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HomeMy WebLinkAbout0055 FORSYTH COURT �� �� /� 1 j f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel�S. Application e6'6�{ # Health Division Date Issued re Division Application'Fee u Tax Collector Permit Fee`��. Treasurer Planning Dept. •�, '' Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address.S s /,LE coo 10 Village7� 1 Owner A 4� 1®I f^' � G Address_15— /L S `J V 0�✓1- Telephone Permit Request 67 Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay u� -4. Project Valuation Construction Type v--�Z i Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Q-' Two Family ❑ Multi-Family(#units) Age of Existing Structure -� Historic House: ❑Yes a No— On Old King's Highway: ❑Yes 21-N0- Basement Type: Ui ftll ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing—A new Half:existing new f Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing new First Floor Room Count M _g � Heat Type and Fuel: ❑Gas a 0^ ❑ Electric ❑Other ; �a Central Air. ❑ No Fireplaces: Existing New 0 Existing wood/coal stove: 0 Yes [A-Pdv` Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑ex sting L Rew size �4 Attached garage:l�'�zisting ❑new size Shed: xisting ❑new size/� 9 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Uhlro — If yes, site plan review# Current Use P� t 0 X-7-L Proposed Use BUILDER INFORMATION Name ! 4✓4 AV Telephone Number ? 9 C( G Address License# S l pk 4-as-—o w^j Home Improvement Contractor# 4 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE d FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE OWNER y DATE OF INSPECTION: FOUNDATION y FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL k ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL R FINAL BUILDING / oa- DATE CLOSED OUT ASSOCIATION PLAN NO. r 1 � ; The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street' s Boston, MA 0211 i .� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information a Please Print Legibly NaMe(Business/Organization/Individual): En w tA.fz- t)vi /W 6 Address:ffe)>e l// S" /1-1Jf/2-3 7'a 14g r "CZ G City/State/Zip: Phone.#: 9 ? 0213 F. 9 Are you an employer?Check the appropriate box: Type of project(required): 1.©-f am a employer with V 4. ❑ I am a general contractor and I 6. ❑New construction employees(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 ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' ' Y P tY $ 9. ❑Building addition [No workers' comp.insurance. comp.insurance. required.] 5. ❑ We are a corporation and its "' 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. F right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4), and we have no .. employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 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. lContractors that check this box must attached an 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. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site ' information. Insurance Company Name: L Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: S: e S' City/State/Zip: y Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under;Section 25A 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 fine 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 verification. I do hereby certify under the pains andpenalties ofpeijury that the information provided above is true and correct. Signature: Date: Phone#: ? 7 ` 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 Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: ' I Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a buusiness or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter-152, §25C(7)states`Neither theecommonwealth 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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your 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 Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-72.7-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-77451 Revised 11-22-06 www.mass.gov/dia It-) `v 1),) G F # S IMPORTANT - UPGRADE REQUIRED r STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE C+�R TICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. I CARBON MONOXIDE ALARMS FSIGNATURES ECTO