I VWC-100-6017656-2014A ITEM 1. The Insured: Michael McCarthy Construction Inc DBA: Mailing address: P 0 Box 52 FEIN:**=**3862 West Dennis, MA 02670 Legal Entity Type: Corporation Other workplaces riot shown above: See Location 2. The policy period is from 12/15/2014 to 12/15/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance:Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 500,000:each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 500,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTEA 0712979 INTER SEE CLASS CODE SCHEDU E Minimum Premium $550 Total Estimated Annual Premium $29,332 GOV GOV Deposit Premium $7,748 STATE CLASS MA 5479 State Assessments/Surcharges $28,601.00 x 5.8000% ' $1,659 This policy,including all endorsements is hereby countersigned b P Y 9 � Y 9 Y 12/15/2014 Authorized Signature Date Service Office: Bryden&Sullivan Ins Agcy of Dennis Inc 54 Third Avenue PO Box 1497 Burlington MA 01803 So Dennis, MA 02660 � 1 / WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, ` v� ucart with ite narmicsinn V Assessor's map and lot number*z,7,11..-P.iffe E Sewage Permit number ..................... ................... MARIST&BLE. House number ..................��Af.......................................... 219- T 0 W IN 0 F 13 A R" JIN S T ABD L E t; U BUILUIND., INSPEOhMm- APPLICATION FOR PERMIT TO .................. ................................................................. TYPE OF CONSTRUCTION ....................... ....... .................................. ............. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the followin9 information: 1 Location ....... .................... . 7 .. ..................... Proposed Use ..... ................................................................................................... Zoning District .... :....................:Fire District ........... ......4� Name of Owner /-/..... .Address ...... ........................ Name of Build, ........Address ................................ ........ .......................... ........ ... Nameof A.rchitect/................................................................Address .................................................................................... Number of Rooms ............. .............................. ... ........ ....... Exierior ........ ..........Roofing .... ...... /7 .................................. Floors ................ 4,/ .......................Interior ............ Heating .......... .....h,,X �27.......:� ..........Plumbing ..................1-1. ....... .. . ....... ........................ Fireplace ......................� 0K.-A—W..,.........................................Approximate Cost ........ ................................................... Definitive Plan Approved by Planning Board 9 Area .......................................... Diagram of Lot and I Ct� Fee ............................................. Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH t. 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 .......... . ........................... C2-,S Construction Supervisor's Licensee®.............................. I, SMITH, JAMES K. A=194-088 No ,.3 0 6 7 7 permit for „One Story Single Family Dwelling ......................................... Location .Lot #10, 80 Helmsman Drive .......................................... Centerville ............................................................................... Owner James K.....Smith ,.. . ......... ..................:...................... Type of Construction ...,.,Frame ............................... ................................................................................ Plot ............................ Lot ................................ Permit Granted April 28 , 87 . ........... ...................19 Date of Inspection ....................................19 Date Completed ......................................19 G r. ...w.,..,�..�,..:n..�,y,....,.:.�:�.:-�t-'� s'+=..�....:...;.�.- "�"."'+_'.�:."".""`.::-,-,T .".+-�.2�r, .--r�kc�r'....:.'ur—�-rw,r;��.iF-�.r�'ncfMy°=:,wr:�:�«'�•�z,.::-t=-yw- ,:.