HomeMy WebLinkAbout0794 PUTNAM AVENUE �I9 `} f�INRM AV£ .
i
' Town of Barnstable * y�& q
Permit# 067V I•
Expires 6 inonihs from issue date
Regulatory Services ��` 0
Thomas F.Geiler,Director Fee
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601 nA'
www.town.barnstable.ma.us
Office: 508-862-4038 r"
EXPRESS PERMIT APPLICATION Fax: 508-790-6230
,r Not Valid without Red X-Press IRESIDENTLAL ONLY
Map/parcel Number
Zential
Address / �r �G Value of Work
U Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address ACg.•
Contractor's Name__
Telephone NumberC�
.Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
®PRE S PMIT
❑ I e Homeowner � '
have Worker's Compensation Insurance
0 C T e 1 2007
Insurance Company Name
�rnin�ni rid R
v v i vT�+t e
Workman's Comp.Policy# L,RNJTABLE
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
e-roof(stripping old shingles) All construction debris will be taken to j
i
❑Re-roof(not stripping, Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value r
'`Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Leftet'of Permission ' M
py the Home proveme ontracto s License is required. I '
iIGNATURE
?:Forms:expmtrg
:evise061306 , .
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,M,4 02111
www.mass.gov/dia
Workers' Compensation Msurance.Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): 11-4 A.1 cick
•Address: y/",
City/State/Zip: Phone.#:- 3-61 P
Are y an employer? Check the'appropriate box: -Type of project(required)-.
1. I am a employer with 4. Q I am a general contractor and I
- . employees(full and/or part-time).
have hired the sub-contractors 6. ❑New construction .
2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g, Q Demolition
working for me in any capacity. employees and have workers'
insurance.$ 9• Q Building addition
co
[No workers' comp.insurance �' 10. Electrical repairs or additions
required.] 5. Q We are a corporation and its ❑ p
'3.❑ I am ahomeowner doing all.work officers have exercised their 11.Q Plumbing repairs or additions
myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t C. 152, §1(4),and we have no
employees. [No workers' 13.Q 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.
(Contractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,tbey must providt their workers'comp.policy number.
lam an employer that isproviding workers'compensation insurance for my employees Below isthepolicy and fob site
information.
Insurance Company Name: V/��A,,OtL�9r
Policy#or Self-ins.Lic.M /4� ,0052./J� Expiration Date:
Job Site Address: Age- City/State/Zip:__ e 67/'�e�;O �
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 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. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification, i
16 hereby certify under,the pains•annd ppeenalties of perjury that the information provided above is true and correct.
U
' Sienature; • Date:
Phone#• t5 2�ldo
Official use only. Do not write in this area,'to be completed by city or town of7cial
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health.2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
r�
,. ' I'
Ot 1HE 1 Town of Barnstable
Regulatory Services
. BARNSTABLE,
Mass. Thomas F. Geiler,Director
�AlEn �a, Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
"'w.town.barnstable.ma.us
Office: 508-862-403 8 .
Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section.
If Using A Builder
I, as Owner of the subject property
herebyauthorize � to act on my behalf,
in all matters relative to work authorized by this building permit application for: .
�q �i/ �� �
(Address of Job)
r� 4 .
91ga of Owner Date
Print Name
. r
QTORMS:OWNERPERMIS S ION
1 11D P JG r.0" F ZI —
r •• • v .0 plll 'I rRI".9iH
:E t,THFFIGATE F tI SU IN Y�WNN YYY
PRODUCER r H15 CERTIFICATE 181SSUED AS A TIER OF INFOlNIAON
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Olde Cape Cod tns,4Cy inc HOLDER.THIS CERTIFICATE DUES NOT AMEND,EXTEND OR i
298 Winter8treat ' ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW i
I Hyannis,AAA 02601 _,�
� MO IS AFFOOIN�d INSURANCE
COMPANY A GRANITE STATE INSURANCE.COMPANY
! INSURED
WWI Constructlon Inc
Po Box 692 i
I
Hyannlspert,MA 02672.000D s• i
THIS IS TO CERTIPY THAT THE POLICIES OF INSUtANCE LISTED BELOW-iii BEEN 1158M TO THE INSURED NMEO ABC7VF FCR
THE pOLICY PERIOD INDICATED,N0T vW MSTANDINC ANY REQUIREMENT,TERN OR CONDITION OF ANY CONTRACT OR OTHER �
PJOCUMEW YViTH FISSPECT TO WHICH THIS C51litTIFICATE MAY BE ISSUED CA MAY PER7AW,THE INSURANCE AFPQR0201'HE
POLICIES pESCRISLO HEREIN IS SUBJECT TO ALL THE TWO.OXCLUSIONB AND CONDITIONS OF BUIH POLICIES.LtAdiTS SHOVIN
MAY MVE BEEN REDUCED BY PAID CLAIIIJIB.
