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0073 LAKEVIEW AVENUE
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Richard V.Scali,Director �� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number Not Valid without Red X-Press Imprint Property Address 79 Lt Q k e V t'e W �V e t ��ti�e.2 �/i � Rk ❑Residential Value of Work$ edO-0-0f- 0-0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&AddressContractor's Name Name C 12 eo2 trllC ( �Gt 1� ��f��'�P17 _VtdiIOil Telephone Number 239 4/4f0 1-,2 3�/ Home Improvement Contractor License#(if applicable) 7 � �� Email: Qlej Alh e�le rry p2 a I t • ecv� Construction Supervisor's License#(if applicable) l o dyw ElWorkman's Compensation Insurance. Check one: ❑ I am a sole proprietoroM ❑ I am the Homeowner 44��77 9"'1 have Worker's Compensation Insurance p FEB � Q Insurance Company Name e e 12J CD V 2016 ' Uvvlv UP Workman's Comp.Policy# WA — C2 E �7_ I BARNSTABLE Copy of Insurance Compliance Certificate must accompany each permit. Permit Re_,qupt(check box) �� �/ ,q„/ „`QS 1„ � Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to JT /tlz 4V L L ❑Re-roof(hurricane nailed.)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Impr vement Contractors License&Construction Supervisors License is re uired. SIGNATURE: C:\Users\Decollik\AppD oca\lVTicrosoft\Window emporary Internet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 The Coinnionivealth of Massadiusefts De,pmtment of Irrrdristrial Accidents - Office of Investigations 600 Washington Street s Boston,MA 02111 wtvr%mas&ggov1dia Workers'Compensation Insurance Affidavit-Builders/Contractors/Electtricians/Plumbers Applicant Information Please Print Legibly Name(Busine ttandn ividualy _ Address: 2 CP�,�2 / ��'S b��t✓ �' �` � #� r �civ'v , ,� Der°C2 City/State/Zip: Phone 9-- Are.you an employer?Check the appropriate box; T project(required): �-. I aim a general contractor and I }�of ect p ] { etltrii d}: 1.❑ I am a employer with 6. ❑New construction employes(full and/or part-time).* have hired the sub-contractors 2_❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling slip and have no employees These sub-contractors have 8_ ❑Dernolition working forme in any e to and have workers'capacity. 9_ ❑Budding addition [No workers'comp.insurance �omp.imsurancel ❑Electrical repairs or additions required] 5_ We are a corporation and its 10.officers have exercised ter I.I. Plumbing airs or additions 3.❑ I arm a homeowner doing all wank ❑ g T'eP ' f. o workers' right.of exemption per MGL myself.[N comp- 12.E3/Roofrepairs insurance required.]I c. 152, §1(4).,and we,have no employees.[No workers' 13.❑Other camp.insurance required.] •Any apptimw that checks boa#1 mast also fill out the section below showing their woikers"compensation policy inforinatian. Homeowners who smIni it this afSde indicating they are doing all wo:lc and then Lire outside contractors must submit anew afda"t indicating socb- ZContractars that check this boa must attached an additional sheet showiing,the mmne of the sub-contractors and state whether or not those entities lave employees.If the:sub-coatractors have employees,they urust provide their workms'comp.policy number. lain art einpinyer tlurtis proi4 d zg rvorisers'coitgmrtsation inswrance for my employees. Belot$is the poLdcv and jab site inforrua darb Insurance Company Name: �Dl�� V e 4 p �j Policy#or Self-ins-Lic_#: u ` � 6 ( � AJ�1'" Expiration Date: Job Site Address e V'( e Ve C ty/StateJZip: V Attach a copy of the workers'compensation policy declaration page(showing the policy number and exph-ation date). Failure-to secure coverage