S REVIEWED -- ,- MUST BE INSTALLED PER EVIIED ---------------- _ ! MASSACHUSETTS BUILDING CODE ILDING DEPT. i - I �ATE r , i i RTMENT DATE RE REQUIRED FOR PERMITTING , � X�G /�IC4) of i j,co OAD Z� OIL a kSs -j-clSr, �� lrff SaGrn L✓ �Un �JcJ yr§I J r ., -- /ALL E7 w A.) l w G \ R 1 i f OL S,�l���n hl F- G L 0 SF.1 j o I x 'IJac.L/O'�Ii/IYL042CIIPp�LO� - Board of Building Regulations an tan Ards x :_Construction Supervisor License ` License CS 19597 ` G +s" Expirat on 40/22/2009 Tr# 7332 'Re�stnctign 00;,1, EDWARDJ FANNINGR i` 1 / k • $ PO BOX 1115 i MARSTONS MILLS,:NAA02648 Commissioner s a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 1.11163 Board of Building Regulations and Standards y Expiration 12/9/2008. Tr# 125441 One Ashburton Place Rm 1301 Y,Type Individual Boston,Ma.02108 f Y 3 EDWARDJFANNING EDWARD FANNING 54 SASSACUS RD '02648 M' RSTONS MILLS,MA ,rdmmistrator u ._ .., : .;_Not v i thou :ignature I B-25-2068 10:28 From:MARK SYLVIA INS 5034209227 To:5087906230 P.1/2 ,ACORD,N . ,CERTIFICATE QF LIABILITY INSURANCE °02RO/2008 OOUCER Serial# 101980 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARK SYLVIA INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 771 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OST'ERVILLE,MA 02666 TEL: 608-428-0440 FAX: 808420-9227 INSURERS AFFORDING COVERAGE NAIL# IN6UNCD INSURER Ai FARM FAMILY CASUALTY INSURANCE CO EDWARD J FANNING INSURER D' DBA EJ FANNING REMODELING PO 90X 1115 INSURER C:' MARSTONS MILLS, MA 02648-5115 IN13uRER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BBON ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE'OF INSURANCIZ POLICY NUMBOR P I d P OT P ma N LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 000 000 A X COMMCRCIALGE'NSALLIABILITY 2001XO504 04/162007 04/162008 NO_ D c TIED S 50 000 GLAIM9 MADE OCCUR MRD r4XP An one -!=O S 5.000 PERSONAL&ADV INJURY 8 1,.00,000 GFNrRAL AOnar::GATR 2 000 000 CEN'L AGGREGATE LIMIT APPLIES PER PRDDUC'rr CO PLOP AGO S 2,0001000 POLICY P L.c AUTOMODILD LIABILITY COMBINED SINGLE LIMIT S ANY AUTO lEa eooldent) ALL OWNED AUTO$ PODGY INJURY S (Por pareon) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY NON•OWNEO AUTOS (Per smidum) P2DK"dY J)AMAGC ( r-4 on l) GARAGl!LIABILITY AUTO ONLY•©A ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AOG $ EXCESSIUMBRELLA LIABILITY 13ACH OCCURRENCE OCCUR El CLAIMS MADE AGOREGATG 9 9 DGOUCTI©LLr 6 RETENTION S WORKI"A'S COMPENSATION AND 2001 W 6246 04/16/2007 04/162008 X A EMPLOYERS'LIABILITY ANY PROPRIE3TORIPARTNERIEXECUTIVE EL PEACH ACCIDENT 6 100 000 OFFICER/MEMBER EXCLUDED? FL IRP_ASFZ.IAA'BMPLOYI G S 100,000 It yyooui dosaribo under` L 500 OOO sPFGIAL PROVISIONS below EL OMEASR•POLICY 'MIT 6 OTHOR D(ISCRIPTTON OP OPURATIONWLOCATIONBNEHICL981EXCLUSIONS ADDIID BY 6NDORSOMONTISPECIAL PROVISIONS CARPENTRY THE WORKERS'COMPENSATION.POI-ICY DOES NOT PROVIDE COVERAGE FOR EDWARO J. FANNING CERTIFICATE HOLDER CANC13LLATION I s�4�t AHOULOANY OF THi3 ABOVC DESCRIBED POLICIES 84 CANCQI LED BEFORE THr gWIRATION TOWN OF BARN$TA6LE GATE THEREOP,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN BUILDING DEFT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT;DU'FAILURE TO DO 80 SHALL I OSQ NO OBLIGATION OR LIABILITY OF ANY KIND UPON THC INSURER,ITS AGENTS OR 200 MAIN STREET I. J-�" HYANNIS, MA 02601 s � AcsL$dTATIVEB AUTHORIZ1990 REPROBONTATIVO FAX: 508-790.8230 DEB$ ,'�Ir� ACORO 26(2061108) 0 CORE CORPORATION 1098 °FINE Tp�� Town of Barnstable Regulatory Services Y M BARNSTABLE, MASS. $ Thomas F.Geiler,Director �A t6gq. ♦�' rFnr,�►s 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 Property Owner Must Complete and Sign This Section If Using A Builder I, 4C53e 0//VCY 41 , as Owner of the property, , J hereby authorize ED 4,j d iJ rJ f W to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) -Z44. 3 Signature of Owner Date o Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse Ad'e.