C�
�� TppQ pp IN' AN��, OL40Y EIUM Ctl EFFICTN T! Y ffiPIRAT OAT .
O fiMR DYERS'!AEtILm I U S
t9PROPAIL+TOW
` [`pAR7N�t6J9fXECUfl�R � I � I! I,
[orioleNte ARE'
Ilnc►�'otoLC I 2358B2Q A1612L107 ! 41U�/2dC6 �9'ATll70RYL11hIS9 �.•
' "OVGfOQOA{rDP@GIOtM6Ii0teQOr,6QIttlY• __�•••• �•—'..
ACHACCJOENT ?80•DOC1
Ias,,se Pp;,�v unar i 500,000
- _ 11sbudim GM29YA9 --
f����p�6CHJ TI OPBRlA71 5 CL� PE AL 1 m
` I
( j
CERTIFICATE KOLOFER .� ANCELLATION
T01NN OF BARNSTABLE SHOULD ANt OF THE AOpvE tASCRISBD f"It 6's ee CANCELLED OfFOU THE I
BUILDING DIVISION ExPtw+TInNirjATSTnefsof.THE lssuikdCOWPAHYW,LLtivDIEaVORYOMALA f
l 200 MAIN ST DAYS WRITTEN NOTICC'F070a CERTIFICAT6 HOLDER NAMED TO THI I.K*-WJV
I �jYANN!S�MA C2601 rAILVRP TO MAV,aVOH W&ICE IHA-L INPOBE N4 OkiGAT49 Olt L"LIW OF
4 - ANV KIND UPONTHC90MPANY.ITS AGEHT6 Lill Y361"WINTATIVEI
AUTHORIZED REPMENTATIVE _
I I
-
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:
Board of Building Regulations and Standards
Registration 128560
One Ashburton Place Rm 1301
Ex ifation 4/21/2009 Tr# 131711
1 , p Boston,Ma.02108
"l �rType Individual
4't
RICHARDVILLANI�� Er�
RICHARD VILLANI �z i
109 WAGON LANE ti =�
HYANNIS,MA 02601 Administrator Not valid without signature
•- k
` TOWN,OF BARNSTABLE BUILDING PERMIT APPLICATION,
Map a 2 Parcel 076 Permit#
Health Division Date Issued
Conservation Division Fee
r 0�
Tax Collector ( Q Cv `�
Treasure (00
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
- , 3
Project Street Address 4&4
Village C� t
Owner _ 4.1- Address �Zf _
Telephone
Permit RequesterdXf^ y r,�/1
Square feet: st floor: existing proposed 2nd floor: existing proposed Total new
Valuation 4L ZoningDistrict Flood Plain Groundwater
d ater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family (Y/ Two Family ❑ Multi-Family(#units)
Age of Existing Structure f f:l'- Historic House: ❑Yes 6a/No On Old King's Highway: ❑Yes O/No
Basement Type: ER"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 O'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
�_C%°L�J �r�C �U,��} BUILDER INFORMATION
Name —,���fv+�IJ cl ai��iG �UGrG�A✓t Telephone Number � 0 S]19eV3
Address _11 - / J��C.r�Cti�i
/ �/�2� l/�►/� l�License#
jGvcl, eZAZ14 Home Improvement Contractor# % 2 0 6
Worker's Compensation# rG y d C'�;?S2 06 X
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE G d DATE
J
f FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO. ol
el
ADDRESS VILL'AGE '� ^
OWNER....<.