as required under.Section 2.5A of MGL c. 152 can lead to the imposition of criminal penalties of 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 fume of up to$250.00 a day against the.violator. Be advised that a.copy of this statement may be forwarded'to the Office of Investigations of the DIA for insurance coverage ver fication. I do hereby ce#W&rev er thepains an dpeuea byes of perdnry thatthe information provided above is tnm and correct Si true: r Date: a2 / Phone# 0,(jaciat uss rriily. ..Do not write ire this area';to,be completed by ci1j;or town offlicia City or Town: - Permit/lAcense lssuing Authority(dMe one): 1.Board of Health 3.Building Department 3.Cityrrol"a Clerk 4.Electrical Inspector 5.Plumbing Inspector -6.Other _ Contact Perrone Phone M , Nor-6 2/9/201i6 7:36:50 AM PAGE 2/002 Fax Server CERTIFICATE OF LIABILITY INSURANCE gaTE1Mn�IDorrYrrl TIFICATE'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 0 RODU E A IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION<IS.WAIVED;subject to he terms and conditions of the policy,Certain.Volidies.may require and endorsement. A statement on this certificate does,riot confer rights to he Certificate holder in lieu of such endorsemen s PRODUCER CONTACT NAME: QUARANTELLO,INS AGCY INC PHONE FAX 226 MALDEN'ST IAIC,No,,Ext): (A/C,No): - EMAIL REVERE,MA 01151 ADDRESS: 75YPL - iNSURER(S).AFFORDING`COVERAGE INAIC INSURED INSVRERA: TRAVELERS INDEMNITY COMPANY OF AMERIC.A CREATIVE CONSTRUCTION"SOLUTIONS,INC INSURER 8: INSURER C: INSURER D: 22 FEARLESS.AVE APT 2 INSURERE: LYNN,'MA.01902 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS LS TO CERTIFY`.THAT THE POLICIES OF INSURANCE,LISTED BELOW HAVE 13FEN ISSUED TO THE INSURED NAME.ABOVE FOR THE.POLILY PERIODS INDICATED.,NOTWITHSTANDING ANY REQUIREME 89 NT,TERM CONDITION OF A14Y CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTCATE MAYBE E ISSU OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO:ALL THE TERMS;EXCLUSIONS AND.CONDITIONS:OF SUCH POLICIES,LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS: 1NSR ADD SUB POLICYEFFOATE- POLICYEXP DATE. " - LTR TYPE OF;INSURANCE L R POLICY NUMBER: (Mu11DDIYYYYf IMMDD3YYYY) LIMITS GENERAL LIABILITY -ACH OCCURRENCE $ COMMERCIAL.GENF_RAI,I.IABIILITI: CLAIMS MADEOCCUR, -DAMAGE TO RENTED -$. ' REMISES(Ea.occurrence) MEO EXP(Any one person) $ ERSONAL 8 ADV NJURY $ GEN'L AGGREGATE LIMIT APPI.IFS PER GENERAL AGGREGATE S POLICY PROJECT❑LOC RC{UUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SNULt $ ANY AUTO LIMIT,(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCFIEDULEAUTOS (Per person) HIRED`AUTOS BODILY INJURY - $ :NON-OWNED AUTOS: (Per accident) PROPERTYDAMAGE S . (Per accident) UMBRELLA.LIAS OCCUR - CACII:OC.CVRRENCE S. EXCESS LIAB CLAIMS-MADE AGGREGATE - - $ CEDUCTIBLE RETENTION$ $ A WORKER'S COMPENSATION AND X we STATUTORY On ICR EMPLOYER'S LIABILITY ;YIN 1-192E81723A-15, 03/31t201.5 03/31/2016 i_"'4'f6 ANY RRoaERITDR/aAarn eR/ExecurlyE N/A E.L.EACH ACCIDENT $, 100.000 OFFICERIMENDER CXCLUDED I Mandatory In HH) E.L DISEASE EA.EMPLOYEE $, 100,000 Ir yes,Aescrlbe under DESCRIPTION OF OPERATIONS kMIDW F.I f)ISEASE POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATION iLOCATIONS}VEHicLES)REBTRICTIONS)SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE'ISSUED TOiATI CERTIFICATE i4OLDER AFFECrNG WORKERS COMP COVERAGE: CERTIFICATE HOLDER CANCELLATION [.F.nNARD GI[[VER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED . BEFORE THE.EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED, 7:3%1;AKEV[Ew AV` IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTJ}#VE 1 f CENTERVMLE,ILIA 02632 . . ; ACORD25(2010105) The ACORD name and:Iogo are registered.marks of ACORD 1988-2010 ACORD CORPORATION. AI["rights'reserved. L. -t sanrrsrast�. a, Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner . 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder { GI" h'V as Owner of the subject property hereby authorize e,Q �4 i VO— e0 A to act on my behalf, in all matters relative to work authorized by this building permit application for.. (Address of Job) Signature of Owner Date Print Name - If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft4indows\Temporary Internet Files\Content.Ouilook\2PIOl DHR\EXPRESS.doc Revised 040215 ;o` ��r•�nrrrrit:rarirrrcrr�(�r/r�?,7i,(ird.trir•�crJr((J � .. ` -� Office of Consumer Affairs.&Busiriess Regulation ' I rHOME IMPROVEMENT CONTRACTOR i Registration 182711 Type: 4 � Expiration. xpiration 7/21 072017 Corporation CREATIVE CONSTRUCTION SOLUTIONS INC. - BOGDAN ANDREYKIV 122 FEARLESS AVE.UNIT 2 LYNN,MA 0A902 c...- ---t —- I.. Undersecretary lic Sa fe Ma ssachusetts -Department of Pub Y �✓ Board of Building Regulations and Standards Construction SuperNisor - License: CS-108278 �KIV BO GDAN AND RE _ NUJE, 2 i A _ 22 FEARLESS , L n MA 01902 _ I Expiration ii 06/25/2018 Commissioner. [ License or registration valid for individul use only j e If found return to: before the expo ration date. Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 c � Not valid without signature I Unrestricted -Buildings of any use group which contain less than 35,000 cubic feet(991m ) of enclosed space. Ii Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS J y TOWN OF BARNSTABLE BUILDING PERMITAPPLICATION Map Parcel Permit# Q� r Health Division Lz �/-� Date Issued H 2--L) Conservation Division Yht-1 tv Fee 42 Ste Tax Collector Treasurer `�°I�BYTE Planning Dept. 50 SNIP A trNSTALLE®IN G NCE Date Definitive Plan Approved by Planning Board WITH TITLE 5 , ��v��®>���eNTa�co®�a�o Historic-OKH Preservation/Hyannis TOWN REGUL AT'ONS Project Street Address Village Owner Address 7a L N),!e Nf �-e_up 4-�N2V Telephone Ete- 63r, :Permit Request &6ftw1e . ft V4,oa, +NoA 15c<-,e ena Square feet: 1st floor: existing 12,00 proposed 2nd floor: existing proposed Total new Valuation 9-SO Zoning District Flood Plain Groundwater Overlay Construction Type Woo& Lot.Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure M Historic House: ❑Yes &No . On Old King's Highway: ❑Yes 19 No Basement Type: J4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /,Coo Number of Baths: Full: existing new Half: existing / new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: %(Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes JkNo Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing ❑new size Pool:Cl existing ❑new size Barn:❑existing ❑new size — Attached garage:%I 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 BUILDER INFORMATION Name - � Telephone Number �5b8� AGO — 29 -7 Address �� 4n a SA- 5-1-� License# QtQS �-U�� S l4• Home Improvement Contractor# Worker's Compensation# 4/r= ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO j SIGNATURE DATE O�//Z/41 Y FOR OFFICIAL USE ONLY PERMIT NO. - ,- DATE ISSUED MAP/PARCEL NO. CIO ADDRESS ~' VILLAGE OWNER r' • �� �t F _r DATE OF INSPECTIekl.,4 FOUNDATION - FRAME _ INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING - - ` - DATE'CLOSED,OUT - { ASSOCIATION,PLAN NO. ' I j , t./AI-C1 vtt3 VV n,VI_,Ivut% CI N'I'1:12 VI l,l�l !VI/1 SS/�CI I tJSL:'l"I'S I I 124 I OT 123 I . 106.00 125 LOT 110 18,020 SF+- o* O o °FcK, no ST°RY N LOT 109 Q a 171.61'10 HUCKINS NECK ROAD 106.00 L-I^ 1K 11: V 1 L; w /A %1L:! 