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i r � ' / -® .' SEPTIC SYSTEM DUST BE� Assessors map and lot number ... ..... ... ...... . THE
INSTALLED IN COMPLIANCE ropy
Sewage Permit number .............`rJ................. ........ WITH TITLE 5
ENVIRONMENTAL CODE AN t DA"STA.BLE,
House number ..................: ... 3.`y................................ TOWN REGULATIONS 90o Me 9
TOWN OF BARNSTABLE
BUILDING -INSPECTOR
APPLICATION FOR PERMIT TO !V :. :........1........ ........... ..... .... .........................
...� !� .TYPE OF CONSTRUCTION ....... . . ...... ........... .............................. ..................................
.../. . ............. .............19. ..GJ
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ............ ..... � ..:1.. ......... .5,./.1/.7.1/......4 .. ,j�.. .. .... .... ....................
- 1
ProposedUse .........6).�../../�.✓.:. ....................................................................................................................
Zoning District .......... :. ...............................Fire District .............. ,1 ...........................
.... .. ......._
Name of Owner .....1... v4. .........................Address .f�/••. ....� ../...��. .......
Name of Builder/ '�1 ._' .,//D. � ............Address ....................:................................................
Name of Architect � . 7 ik. e�i d dress 1✓•J ... C!.� .......... ....
7
Number of Rooms ...... � ........................................Foundation .......:�........ . ....... /l........ ..... .... ...... . ..... ..
Exterior ........ . .. 0��... ��.. .................................Roofing ........... �' "iv••
�.�i / ..................
Floors Interior ......... ....................
......... ........... .................`..... ..... .............................
Heating /... Plumbing .. ..:..�... ...��..r�..... �... .... .... .....
0� �..
Fireplace .... Approximate Cost ...............1.. .
. ` .. ..........................,....
Definitive Plan Approved by Planning Board ________________________________19________. Area ..... 4�1-7... ..."�:....:.....
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
c�
ry
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re rding the above
construction.
Name .... .. .... ............................:..........
Construction Supervisor's Licens0. ."/..... 1.....
I
,moo• TOWN OF BARNSTABLE Permit No. ____27853______
Building Inspector cash _____��_
OCCUPANCY PERMIT Bond _____X_
Issued to S L S Trust Address
Lot 642, 134 Zero Crocker Road, Centerville
Wiring Inspector Inspection date `
Plumbing Inspector 1' Inspection date
Gas Inspector ; Inspection date
Engineering Department IrInspection date
Board of Health ( Inspection date
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.
......._
v Building Inspector
L S TRUST
27853 3-
No .. Permit for ...1 . Story
.......... ingle...F.am.-i—1,...Dwe•1 l•ing...........
Location ..L'Lfi.4. , 134,„ eT.1;o...Q.rpCher. Rd.
' Centerville y
Owner .......S...I 5.....Trust........................... y
Type of Construction ...,Frame
................................................................................ - r
Plot ........................ Lot ................................
Permit Granted ......May 7, ...... :...... 8 5 ,^
s
Date of Inspection 19 t
Date Comp ......;�:t.............19
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css�0 ALISLAI/Ju u NDAT/ON Cl�PT/F/G.fT/D
On the' J of my knowledge, information and
belief, I certify to The Town of Barnstable, 'LOT G�2 ZENO CiP�KF�P
The Boston Five Cents Savings Bank .and Ticor
Title Insurance, Co. that as a -result of a ; -
,survey made on the ground on I find
that:
The structure-(s) are located on the site as
shown. :/SAY 2, /9�s SCALE :-. =ZD
The title lines and lines of occupation of the .
site are as shown hereon.
The site is situated in Flood Zone 5504. /NG