` Q:FORMS:O WNERPERMISS ION T� �oFTHE T°wti Town of Barnstable " y�P Regulatory Services " �+ BARNSTABLE, Thomas F.Geiler,Director• ,p MASS. 9,A 039• A,0 Building Division rfD MA'1 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 l HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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 doesSnot possess a license,provided that the owner acts as supervisor. DEFINITION 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 compliance with the State Building Code and other applicable codes,bylaws,rules 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 requirements. Signature of Homeowner Approval of Building Official Note: Three-fainily 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 home:�°v�s 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 homeowner 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. Q:foi-ms:homeexempt Barnstable *Permit# � ,VIVA, Town of B Fxptres dronths from issue date �do f b . Regulatory Services Fee NAsBI'E'$ Thomas F. Geller,Director Ec iu.+"'� Building Division x-PR"t SS Tom Perry, Building Commissioner 200 Main Street,-Hyannis,MA.02601 PERA11� Office; 508-s62-�4038 TO JUC 2 82004 ✓ N OF Fax; sob 790-623o SS PERNBT APPLICATION - RESIDENTIAL ON&-&/VST,48LE E�II'RE r Not Valid without Red X Press Imprint Map(parcel Number y`7 �-- � Property Address J value of Work esidential ^ , Owner's Name&Address C� � lephone Number Contractor's Nana 1 � , Contractor License#(if applicable) Home ZmproveIDent Construction Sup ervisor's License#(if applicable) rkmn's Compensation Insurance '--�� Check one: 1 am,a sole proprietor 1 am the Homeowner ave Worker's Compensation Insurance Insurance Company Name Workaian's Comp.Policy# Permit RV. e"I001 k box) (stripping old shingles) All construction debris will be taken to existing layers of roof) []Re-roof(not stripping. Going over y [] Replacement Windows. UValue,_._--- (maximum.44) *where req e� � �°f perm►t does not exempt compliance with other town department regulations,Le.Mtorie,Conservation,etc. ***Note: Property Owner must sign Property owner Letter of permission. Home Improvement Contractors License is required. Signature444 Z. David Sawyer Construction �. 318 Meiggs Backus Road Sandwich, MA 02563 (508)-539-1992 Pro osal Su miffed To: Work Place: Date �?-O? M � duo Strip, Remove, and Haul Away all old roof shingles. SUPPLY&INSTALL: dCV&(�(�" C44 block— n144- 4t'04 nta) Pi p-& w�vdAca.a rr VaLL �,�. �ua1,vin�� � � tau-, � �c�. �� ou�P t� W CLEAN&REMOVE ALL DEBRIS FROM WORK PLACE AFTER JOB IS COMPLETED. ALL DEBRIS TO LANDFILL. 3c TOTAL INVESTMENT FOR MATERIAL&LABOR$ o2/, OVO,60 All material is guaranteed to be as specified, and the above work to be performed in accordance with the specifications submitted for the above work and completed in a substantial workmanlike manner. Payments to be made as follows Any alteration or deviation from the work specifications involving extra costs will be executed only upon written order,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. 10YEAR LABOR WARRANTY/PLUS MANUFACTURES SHINGLE WARRANTY. NOTE-This proposal may be withdrawn by us if not accepted wi 0 days. Respectfully submitted ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payments will be made as outlined above. Da & Z b / Signatur br6dam- nova c� s. Board of Building Regula 'ons and Standards One Ashburton Place -.Room 1301 . Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 134313 Type: DBA Expiration: 10/24/2005 DAVID SAWYER CONSTRUCTION DAVID SAWYER 318 MEIGGS BACKUS RD. SANDWICH, MA 02563 Update Address and return card.Mark reason for change. Address Renewal F1 Employment Lost Card Board or Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 134313 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 10/24/2005 Boston,Ma.02108 Type: DBA DAVID SAWYER CONSTRUCTION DAVID SAWYER 318 MEIGGS BACKUS RD. , SANDWICH,MA 02563 Administrator Not v i wl. out signature f,~ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ��,� Map 0��Parcel Permit# �/ �~ Health Division IV Date Issued k"16a Conservation Division ` Application Fee Tax Collector LC SEPTIC SYSTE Treasurer INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5- ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis 3 /] r Project Street Address Y-L,3VV-,qF1r Villag� �� Owner Az_E�k Q I � �� Address Telephone Permit Request 9 O y D-VW Jai PY4 ;J n�Fs-1Ci Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatior/tf` o� Construction Type &J-"" Lot Size Grandfathered: ❑Yes ❑No .If yes, attach supporting documentation. Dwelling Type: Single Family 9L----Two Family U Multi-Family(#units) Age of Existing Structure Historic House: U Yes Rf+k On Old King's Highway: ❑Yes 4-No Basement Type: Ef Ftti—U Crawl U 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&nt C) Heat Type and Fuel: it ❑ Electric ❑Other Central Air: � ❑No Fireplaces: Existing New Existing wood/C' I stove: -1 Yesa' Eft Detached garage:U existing ❑new size Pool:.0 existing ❑new size Barn:U e isting aew 50ze r11J co Attached garage:Ong ❑new size Shed:U existing ❑new size Other: '- Zoning`BoardofAppealsAuthorization U Appeal#- --_R-_ _- -_ --Recorded.Q_, Commercial ❑Yes C If yes, site plan review# Current Used Proposed Use Y` tt--��—, A) �/ BUILDER INFORMATION Lf l Pff Name �I � V�Yl�"�/�'Pelephone Number Address/U Z�x /// S License# o S 01 ( -5 4mj- Lei Home Improvement Contractor# Worker's Compensation#CZ0_5 , (A/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �V �S SIGNATURE DATE 671i D 9-;' FOR OFFICIAL USE ONLY• u PERMIT NO. DATE RUED MAP/PARCEL NO. - ADDRESS - VILLAGE- r } OWNER DATE OF INSPECTION: f FOUNDATION J FRAME INSULATION ; 1 r ' FIREPLACE t ELECTRICAL: ROU- FINAL c j PLUMBING: RC7' G .,, FINAL - m s { GAS: R(r S'zz m FINAL m20F= � FINAL BUILDING tr r— Tit S DATE CLOSED OUT M 0 ASSOCIATION PLAN NO. 4 - - lw RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 _ Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _ square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE i square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $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: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) - Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost To vm of Barnstable oY•tKe ro�� • • , o� Reguiato y.Services .�- � a • srear�, � Thomas F.Geiler,birector Building Division q�j°lFD�P4 kti� , Tom P erry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , Fax: 508-790-6230 Office: 508.862-4038 , P Date AFb'7.DAYIT CONTRACTOR ' SUPPLE O�M NT T ERM[T APPLICATION MGL a.142A requires that econstructio alterations zenovation,repair,madeznizatlon,conversion, •improvement,remov , emolitio , r nstra dditi.onto anypie-existing owner-occupied budding aontainirig a sat one not more than four dwelling units or to structures which axe adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements, f'Z-" C-0 Estimated COSt14—=, e of W Tye �• � �� Address of Wozk: , Owner'eNaha; LF� �� v✓��d Date of Application: 0,� I hereby certify that: geOtration is not requited for the following reason(s); , (]Work excluded bylaw []Job Under$1,000 , []Building not ovmer-occupied []Owner pulling own permit Notice is hereby given that: Ogg PVI,I,TN G THEIR OWN PERMIT OR DEALING OYEMENT WORK Do NOT HAYS CONrF-kCTORS FOR APPLICABLE HOME IlNP ACCESS TO THE MITRATION PRO GRAM OR GUA -AI�TX FUND UNDER 1V!GL e,1�2A. SIGNED UNDERPENALTIBS OF PERM Thereby apply for apermit as file agept of the owner; Uyd Contractor Name Registrationl�Io. ate OR Owner's Maine _ ' The Commonwealth of Massachusetts —�4 .Department of Industrial Accidents ' �16�r BfaG►�sd�s' 600 Washington Street Boston,Mass. 02111 Workers' Com ensation.'Insurance Affidavit-General Businesses ' �, ',r.'y''�+''�G.4/c��� �� �'�.t.;'>kSt.s> '' •t'•.: '""lyh4., '"�!wr.. ... 1"'R-'si • IISIIle' �{�/^I4yl t"'/�• •' 4 ;.CJ`/�/��l��t� �" — address• � U'1�' ��� � - .. city ~ �! /I'E,Z LLB t state;/ ' zin: (.1 `"�yd ybone# work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment worldng in any capacity. ❑Office❑ Sales(including.Real Estate,Autos etc.)" am an em to er with Q em 'lo es(full part time. Other I am an employer providing workers'comuensa or my employees worldng on this job. t.. - coiiipanymame• ' i. city .phone.#: 0 surance. .m cd „y. l "'# I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: coinpany name (: address: - city U fione'#: insurance co..".� =•- .. :.`.. ::`��. company-n airie x city' uhone isf�` 71 insurance so Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of.