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Home My WebLink About2126 FALMOUTH ROAD/RTE 28 s y.. 0 um 0 a f a , - .4- Town-of Barnstable *Permit# ,4/A Expires 6 months from issue date Regulatory Services Fee * sARxsrASL6MASS. + s ,�� Thomas F.Geiler,Director �l ZS 3 Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601. www.town.barnstable.maus Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p Not Valid without Red X-Press Imprint Map/parcel Number Property Address l b ra Imo dA -EXResidential Value of Work 31000 . 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l,[ J1A /! /t t 0 ore, 1 fmotllf 2d e OR63 - Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor AU G 2 4 2012 �f I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name" TOWN OFBARNSTABLE Workman's Comp.Policy# .Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) eRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side` #of doors ❑ Replacement.Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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 Improvement Contractors License&Construction Supervisors License is requir34 SIGNATURE: e Q:\WPFILES\FORMS\building permit forms\EXPRESS.d6c Revised 053012 ^S Tfte Comtrranmealt�li ofMassackmetts Depwftent,oflndustyial-4ccidents . f1�jive of Investigations 600 Washington Stmet -_ Boston,M54 021.11 not:masgoxidia Workers' Compensation Insurance davit: Builders/ContracbrsTlectricians/Plumbers licant Information Please Print Legib 1C7jNatnePhone 47- Addiess: & �d- [C�ty - Are you an employer?Check the appropriate boa: Type of project r 4. I am:a contractor and I Ylse P ] (required): f.❑ I am a employer with ❑ 6. ❑New construction " employees(full andlor part-time).* have hired the sub-tomnacton 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling. strip and have no employees These sub-contractors have S. ❑Demolition .woddng far me in any c employees and have woAers' capacity. 9. Building addition [ND worb s' comp.insurance Camp.ins ratwye ❑ 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions d officers have emercised their ❑Plumbing 1I. �3. I am a ho�edriAner-doing�a11:vvoilC . g repairs of additions myself [N0'woriners'comp- right of exemption per MGL 12.❑RDof repairs insurance required.]1 c. 152, §1(4�and we"have no employees.[A o workers'. 13_❑Other comp.insurance reqWred. 'Any appficant that checks Lau#1 mnst also fill out the section below showing.then wodexe comPensation pommy infurmation- Homeaaro ers uho submit this afhdmra indicating they m:doing all wank and they hue outside contractors mast submit anew affidavit indicating such. iC;bnuwtars that chedrthis bind must attached an additional sheet showing the Smme of the sub-c s imd.mn Whether oemt fhose'entities ham employees-Ifthemb-contractats have employees,they now pmvide:their Warders'comp.policy mnaber." I am art employer that is providing workers'componsation,insurance for sty awplgfvees. Below is thepacy and jab site. information.. Insurance Company Name: Policy#or Self-ins.Lic. Date: Job Site Address City/StatelZip: 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 25.i 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 foam of a STOP WORK ORDER and a fine of up to$250-00 a day against the violat . Be.advised that a copy of this statement may be farliwdled to the Office of Investigations of the DIAL for insurance coverage verification.. I do hereby c to,and sr thepains and penalties of perjury that the informafion,prsmviti;ad above fs dolts and correct i an tune1. s 00 A Ph Yob 6- official use only. Do not mite in this.area,to be completed by city or town arfrcial City or Town Permit/License If Issuing Authority(circle one) 1.Board.of$ealth'2.Building Department 3.City/Town Clerk 4..Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 HARNSU 9� MASS,1639. ,. 'own of Barnstable Regulatory Services Thomas F.Geiler,Director Building:Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ina.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Ust , Complete and Sign his Section If Using A wilder as.Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this uilding permit application for: (Address of ob) Signature of Owner Date - Print Name If Property Owner is applying for ermit,- please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\ENPRESS.doC Revised 051811 BIKE 'Town of Barnstable Regulatory Services BnBxsrABM Thomas F. Geiler,Director 9� s6g�q. ,��' ArF 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 HOMEOWNER LICENSE EXEMPTION Please Print ,DA-TE: a= 9K JOB LOCATION:-1oyak tr/iB fffiyA � 6AfAVj-&a ® �� '-��hum r street C�ry j Q village HOMEOWNER"": ku� f t/C� -� 606117 ?/ t-'------ name home phone# work phone# CURRENT MAILING IADDRES8.--1 - Q 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 does not 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 proced)xel and re uire is and that he/she will comply with said procedures and requirements. iSign6ture o omeowner Approval of Building Official Note: Three-family 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 homeowners 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc wised 051811 Assessor's offioe (1st floor): / - /.n THE Assessor's map and lot number ../ ..d..............._..'.................LJ`"` Board of Health (3rd floor): Sewage Permit number ...'..!....1.......��.... ............. ......� i BAH-a9TABLE, S Engineering Department (3rd floor): ,Z..i r 9ce, e - House number ............................ ...`...k.......................... c \0� MAY a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE � BUILDING INSPECTOR : : APPLICATION FOR PERMIT TO ....... lC/ T ?K�� .. U� TYPE OF CONSTRUCTION ...............�...................'"':............................................................................................ .................. // 2 -..�9-.....-7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fo-r^a permit according to the following information: Location .............. � F .•4�r �� .......... .............. ......� ......... Nt� /� 4-- ProposedUse .................... ... ........................................... ...... .. ................................................................................... Zoning District .........�: . ...............................................Fire District .. �� //,,,,�c /u. C�1 Name of Owner J/4. . ..... GG....................Address 2W245R...?F.:.Z V . ..... Nameof Builder ............ ..�=.....................................Address .................................................................................... Name of Architect ......... -1�`�.�...................................Address ...........-.......�� . ............................................................. Number of Rooms ............... .............................................Foundation .......mp Exterior CCxt � . `C. L Floors � Interior .... .�Z. �f .... .............. ......................................................... ............................. Heating ......:. �. .. .T,I �G-...................................Plumbing ........�K.<. / - Fireplace .........../ .t...�............................ Approximate Cost ........ . ...ALIZ. .,,... ............./........................ Definitive Plan Approved by Planning Board --------------------------------f 9-------- • Area .. f'`j-/ - �Y...U. Diagram of Lot and Building with Dimensions Fee -.1 f� Qd SUBJECT TO APPROVAL OF BOARD OF HEALTH �n . 4Xir- . 41<7 � N t L&i-/ r` r 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 ' Construction Supervisor's License ......... ' No Permit for Dormer __S ' le_Fazu==^_Dvvelligg�___ Location ..2126— th_Il�ad--'--. _ ' -----.{��t�zvill!�_^_________. . . . .' � Owner — —88o��___________. � � . / Type of Construction --I,��g��-------. . .' ��. ' Plot ............................ Lot ................................ ' ' Permit Granted --Nm —25x_lq 87 Date of Inspection ....................................lV ~ Do^o Completed ------------'lV ' . ^ ^ ' ~ . /. ' . ' . . ' . . ' ' ==� , ' - � ' ' . ` t ' � 4 Assessor's offioe Nst floor): li_CJ �i r r^ [v ( / LJ� �'•. � "" F THE T Assessor's map and lot number .......... ............... ...'