DATE OF INSPECTION
FOUNDATION
FRAME a:
s
INSULATION
FIREPLACE f
ELECTRICAL: ROUGH FINAL _
PLUMBING: ROUGH FINAL -
GAS: ROUGH FINAL
FINAL BUILDING
• 7
DATECLOSED;OUT
ASSOCIATION PLAN NO. r 1`
p{ • 1
`a
`------- ._ The Commonwealth of Massachusetts
Department of Industrial Accidents
o; ,;-3-", --_-�� Ott�caolla�estigat�oos
600 Washington Street
Boston,Mass 0211
Workers Co m ensation Insurance Mdavit
"'— a�f' . � Gam'� �'��d G• /i- ✓�'
locaticn
k own Pc-d,ez z dt 1/,►;f ifs
city SaNi d Alt F phone#
I am a homeowner performing all work mvseif.
I am a sole proprietor and have no one worldn in alxv ca u-------------
nity
&I am an empiover providing workers compensation for my employees working on this job.
compnnv name:
A
� ^ : .
city hone#k'
insurance cn. ✓ oiicv# .:;;
I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below wan
have
the follo«zng workers' compensation polices:
company name:
address:
�`•h
<e.
ctty:
t
ins a rn n ce co.
camnanv name: ::;;;;;;:-:::'::.;:;.:;;::-:,-:_._.::.::,>'., ;..:...;:..;:.:•;;>;•;;:<:;.;';.;>:;,: _::._
....................::...
address: ::.:.:..:: .:...;> ::: -':
:.:;:: ::::..:....... ...:.. ::.h
one
.:::::.,.:,::::::: :::.:.:::..:.�.::::<::;.;:;:.:.�<::...........::,,..::.::. :.:.:�>:.:>:.;..:,.....,,,..<>:,:,.:,..� pricy ......... . :..::.�,..::::..... ::... � �%/%%//%:
insurance co. "'
Failure to secure coverage as required under Section 25A of MGL ls2 can lead to the imposition of criminal penalties of a fine up to S1. 00.00 anal
one vears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
coQv o C this statement may be forwarded to the Office of Investigations of thrf)IA for coverage verification.
I do herehv cerrify'u he pains and pe es ojperjury that the information provided above is trrw and correct.
Date
Sigmnire
Print name
a.` oiIIci;ruse only do not write in this area to be completed by city or town official
permit/Ilcense# ❑Building Department
city or town: ❑Licensing Board
❑Selectmen's Office
7 check if immediate response is required QHealth Department
contact per9on:
phone#; ❑Other
.A
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers'
� Ian�ffi"
M person m the service o y
employees. As quoted from the 'law",an emPl°Yee is defined as every
Tess or implied;oral or written. R
of hire, express
artnership, association,.corporation or other legal entity, or any two or more of
An employer is defined as an individual,p resea deceased employer, or the receiver
the foregoing engaged in a joint enterprise,and including the Legal representatives of a Partnership, association or other legal emp y emP y io`• Io ees. ,However the owner of a
trustee of an individual, entity,
dwelling house having not more than three apartments and who resides therem, 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 c
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chap shall withhold the issuance or renef
ter 152 section 25 also,states that every state or local licensing agebcy
of a license or permit to operate a business or to construct buildings is the commonwealth for any applicant who h:
not induced acceptable evidence.of compliance with the insurance coverage required. Additionally,neithert
P
commonwealth nor any of its political subdivisions shall eater into any contract forte performance to the contra can g
arc eptable evidence of compliance with the insurance of this chapter , .� presented
authority. .
Applicants
n and
Please fill is the workers' carapensation affidavit comp letd ch the box that applies to your situation,Y,by e�nng
, sx} supplying company,names, address and phone numbers with a certificate of insurance as all affidavits maybe
submitted to the Department of Industrial Accidents for confamation of insurance coverage. Also be sure to sign.and
. or town that the application for the pennit or license is
date the affidavit. the aff davit should be retained to the city' ons the'law"or if yc
Accidents. Should you have any questi regarding
big requested,not the Department of Industrial policy,please call the Department at the number listed below.
are required to obtain a workers' compensation
City or Towns
legibly. e Th Department has provided a space at the bottom of t
Please be sure that the affidavit is complete and pig legr �affidavit for you to fill out in the event the Office of the has to contact you regarding applicant. Please
be sure to fill in the peimit/liccnse mrmber which will be used as a reference number. The affidavits may be retanned t^
the Department by mail or FAX unless other have been made.
