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BY DATE SUBJECT._.,........................................... .................. SHEET NO. OF
CHrD. BY`. DATE ...........................................................I.................._...... JOB NO............................,................
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--.. 7� SEPTIC SYSTEM MUST BE'
Sewage Permit number ... INSTALLED IN CD���i?LIANCE.
WITH Ar.,ICLE II STATE
yoFT"ET TOWN OF BARNWhTX19itNDTOWN
H8HHSTLBLE, i
"6 9 .•� BUILDING INSPECTOR
APPLICATIONFOR PERMIT TO ....v!®.................................................................................................................
TYPEOF CONSTRUCTION .......... .................................................................................................
... ..........19 7
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following info ation:
Location ....... .......... .............. .. ...... . .. . ... .. .. ....... ............. .. ........... ................................................
ProposedUse ... ., 'C..z .................................. ...............................................................................
ZoningDistrict ................................... ...................................Fire District ......... .................................. ...............................
�.. ....... .......................Address ......................- ." .. ................................................
Name of Owner ....J �'�
Nameof Builder ...............s. ..............................:................Address .........................'..........................................................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ........... ..............................................Foundation .........................:........." ......................................
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Exterior ,. ..... .......�C-�.......................................Roofing ......... ......Cr• ••'•••...................................
Floors ......................Interior ...... ... . f..
.................................... ....... .................................
Heating ....!.....H........:'`�..............................Plumbing ................. .......... ....................................................
Fireplace . ......................................Approximate Cost .......... y!...
O...... ................. ... ....... .... p y� .I....
Definitive Plan Approved by PI nng Board ________________________________19________. Area ................ 0.................
Diagram of Lot and Building with Dimensions Fee .........�/..........—...............
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable garding the above
construction.
Name ..........................r.......................................................
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Small, Alan E.
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'No � Permit f=o_^~ mom story,
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Location �-..��������.------------- ~ �
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Centerville ~ '
----.----.---------------.—, "
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Alan E. Small \ '
Owner ---------�-----------'— � \
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Typo of Construction .....�����-------- .
................................. 7t
Plot --.----......... Lot __ ____\
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23 7� ' �
Permit Qron�xJ ---�.���.����----.]P '
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Date of Inspection ��./��
Dote Complete6 ...x. .. .............................
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PERMIT REFUSED
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......................................... .....................................
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Approved ................................................. lg
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