�... i „w,R.. ,;"f.��. is ^.,� oitxs� TOWN OF BARNSTABLE Permit No. 3 77...... BUILDING DEPARTMENT }"';,, I TOWN OFFICE BUILDING Cash ........ ��enar HYANNIS,MASS.02601 Bond ........�P' lvl�� CERTIFICATE OF USE AND OCCUPANCY Issued to James K. Smith Address Lot #10, 80 Helmsman Drive Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD 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. December 16. 87 / , 19................. ..... .. ............Building Inspector Inspector a'�y��•. TOWN OF BARNSTABLE , BUILDING DEPARTMENT t sssaarAM : TOWN OFFICE BUILDING rb q HYANNIS, MASS. 02601 �o rnr►• MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has/been issued for the building authorized by Building Permit #...��.V/".7z..................................................... issued to . .'.'..h..............�t b........ F ... Please release the performance bond. s DATE Za - )V-97 CONTINUATION OF ROAD BOND BUILDING PERMIT # . a 6 6 7 7 The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items are completed to the satisfaction of the Engineering Section of the Department of Public Works. 1"Xloam and seedshoulders as soon as .` weather permits. other (explain) i 14 LOCATION S SI D Owner/ ntractor r i Q EN'GINEERIN.9 UTHO ILATION Yi 41 .... l` w. .,� 4 f;•.., �. I',`!.'�'3<�r SM '40 •3 W.. AU �• 6ARNSTABLE, MASSACHUSETTS ��'� Orb _ • �n�'�'7 DATE titJZ I 2E� c1 19 �37 PERMIT • QyineL - ADDRESSiZs L%abii� •P. V lJ t.� I :/t, - (NO.) (ST,RF,ET) - (CONTR'S LI CE NSEI ERmrr TO Bui d Welling ( 1. JIdv) STORY i• t 1:1C) Li Fa l)-yl 1l1 lC•iDWELLIRNG UNITS (TYPV OF IMPROVEMENT) .NO. (PROPOSED USE) Is AT,.(LOCATION) TTSi i - ZONING 'Lot #10 80 Hc> 1 n Z✓ ?, �a::- :c�ililll .F<.{. DISTRICT (NO.) (STREET) BETWEEN ,. ., AND - .(CROSS STREET) ,(CROSS STREET) 8 LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS-TO BE FT. WIOE'BY FT. LONG BY FT. IN,;HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP - BASEMENT WALLS OUNDATION f„ (TYPE) ' ' REMARKS: :7i?wage #8 7-258 S AREA OR" 1232 `_q �J" D00.VOLUME c 0.0' PERMIT !. 00 . 77 ESTIMATED-COST 3, (CUBIC/SQUARE FEET) - A ( OWNER James K. Smi-Ch ADDRESS c1rll.st tt > BUILDING DEPT.' BY i THIS PERMIT`•CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR '�► PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED "UNDER THE BUILDING CODE, MUST BE AP- PROVED.:BY. THE.JURISDICTION. STREET OR ALLEY. GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THEDEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT'RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY'APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM of THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND ! I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. I 2..,P.RIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. I -POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 2 Z �/✓IS`A��ir P 2 3 HEATING INSPECTION APPROVALS ENG ERING EP TMENT I ,z OTHER 2 BOARD OF HEALTH .WORK 9114ALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. I"PERMIT IS ISSUED AS NOTED ABOVE NOTIFICATION. • i __._... ......f.. ,it;. ... DESIGN--- DATA. = '� SJNGLE FAMILY: =: 3 BEDROOM �o� 'A NO GARBAGE--DISPOSAL DAILY=`FLOW _ I10 x 3 = '330 G.P. D. SEPTIC= .TANK -a - 330 x 150%= 495 G.PD• USE 1000. $ GAL. TANK -i 2 �(02.S,F, n DISPOSAL =P1T-- = USE - (1) 1000 GAL. SIDEWALL AREA= 150 .S.E 150 S.E. x 2.5:-= 37.5 : G. P. D. \ „ BOTTOM AREA 50 S.F. ti 47 = •8 50 S.F. x 1.0 a - 50 G.P.D. s TOTAL •DESIGN a 425 G.PD. TOTAL :DAILY FLOW = 330 G.PD. PERCOLATION RATE 8 "1"114-2 M-IN. OR LESS � �` �wv Of SS �Ji PETER k16 v FsICHARO- •� i 9 u A �� SULLIVAN 0 aS +y EtAxTEA as r No. 29733 co No.24N8 Tfi:Rly �yb u� Fss N � Y � P- TEST HOLE- .._4 39fr2 $Ai.,11M� NvE Z11Gj Ro.3 G.(-foa> CL: 47 _._ = l.Sz-� F. G. = tl r '• • TOP FND.= - t, . . tAA��• PVC.) '''• INV �q- � 4�� SCHE0.40 l o o 07NV :.., loco n)v. ruv �rST IaJ. INV. .. CAL. I �A L. 'o lEA cA Aso �3' (.'3•Z Rx�i► (.3.4 b3.6 S 6-YTo C_ j G1t?A V _. ._ . .. .