The office of Investigations would mce to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call..
a
'The Department's address,telephone and fax mrmber. ,
-- The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investloadons
600 Washington Street
Boston;Ma. 02111
fax#: (617) 727-7749
phone#: (617) 7274900 eat 406, 409 or 375
The Town of Barnstable
• BARNSTABLE,
9� MASS. �0� Regulatory Services
A,E p 39. Thomas F. Geiler, Director
Building Division
Ralph Crossen, 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.
Type of Work: d' —P r'C��y'/ /� Estimated Cost
Address of Work:
Owner's Name:
Date of Application:
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
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: n•
Date Contractor Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
t �AVQ
t BONE INPR,VENENT,CONTRA
Ftz:- �,•91St�i� 01 '�1t1�9e3Qt�N��'��� ,Q=i�
- 4 q
Syr r4^G+ -{ r asF t fx: vw�
.BONNIE AYLOR Y.
aADMWISTAATOR '' 63.A/ r
m
en J ` 1
i€P
> !`
-o-r�
L ®T 3 ULOCATloiq
�• ..!` �i� ».a. ..ti, ::a C••A lei. .t. r. 0 A'T Fi. 1�:J-. } 4._• 'a f 4. .e
-r
!y't%}.:�,:�yr.Af L i}+/,}I't11�'r F�)t/A`A7/.. �f, �e l..,. 1 •. !+'' /4�'�
- I S.�iti�'A!F T ti{Y iltl/t 1.1.0 A/r F�.I'4 wiC .. • M�•o. +�� � :t • .. • y
f,0,64,
+
I CERTIFY THAT THE TO!J.i':?I.''�.�: •';.6' SI;I;INN
ON THIS PLAN IS LOCATED ONi THE G;=iO:.!ND ;
W. .v F A LT `( f r U "i' AS SHOWNFiEiECJ�� il� } ' i Ri' i'r4�i F4:isiS TO i
5 _Q v .� -� THE ZONING LAWS OF THE TOWN OF
A I THE E 1 �1�by '�•f 1..1... VftiF• -, -c-1:10.
Assessor's map and lot numew� ... ..... y7..............:
SEPTIC SYSTLAA Fir�LQiT BE
INSTALLED l� CC°�'PLIANCE
hex
Sewage Permit number ..............70............................. WITH APT11-C,,E II STATE
SANITAIRY COIDE AND TOWN
�ofTNET TOWN OF BARNSTAIBLE
i BARNSTABLE, i
"6 9 ,•� DUILDING INSPECTOR
c M -4 a'
APPLICATION FOR PERMIT TO .......................... .. ....... . .... .. .
TYPE OF CONSTRUCTION ... C/[...... y...............................
........�,��......j+..........19..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .0 .....r1.. .. �. .�!�!..... V.�� .............�a.. ... .......................................................................
ProposedUse .........................................................................................................................
ZoningDistrict ........................................................................Fire District .....Q U. .. .....................................................
Name of Owner .W.. .(- :...". .1...E'l......1..I�.,VCr...Address .r.�.�...�.��.+?�...V..!......!.!.��1�fll��.�t........
Nameof Builder ....................................................................Address ....................................................................................
Nameof Architect ..........................I........................................Address .....................................................................................
Numberof Rooms ......r......................................................Foundation 10......../...........................................................
Exterior ..W167 .... .��. .�.9Z...S...................................Roofing .. .f ...0A..1....................................................
Floors Interior ...`���� T k 0�
..............��jj..................................................................... .................................... .................................
Heating ... ...... .A...................................Plumbing ....../ C....."-. ...................................................
Fireplace .....y C-S..............................................................Approximate Cost .... ........................................
Definitive Plan Approved by Planning Board ________________________________19________. Area ... /00..9.'. - .....