............. j „�a'� � ��CUTE ��1US EI iK Qom° c�♦� Board of Health (3rd floor): �� IN COMPLIA��. j j Sewage Permit- number ... .... ...... WITH TITLE 5 t BAH39Tl1DLE. Engineering Department (3rd floor): 2( > 4,01V'ONMENTAL CODE 1�M. Ma39• \0� House number .......................................�.,....................... TOWN REGIULATIONS 0 APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only f TOWN OF BARNSTABLE --? � BUILDING INSPECTOR. APPLICATION FOR PERMIT TO .. / /..................' -:?-'.... 'r............................... TYPE OF CONSTRUCTION ......tt-'200................................... ........................................................................................... /�.- ...19.. 7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to' the following information: �1 Location ..............��. t;1 ....... /..CF.� 7V....(.`� -:> .........�Of?�t .... oE5........C....... .............. ProposedUse ............ ....�j 4 - � Q ...............4_8....1'/..1...".............................................................................. 11 Zoning District ......... -...............................................Fire District .. �..�Yl......��-Y.` ... cJ1..t'..... Name of Owner !`7�.'�!..�� ....... `r/6� ..........Address... ��Y� / �tJ% ...... ^-....... /...... Nameof Builder ........... .�:....................................Address .................................................................................... Name of Architect ......... ....................................Address ....................Gr ................................................................ Number of Rooms ...............0.............................................Foundation .......A� ............................................... Exterior ...................................... / � ..............Roofing .........! T� ']�-K-- .....�f'[—/... ......... Floors ......................................................................................Interior .... Z,T ,..'..... - .............. rieating �.. ...................................Plumbing ....:...�...... ........ ,f 4..,..... .......................... Fireplace ........... o...........................................................Approximate Cost ....... . Definitive Plan Approved by Planning Board ____________________19______ . Area �.. .:..... U. d Diagram of Lot and Building with Dimensions Fee Q`'f SUBJECT TO APPROVAL OF BOARD OF HEALTH CZ 4xlf \v �l 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.... .C-G'"I„`.`T/.-.. .............. t' Construction Supervisor's License ........... .. ..................... MOORS, JAMES 5 BUILD DORMER 3144 No ................. Permit for .................................... Single Family Dwelling........... ........................................................ Location 2126 Falmouth Road ....................... .............................. .. ... Centerville ............................................................................... James Moore Owner .................................................................. S Type bf,Construction ..F.r.am.e............................. .. ... .. ........... ............................................................ Plot ............................ Lot ................................ 4 anted ....Nov ember 2.5., ',�jq 87 Permit' Gr ............................. ... NI Date of Inspectio' n ..................... .. .... 19 ell ll; Date Completed ......................... 19 1 t v Ile .10 A Ae L Assessor's map and lot numb/.. 4..,/....... ...�...... '. 4T14ETO�o Sewaga Permit. number ...... ................... w R w BAUSTADLE, i ' Cl.' 17................... O M639 0� House number ..............:........:. ........,.. oo �D YI1y d` z TOWN . OF -7BARNSTABLE BUILDING INSPECTOR s 3� t�� t I APPLICATION FOR PERMIT TO /I/ 6'YF,a .4:.: ......�... TYPE OF CONSTRUCTION ..................... ....... . � �-..?`! ..r�•...M1......................................................... y r ..........��•..r.:3.......1994 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............................................. ............. ProposedUse ... 5 .