1V CJ J ZONING DETERMINATION T11E LOCATION OF TILE ORIGINAL DWELLING SHOWN HEREON EITHER WAS IN COMPLIANCE WITH TM.A APPLICABLE ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED WIT11 RESPECT TO 11ORIZONTAL DIMENSIONA REQUIREMENTS ONLY OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION. UNDER MASS. G.L. TITLE VII CHAP. 40A, SEC. 7, UNLESS MIERWISE NOTED OR SHOWN HEREON. A CONFIRMATORY INSTRUMENT SURVE IS ADVISED WFIEN STRUCTURES ARE SHOWN 'L'U 13E ONE FOOT OR LESS FROM PROPERTY OR REQUIRED ZONIN SEMACK LINES. FLOOD DEIERMINA110N VIE DWELLING SiIOWN HERE DOES NOT FALL WITHIN A SPECIAL; FTMI) HAZARD ZONE AS DELINEATED ON MAP OF C(*FV LAITY 1k 250001 *0005C AS ZONE C DATED 0/19/05 BY TIIE NATIONAL FLOOD INSURANCI PROGRAM. CERIMA)I N FNOR111 TO STEVEN J. PI7,'7,UTI, ESQ. , 6Ibe btone Raub burbey (to. ,�*�1N oy RICAN MORTGAGE COMPANY AND feu �e[by 3ltoab INSURANCE COMPANY, VAT 3 711ERE ARE NO VISIBLE ENCROALlIt1ENTS elU eD(orb, f�l� 02745 CAM ER OR EASEMENTS EXCEPT AS s11OWN AND 1-800-993-3302 ` q Tn1AT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION. fax 1.800-883-3304 �`'3 The Town of Barnstable : .�srrsresrE. • 9� 16 9. ,e$ Regulatory Services ��N,►+" Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 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. p0 Type of Work: ,9 0 _Sovo Q er k, R4—'f�� Ckee1C-_-Estimated Cost Address of Work: Owner's Name: Ac>S'p cam- Date of Application:��o 1 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 of the owner: 01 Cow c+a�J l 2�1 b?4l Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav ` I CONRAD REMODELING 10 Locust Street Hyannis MA 02601 � GDP l�l.vwoo . 3 { �Ao S �tJ ctltErl T- k� crEEM i IDS Focr�- �►� iJ +-e>M -�. G W4L — vv .. O 27� CONRAD REMODELING 10 Locust Street Hyannis MA 02601 73 LAIAE vc ew Aye— E� iF L. IT / 1 Foe r 0 N Eve r-�fLI -, CONRAD REMODELVVG 10 Locust Street Hyannis MA 02601 73 ►yam �-\C) v C, .,w_ ELF L P p. . l VIN i i r Qu1}l �JM� E��p� rl�A� it �Ci= 1 Fo o'r COAR AD REMODELING 10 Locust Street Hyannis MA. 02601 f . noo i i} I , } ��E � `.• gt��.s-w� Sc�..c��.�..w� 3� SGrwuv �,��Lr•'dw rti �" T 4 k r �/1Lo l�'IY/ItII[(.'IlfIM.CLLCiL rlL.. G/<1::::flf'11fGJGcft' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 009857 Birthdate: 12/23/1956 Expires: 12/23/200V Tr.no: 13457 Restricted To: 00 JEFFREY M CONRAD 10 LOCUST ST "'''. / HYANNIS, MA 02601 Administrator ;Tide �omma�w�ea�!✓n�'`taarf�c�u�.;ell I, /. cxairation Conrad Remoceiing Jeffrey M. Conrad G� 0 ocuet Sr Mrs 02601 noADMINISTRATORwNY'�nniS _ I ESTIMA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet.X$115/sq. foot= (above average construction) square feet X$96/sq. foot (average construction) square feet X$57/sq. foot= • GARAGE (UNFINISHED) - square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= EC square feet X$15/sq. foot OTHER off-® a O square feet X$??/sq. foot= Total Estimated Project Value The Commonwealth of lllassachuse= Department.of'Industrial Accidents ( ` 4 „ Ol�lceollarestlgatlods 600 Washington Street f Boston,Mass. 02111 Workers' Cam ensation Insurance davit RE �i�.'M %%/��i�,��/�, �%///'//i///%///ice%%i'��/�%%///i/%%%/r%/ir„": name' C©W location- S-F- city Y`) t hone Zvo ` ❑ I am a homeowner performing all work myself I am a sole MUU'L etor and Dave no one v mime in aav caaacity u ❑ I am era:employer providing workers' tamnpeasamion far my employees wodang on this j ob. 