SS
-
2
^ Ir
Diagram of Lot and Building with Dimensions Fee .f.0,5.7
SUBJECT TO APPROVAL OF BOAR2 OF HEALTH
I hereby .agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
t .. Name .. . ....�� �� ..............
Assessor's 'map and lot number .......... ........:...../.............
7&
Sewage Permit number ...............
...................................,.......
`111ET��y� TOWN OF BARNSTABLE
1i BAWSTADLE, i
"6 9IN
� d'
BUILDING INSPECTOR
� MPY
APPLICATION FOR PERMIT TO • ................................................
TYPE OF CONSTRUCTION ! (/`7l` ...�'� !�..f.!<x l r -!3� ...............................
0 , ......................19.. 1
TO 4 INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according' to the following information:
Location .4.... r... . v... .. i�h/.p..!h"......A v. ...............Cd-el"....T.......................................................................
ProposedUse ........................................................................................................................
ZoningDistrict .......................................................................`....Fire District .Co7o�.../.........................................................
Name of Owner .: :.. r ...!.L�... ,l, l)r� !,,,...Address .......................... ,./.,Otl/�/,::........
�.
Nameof Builder ....................................................................Address ....................................................................................
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms M� Foundation � �,. d u^ rUW t-R ( ��-
rf /.............................................. Q..,............. ..,. .....................................................
Exterior W�T t� C. q1� `S Roofing ..l1. ...� .. ..././................................................
...................................... ...............
Floors L .........Interior ....!.............�.! i` �..
.................:........................................................... ..............................................................
Heating' ............ .. .. ..................................Plumbing ...... .y�..........�.......................................................
.................
Fireplace ..... .. ....a?..............................................................Approximate Cost .... ..:ra :. .( .......................................
Definitive Plan Approved by Planning Board _______________________________19________ . Area ...../o0�.r...-. -!r......
Diagram of Lot and Building with Dimensions Fee ..r!
................................
!J
SUBJECT TO APPROVAL OF BOARD OF HEALTH
`I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .. s .......... ... ....................
. i
W. E. D. Realty Trust A=39--'7 76
e
18169 /one story, f
No Permit for
single family dwelling ! ?
{, .....................................................................
i GGLI Putnam Avenue
tocation�( ..........................................................
Cotuit
...............................................................................
Owner W. E. D. Re ty Trust
......................................... ........................
Type of Construction fra e
. ..........................................
....................................L....C...../te�
..........................
Plot ........................ L ..-........................N
6 3 1 Q A
F bruary 11 76
Permit Granted ........... ...................19
Date of Inspection .... ........:......................19
Date Completed .... .... ............... ............19
PERMIT REFUSED
............................................. ............... 19 .
..............
&.,,,.w ...... ...................................
......................................... ...................................
Approved ................................................ 19
...................................... ..V...............................
� !i...@...................................
(n'3Y
La-r 29 I 'x L - �
_ 7 � �s. 5a2,•� � _ s
12
//•+�� _ e to t.I tfy �� /r`
ni
o
t • <
�• ' �}
P I r�1T t MAS
CERTIFUED PLOT PLAN
�4
ILOCATION. .
�v C7 U ti'�1•� 1 9�1 G��'r' .....d.�,....
1 ^.
SCALE .�. r�,.l ii i���E ��• )" 1 �'� ' t':,= ;
L�Ls
t PLAN REFERIENCE �• !
I:Siv 1 Uti�, NU URI E , s{�L t�Tll � � � c��r . �
itJC"T'71 w!`AP%�yr.��t((1'dLC�l'r3,
CERTIFY 'fHAT.THE Si,-OWN r E
C LOCATED ON THE. r3R�JNO
�• •� t `F�A i.'i `(� , t U 5 1- AS'SHOWN HEREON A NO
ON THIS PLAN IS LOCAT1"a1AT iT CON FORMS TO
THE ZONING LAWS OFF THE TOWN OF
5 ,A 14 J T R E• C -T, ;.F�. ,R,v � 1...� HEN COihl��'F RUCTE D. E
{� i M ,+S• ?'� y .Asa w j.
��f 1A DATE . 6. ' T� It
PETITIONER : . g
REG• LAND .SUPMHH OR.
.z•�vs=pw�•r ..