$100.00 a day against me. I understand that g copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under thepain and penalties ofperjury that the information provided above is true and correct =-g Signa Date el, / Print Phone# � rfficial use only do not write in this area to be completed by city or town official L.he. pgrmitgicense# e. []Building Department v ❑Licensing Board F mediate response is required []Selectmen's Office E]Health Department n: phone#; ❑Other ) 4 Information and Instructions Massachusetts General Laws chapter 152 section 25.requires all employers to provide workers' compensation for their. employees. As quoted from the i'law", an employee is defined as every person m the service of another under any contract 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 bean employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.comnnonwealth 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 permit/license number which will be used as a reference number. The.affidavits may be.returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would lice 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 eln"of wesngmRs 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext.406 of T Town of Barnstable Regulatory Services BAMSWM ' Thomas T.Geiler,Director KAM 1639• Building DIVIS]AII g - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as.,0uinex.of the.subject propettp ._......._... .: hereby authorize d 4E : . .to Act on znp.behalf,. in all mattets zdative to work authorized-bp.this building•permit•application for: 5� �dzryT�r dZ Cis (Address of Job) ; Signatute of Owner Date Fl- - R✓J i• 0�/Is LL O P riat Name • {. ,per �JZC '(OO�IJ%/IlZ04t[!/C2L /(/ (LC12uoe4co is II \ Board ot-Auilding 1 'egulauulis anJ Stand�rras Luense or registration valid.for md'►viduluse only HOME IMPRObE�2lENT CgNTRACTOit_ befure"the ezpnatiowdate. If found return to: Board of Building Regulations and Standards Registration 19 1163 'One Ashburton Place Rm 1301 lug Expirat on 1 21912 0 04 Boston,Ma.02108 u Type Ir{div,dual EDWARD J FANNING , t %` i EDWARD FANNING 54 SASSACUS RD MARSTONS MILLS,MA 02648 .Adinistrator t d svi t signature m Ir Tie iJonvrreoauuea�C�i o�:. aaaelze P I � I BOARD OF BUIL``DINGREGULATIONS Li cent eCONSTRUCTION S.UPERWISOR A 4s Number CS OT9597 w Birthdate 10/22/T9,46 h -- Expires 10%22/20.05 Tr.no: 8107.0 Restricted £00 ! ; EDWARD-J FANNING ;I -PO`BOX 1115 MARSTONS MILLS, MA 02648Ad � Adm,mstrator , a Iip A. . Y , t AP .055 # 55 o 55 06 59 c:\conservation.dgn 6/14/2004 9:52:02 AM y7#E , f _/J vJ E.J. Fanning Remodeling P.O. Box 1115 Marston Mills ass C/ f 02648 Al It X/O N � v c ... 3�i' / mil !� Ajar r �v �. `f - E.J. Fanning Remodeling P.O. Box 1115 y Marstons Mills Mass 02648 rD' _ 19 H po v _ tr ' ti •'_, TOWN OF BARNSTABLE Permit No. -------.--— . Building Inspector �aun.br Cash - - -———--- .YL .syv. NO OCCUPANCY PERMIT Bond ------. Issued to _ aaI t--y Address Wiring Inspector Inspection date Plumbing Inspector' Awl / Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health —,f Inspection date r 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. ....................................................... 19......_._ .................................................................................................._ .... Building Inspector r�- - FROM 4 TOWN OF BARNSTABLE EUILDING DEPARTMENT Myr.�,�.,Francis Lahtei ne, T rt Ei7 MAIN STREET I ANNIS, MA 0*1 own Clerk ° '^v r m .c• -...-es +y.v:ro+'ns�.a _ ME.#r.5.t+m.Ri+a+IP tlR FI"V 4'n•4 xawR yF Phone: 776 1120 SUBJECT: ,. FOLD HERE - DATE MESSAGE a4+1.+fir ♦.4sq.w is a .. - Fork has,'been scar le d miler Permit 026059 (W ] l-_4ty �4. C ?I.M-+�d. N w Please - - ,. �t rel.�se„&gad.. t SIGNED - ... DATE f REPLY W87-RMI .Y. RECIPIENT: RETAIN WHITE COPY,,RETURN PINK COPY • - - • y PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY,SEND WHITE AND PINK COPIES WITH CARBON INTACT. `" z { o x r �iJL� 4S f Y ol k ♦. ',<r Eta H }._., ' }. t � �za�o CEQT1FtED` 'PLOT' Pt,.-4%-J- . 3 +�c'fSTg� �� A �a suR`I�'i LOGATIo�4 Ir ME �6RTt �f TIdAT TN -w4DkTl09 -5"0..UU - - W I TN Tt••1Es 51 D E. ' %4>LQ ral aN 'i CcrKPLYS AND SET$ACK,..IEgUiREN�ENTS OF TN�c , � • t _'t�..�►R.iJ`�T"� A�.iD 1S I�dT G G, �( -Tcw u �LoLA'TE� W.tT1-l'�'� IFLoOD/� F1LAlIJ BAIATCVZ �• UYE' t�.JG. i �i 2-$•�,S{. � � REGISc� SueVEYeItS OA'Tr=: OS'TEQV% .U= ..'TNPs- t7 ♦.AW +s war 15A•SE•D LIJs YeJMEIJT �jt,lRvr.,f 4 TEAL- VFC5FT4 '5140" WD APPL1 GA►�t-r+ ' <..I N�S usSc To �DeTCvMINC f4 . � X''�'� '9�t•,¢'�� �"�:, -,� `1f �""say •rX : '` .r - � j; `� N (/ /yJ j , A s sessor's ma and lot numbed ...