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I m dersrand that cuff of this stattmmt may be forwarded to the OMce oflnverdpdam of We DIA for taMasioa. I do har3y ceri*wide the polls artd of perfsry that the information provided above is vw and correct S Date O/ ?:10/ Punt name r f,4 ✓2 C a143 i"NPYQ Phnae it ofncLal use only do not write in this arm to be eompicted by aty or town ofndal dty or town: perndocense 0 ❑Bmidiag Depsr=ccl ❑Idcenstag Board ❑chceleif iamtedlste response is required ❑Selecttnen's MEL= ❑Health Deparsm� contact person: phone M. 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TYPE OF CONSTRUCTION ... ..................................................................................................................................... ................ ............19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applie for a permit according to the following information: Location ........... ..... ..............��,d.r,V..r-:We.45k!4�.......................................... ProposedUse ...............:� ! �1. ................................................................................................................................ Zoning District -.l. ................Fire District ...�..e:-4!T Name of Owner ........ ...........Address .........1.7-TA.1.{.exV.44W....1f 7.....zwo Y� Nameof Builder ....................................................................Address .................................................................................... Name of Architect .................Address ....0v!sC.....ry Vd.z.......f? Numberof Rooms ........... ....................................................Foundation ...........I r*�1.C'. 7K......................................... Exterior del—lx -K.....1' '?��'� �......4W4,A94;-...Roofing .......fP.X,47".L,. 7.................................................. Floors > '' !�G..................................................Interior. ........... �1b✓Gcl�d��i. ................................................ Heating ................... ...............................................Plumbing ...............e ........................................ R. ./ Fireplace .......................d...[/ ................................................Approximate Cost',. Difinitive Plan Approved by Planning Board --------- _-----------19_�', a 0 Diagram of Lot and Building with Dimensions ^W V 4 - m t A 7' (� \Y1 i�� o -00 ZQ z w cr w ac ¢ � � � m 0 Ld 0 f5 in Q �Z Cr .�'�u'i © gym , 0O w . I^ m W -(� i ems, _ - -- 3 WW ' z -� to ~ W "xn q a � Q N Z z �o < L a pV ,l 1a6. � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ ........k"'."azexaf ............ Holly Development Corp. No ..�5�75.... 'Permit for .....one story.......... single family di,yelling I9 Location .........akeview `rive Centerville ............................................................................... Owner ...........Holly. ..Develo.pment..Corp. 1 .... ...... ............. ........... .............. f rame Type of Construction .......................................... ..................................................I............................. i Plot ......................... .. Lot .........110............... Permit Granted ...... ...................19 72 /� �.� AA Date of Inspection . .. 73 ,�t. G Date Completed ....... .. ... ..............19 Z I n 1.6 Cuft PERMIT REFUSED j ................................................................ 19 ....... .......... ........................ s ............................................................................... I Approved ................................................. 19 r ............................................................................... ...............................................................................