�. o T4^J�L.. P2o F lC C L`RTi Pi CD VLoT PI,A Q o'. w45lIED '" SA+�I� - o STOMI�C Ji 57 No SCALE \_O C.A-n o IQ C1:. IZ.V Iv..L. pLqN 2C_FC_j7 AXG VLSI I�tO WAS ` ��qA► 38��C�t 2'7 = C�t.T►F� Tl-IAF-T{{L •FcuwDATl a tJ SNoW N eAKTL--Y- NYcr, rkc. HEPJroL3 CQKPLY1 wiTN THE= SIoCELW Arjo 5`:T$AGK. F-GC?vIR MC='vTs oF=- TliE oS7lEz✓1LLe; —m,4ss Towel 0F PSA%21uSrATl-LIE Amp IS ?.�oT LOCATCD wrn4t?4 THIF FLOOD \'A Ar N . 19PR4-IcgAl7 :14t4E-5 k SaA� Tip . �.. 7416 PLAIQ I s NOT 6AS G-p o 1Q AIQ I N STEM I=N Su 1�.11=.Y AtVO �1-11: oF•F SL`�5 SH oval I�i I•.I t✓-12.0 o r�l �•�(i�. ^` /� a SHOULD iJUT CSC VSt:0 To (Zs-11AZUS .. H t-csr . ROUGEAU, BUTLER & LARGAY COUNSELLORS AT LAW 720 MAIN STREET POST OFFICE BOX 608 HYANNIS, MASSACHUSETTS 02601 RICHARD N. ROUGEAU (617) 771_4230 WILLIAM F. BUTLER, III RICHARD P. LARGAY April 15, 1987 Mr. Joseph Daluz Building Inspector TOWN OF BARNSTABLE Town Offices Hyannis, MA 02601 Re : LOT 10, Helmsman Drive Centerville, MA 02601 Dear Mr. Daluz : This office represents Mr. James K. Smith, Trustee of J.K.S Trust. I am writing to you regarding the issuance of a building permit for a single family residence under construction on LOT 10, Helmsman Drive, Centerville. I have completed an examination of records at the Barnstable County Registry of Deeds and the Town of Barnstable Zoning By-Law and it is my opinion that LOT 10 qualifies as a buildable lot. Lot 10 was created by an approved subdivision plan endorsed by the Town of Barnstable Planning Board on October 1 , 1984, and recorded at the Barnstable County Registry of Deeds at Plan Book 389, Page 27. Smith took title to LOT 10 on September 20 , 1985. In November of 1985, the Town of Barnstable adopted one acre zoning for the subject area. The Town of Barnstable Zoning' By-Law, Section G, paragraph E( 2 ) provides that such a lot "may be built upon for residential use for a period of five years from the date of such recording or such endorsement whichever is earlier, if , at the time of the adoption of such requirements or increased requirements, such lot was held in common ownership with that of adjoining land located in the same residential district; " . Therefore, LOT 10 enjoys "Grandfather" protection, at least until October 1, 1989. Therefore, it is my opinion, that LOT 10 complies with the Town of Barnstable Zoning By-Law* for the issuance of a building permit. Thank you for your attention to this matter. r V truly you Richard P. Largay RPL:srr "and lot number UST INSTALLED 114 COMP TOWN OF BARNSTABLE BUILDING INSPECTOR . ��0 @ 0-0� � �� .A A6 - � PERMIT .........Location . ........ .1,49 . .... ..... . ......&ze��.. .. -_-_._'-'-'-'_'---.' _-'-- �� M0TO .. - . _ ' � � _______________-.---.TYPE OF _- l9-2 TO THE INSPECTOR OF BUILDINGS: The6e for oo�r6 the f��v information-. [ � District . . .. . .. .......... . . ... ...................Address........ff-.Ioj�. . ... Nome of Archite t /---,-----..------------A66reu ------.----.------------.-.--.. - Nom6o, of --Foundation . E4orio, ..... --.uoo+ng ' - Room -----. -------.|n��o, .. ____._ HeatingPlumbing ^"--� -xn��.��,yx.^.�aor��=��----. mo/n0 -----..=�..-.. .................... Fireplace -------��,�-~�._~~��-----------.Approximate Cost --' . .. Definitive Plan Approved by Planning Board 19 Area ' of �� and Building vvhh ' ��- ' Diagram u ng Dimensions Fee ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH | ^ - . . ^ . ` . . ' . ` | ' | , . ' . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS � | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r6 construction. Name -��-. ��'..._~ Construction Supervisor's �� fd -- --_ � . ./ . One Story No ~.��.�.�..!.. Permit for ... ................................ ' --Si��/IIe—I�ami.11'..Dvve.lI.ing—_--- ' Location ..LVt—#�lU..__O0.�BeIm z�..Dr�ve ^ Centerville ----------.---------------. ' ~ . James I{ Soui�b - . Owner -------.—.�—_________~_.. Frame � Type of Construction .......................................... . ^ ............... Plot ----.----' �t —�---------. ^ ' ^ . 'ermh �ron�xJ _..�J?riI 2O �____lV 87 � . Date of Inspection ..................................... 017 Dote Completed - ` / . . ~ r . ' *% �g � � �.> ^ . / ` ~ ` . ' ``