� THE r g i MUST 371 ��pF t0�♦� �;� 4/ / _. wSewa a Permit .number 1 /...�� �?�1.. r N COY P r"" r Afl � � Z H9TAD E. House number ...................... ... ............................... I �� ? 90E Maas a; 03 NViRONIV �'1Ao�4 �dr,.-•sMe - �{ TOWN OF BAR 1`STA°BLE21 U I L D'I N'G� INSPECTOR ' ,'APPLICATION FOR-_PERMIT TO F.�k�4.. .. nvio t .... ... ✓ r..... � iZ:�d $3, TYPE OF CONSTRUCTION• ..W®�. t!` ........ ..... . sF f i QQ TO THE INSPECTOR.:OF .BUILDINGS: : 5 The undersigned 'hereby applies for a :permit according :to the following information: Location ... �?.! lop... .. `. f Proposed Use p ... .... ... Zoning District :..:... `..... .... ....... ....... ..................Fire District ..* 4 .1. .:.....:. Name of Owner !!�!�: o. . Address ' �X. .� �....... � //� ��jif.55. b . Name of Builder lv l.L 1, V IZ \ .... �i� ?. �! � � .:'. .�-' 4) �1'(I S• Address .. ..... Name of Architect .............................:.....:..............................Address ...,.........,..... .................... - /® ` F 157 Number of Rooms ... ....:. �C�L.x'.A ��� —!E ...... ......... ......... ...:.............:Foundation ..... ......... . ..... .. . ......... r _ . -.....0 �1� .�r1..... C'�r1r"r��t1 �C/�S l F 1. 1 Exterior W1�' ..Roofing ........'. .....r.Y.. ............................................................ .'Floors ���..r. 1z''r/V......�'.:..�%���--....._..._.... .Interior ...51Ctr�!�........ ;�+......�..........�-?2...:.......... e 9' , �.. �� Cr�� 9 vC_ l'1� ................................. H'edtin a.... ..... ..... .. ................ .....Plumbin 4f Fireplace ..... ......................... ....:::...................M.........Approximate. Cost � ..G...Q......... .. , Definitive Plan Approved by Planning Board __________________ __________19________ Area_ .....s?�..� ........:...... •,,'D_iagram of Lot and Building with Dimensions Fee Fv� SUBJECT TO APPROVAL OF BOARD OF HEALTH MYTH Cu^U'ri j NO 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. r Name Z.........!:.......`..:L�ie.. ....................... 0%Z y55 Construction Supervisor's License .................... ............... ' W. E- REALTY •TRUST o iNo .,26059 Permit"for One Story. .:.. Single ly Dwelling. .... ^� v Location ..Lot 40, 55 Forsyth Court < r ........................ s r Cotuit ti .............................. Owner .. W. E. Realty Trust P' ................. .. ...... ......... ....... Type..of Construction ............................ Plot Lot.,, ...... c w February 9, 84 Permit Gragted ........................................19 Dgtdjof Inspections•'.'•:.. .............. .. 19 { � �D e Completed . ..... 19 .% .�v � � - '-• ,. �� ..... s �_ - •..' t �.,, . fir. .,. _ . � , i� Assessors map and�lot.numb r .... THE T : y } t} SI�r �1 Q�� Off♦ Sewage Permit number .. .4. .......... .. ....... .. ��., ``:E�i�.! C3 r i '�4STi IDS ��` Aj IT58TIR-E . Z A"STULE, i House,number ... ... ... ....... .... E/ 9Q M6 t� B t @a r' a ��yy�q DNA TOWN OF BAR I STABLE Y RUILDIRG INSPECTOR " (� APPLICATION FOR PERMIT TO C .N.t....�.. y' . :6.H. .!`'!. . '. ........ 1... ..1..�......................... TYPE OF CONSTRUCTION .............. .. r .........5.�..v A.. :�........19.. �6 TO -THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies'fo;-r�'a permit according to the followin-g�-information: Location Jv�r...... 0i`. .(...!1....... UC�j�� „�,C3 :.L..6....f:. .........0.:2 z33 ...................r. Proposed Use DW J.Ad- :l..UI. .PCB.6. ... .............. ..............................................`..................... ZoningDistrict ........................................................................Fire District .............:.......:........................................................ Name of Owner )ROcF.p w1w�y.... ...'.',Address .....SAOP......... ...........:........................................... Name of Builder S...6✓ ,tfcAl_,l&.. ..:..Address VC.01M.I,a30......&YAPM4. A...G!!l. 0 I Name of Architect ...........Address ...:...:.:....................................:........:........................... Number of Rooms ......Foundation Exterior .............Roofing .................................................................... Floors ...............:.....................:::.........:.:.....:.....Interior' ..........:......................................................................... Heating ..................................................................:...............Plumbing..................... Fireplace ............... ............................ ......... .....Approximate. Cost .. ...!.. .................................................... Definitive Plan Approved by Planning Board _______________-----------------19________. Area ... . 7 Diagram of Lot and Building ,with Dimensions Fee G� ........... ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 C/ __ _ 38 ��G��pT4c • 00 _ 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 ......&.�.?r`�a... .. .......... ^ Construction Supervisor's License rQ', .MCEWEN, BRUCE & -MkNCY 26928- Build Swin ring P No Permit for -oG1 Accessory to dwelling ` 55.•ForsXth••Court. ..... .... .... Location ... .......................... o 01 - C tuft �r, � tt c Bruce & Nancy IvlcEwen Owner ............. ....................... ................... tT.,.,,• Type of Construction Gunite..... ........................................ ........ .............. }, x v - ...,Plot ........................ Lot 1......................... .. .. Loll Permit Granted AllgUst. .31,. . .. 19 84 Date of'Inspection............................ ...x19 NI Date-`Completed .... . '. A LJ Assessor's-map and lot .numb "r 1.....✓. ... .... .......... TN E .......... . Sewage Permit numberD ..�.i... . .. ,► Z DA"STULE, i House number.......................... :... ..P v .................. 9O MAB9 �• 4,o�i639• �0 TOWN OF ' BARNSTABLE f BUILDING INSPECTOR APPLICATION FOR PERMIT TO �5.��?.?`?..1 .�,........S.C.0.!.M..."�.`'. ............�0 :., . ................................... TYPEOF CONSTRUCTION .............. ..... .............................................................................................. .........�. TO THE INSPECTOR OF BUILDINGS: �t The undersigned hereby applies for a permit according to the following information: Location 5 ...... �r.5 h.......Cv.v YTS fig..`. .. r4.:.......0 2 3........................... ........... ...... ..... d. ./ ;. �� ProposedUse .. .� 1A!'!.!A..4�. ....���.�. .... ...................................................................................................:......... ZoningDistrict ...22....................................................................Fire District ......................................... Name of Ownerj. :. .;..t�ANC� C. 4!a .......Address ....SAt'.:IF.................... ............ ........ ................................................ Name of Builder ?"A ..6.1.LA.,?..to.tj.k. ........................Address Nameof Architect ............................`......................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................:................................................ Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .....................:.............................................................. Heating .................... .........................................................Plumbing .....................................................I............................. Fireplace ..................................................................................Approximate. Cost ..... 0..0.O.t.....wo.......................... Definitive.Plan Approved by Planning Board ---------------_---------------19________. Area .. ! Y. .... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 3g ��s�Pc��,�', � � u�Y .��►�� 7 60 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. �Q Name ...... . ...ie.. ............ Construction Supervisor's License .... ....... .U........ MCEWEN, BRUCE & N&NCY /A:--.:55-64 No ..... Permit for ...Build SWiMUing„P001 ........Accessory.,.to..j:AP.UI.-4g....................... Location ............... ............ ......................co.tat........................................... Owner ........53MQ.Q...&.394MY..MQ�em................ Type of Construction ...Gumtte.......................... 1. ................................................................................ Plot ............................ Lot ................................ 84 Permit Granted ......August...3.10,.............19 Date of Insp6ction ....................................19 Date Completed ......................................19 Assessors map and lot number'..... .. ...' 7 OF TH E t0 Sewage Permit"number ...... .........../�........ .�'................. -s Z BA"STADLE, i House number ....................... ... ... ......�......................, y� MA86 pow t639. \0� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TOlL� �L/ Gv .2 "la"/ric�}�S� TYPE OF CONSTRUCTION ..t1�00'� -H � ......................................................................... .e.........3..............1& f TO THE INSPECTOR OF BUILDINGS: h. The undersigned hereby applies for a permit according to the followinginformation: Location ...``:`:.!... �4 ..... Rz,5..yrA...�.�.GUzc..... .3. ...:�` ". .... .....f ?.:...................... ProposedUse .................................... .............. ................................................................................................................ Zoning District ..............l....i..•.................................................Fire District ... V............................................................ Name of Owner ....Address^ ' 3�0.......6...9...1...I.J../..T...�t ........I........... o —TG MKS S t 1. i U IT', Nameof Builder ....................................................................Address .............Old....................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms �...........................................Foundation .......... ...�Df�.'-�.. Cpi(J�C'.ETE /o .. /............................ Exierior �.............................. .............................................Roofing ............... ........................................................... f' o U )1)14)- 7a A(ldt-L S�IGI� �. .......:....;...... .... .......................Interior ................................. ...................................................... .............. .............Floors Heating .� Uti ....Plumbing �1�.� ��.. rfpe"F......................... ..... .............................................................................. .................... ..... Fireplace �� Approximate /4.� coo .................................................................................A roximate. Cost .....................................�:._j.-....... Definitive Plan Approved by Planning Board ________________________________19________. Area ..... ...........r.............. Diagram of Lot and Building with Dimensions .............................................Fee / � S YTS SUBJECT TO APPROVAL OF BOARD OF HEALTH Ct9U 2T 3� e l >o ay ho I oL�, �, 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. 17/ , Name .W.....u........ ............ .�i ................. 9.� Construction Supervisor's License .................................... W. E. REALTY TRUST A=55-64 26059 One Story No ................. Permit for .................................... Single Family Dwelling -7 ............................................................................... Location ..Lot..40.,....5.5..Forsyth.,.Cou.rt............ . .. ................ ...... .... .................cotuit................................................... Owner .....W.....E....Realty, Trust..................... .. . E. ............ Type of Construct-Ion' XX�a.TJPP.............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted ....February...9A,............19 84 Date of Inspection ....................................19 Date Completed ......................................19 a(L NEu �2A n,p /L O C_ —>�A1�T• n v�� P!3-r tzr2 Y S, A-Lj ,.,, , i Ir , i AJ t __.. _. o0p S I I � ;011��AGE sN�.n—Ulv �i, 1sh} /4rvl�c o F1 17 JLA - 13Fn Roo vw SE-coNn 'PLeov( 30, tl D�atc o10 S'F 1 N / + o �j V• ROOtA- I�J ( �. �r'i}1LF�G� as/�otd/ �_ GG' uric HEN '�=py+,rLALL 3 PEW lit y I �� 6PF(CE V , R-F- ,x cn �G'�R,vnlrniG (tEN1oD6L,^' •?Cy-a�8 J F1 AT \ 13E11 goo rh _ — � �,� IlslllLf�G� ar}'xoZ�' `' GC 1 IiG�I�N n �/Ut�1Ly s. „ 9'>e ',�Tlklltl� aLZ,' �Cl—PRnJn/tnJG