�' Z....... ...... ................................................. Zoning District ..........................Fire District ............� .. :......................... Name of Owner SM u �� `�- " Address .. ............ - .....C..... ....... .......... .` . ...� ... .. ,7,J.... .. h� 1�.� �� i•? «. .. .`!...Address ..t.�.��...... J . .},� �'� 1tJ,��..s Name of Builder .. .. ...................... . ... .... Nameof Architect ........ .... . ...........................................Address .................................................................................... Number of Rooms ........... .................................................Foundation � ""' ....... 'A r� . Roofing ....N � �: v ................ .............Exterior Floors J � 'V.........................Interior ... E,.0 Ct3 Heatin ' .. f�ti ....S(......Plumbin . /d i ......................................... g ....,........�...,..... .....� ,,....... -fir �........ g .............. ..... a 0 Fireplace ......... r. ..........................:....,..........................Approximate. Cost ................. ................................................. �...�...,.... w Definitive Plan Approved by Planning Board _____________________19________ . i Area �` .. �........ � c ..' .y J Diagram of Lot andk Building with Dimensioins M *Fee ........... .. ............................. SUBJECT TO APPROVAL OFf'BOARD OF HEALTH t` t 'S ti OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS + I herebyagree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above 9 9 9 9 construction. % Name Construction Supervisor's License d4 ` JAMD0 {X]. INC. A=165-94 ` r 3685l ^ One Story No ---_-. Permit for ------------ Single -Family Dwelling ^ . - . ----.'�-----...�.-----.....-----.--. � 2136 Falmouth Road (Ite 28) _ ' Location— -----''---------------' Centerville -'--------~------~--------- ` ^ ' Jamun Co. Inc. Owner ............................................... . , . . . I�ze-aoe Typo of Construction .......................................... ^ ---.------.-------.---------. � . Plot ............................ Lot ................................ . . . . ` . Pennit Granted -. ............. 84 ' - Date of Inspection ------------lq . ^ - ' Date Completed -.�-----.---�.'--l9 ' ^ ` . . ��y �� . ^ ' ' ~ ^ . . - . . .. . . . . ^. . ' , ^ ^ ' ~ . . | t: TOWN OF BARNSTABLE Permit No., 268S Building Inspector, , Cash Wl. • J- ,ti - S°J0. • 4. ,v 'x 4 .� iMb Sbr4 F .O :k � �tp` OCCUPANCYr PERMIT Bond 3 t . Issued to ,JdIi01I1 QO Ind. Address 2126 Falmailth-Road w<(Rte-28) , Centerville a + e1 Wiring,InspectorI`nsl�ection date `' f Plumbing inspector , / ) \ . {' Inspection date r Gas Inspector,- � (./ y . Inspectionrdate, NEngineering Department` �f�r ��,/✓ ,L_` Inspection date <' Board of Health lL 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 ' rREQUIREMENTS AND IN ACCORDANCE. ,WITH:SECTION 119.0 OF THE-MASSACHUSETTS STATE - BUILDING+CODE.. ...... r� >.� ._._ _r Building Inspector t ' _:: ...a vy. !"ti a': " �.. 1. a:�;� ygtw�r+,�y,." �.`'Cti°'��F'F .•9.j'7�i�Y,i".'!�j� '..Tw .. :.n " • a TE mid • TOWN OF BARNSTABLE permit No 26851 } -� ' Btulding=Inspector:` � ' �uia°u i '.•o. - ' '4 ,Cash r .a- '`°""�t OCCUPANCY PERMIT Bona 'ls�� A r, .Issued t0 nAAddri+SS." y •` ` .yi.; r > ' Jarinm Co. Tnc'. r - ' 2126 Falmouth Road Me28) Centerville Wiring.Inspector nl? ' 1, Inspection date, Phimbing Ifispector _ r . , Inspection date Gas Inspector:- �J a� /f� r k �;; r✓, Inspection date- txEngneering Depa4tment tc` �. -�" nr }.Inspection date yy •,. ,; ' Board of Health Inspection date. h ,THIS PERMIT WILL NOT BE VALID, AND THE,BUILDING. SHALL NOT'-BE` OCCUPIED ,UNTII v SIGNED.IBY' THE BUILDING INSPECTOR,•UPONa,-SATISFACTORY tCOMPLIANCE' WITH' TOWN 'REQUIREMENTS.AND. IN ACCORDANCE WITH`SECTION 119.0 OF'THE.MASSACHUSETTS STATE, BUILDING, CODE. S , h„7....... 19 t•... ... ...0 4' t .. ... .... '. /'•�J\Building Inspector�• s FROM F TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr. Francis Lahteine 887 MAIN STREET HYANNIS,- MA 02Wt Town Clerk -.�,,.��.��.�.,��.,� - . Phone: 775-1120 SUBJECT: FOLD HERE ' ,DATE - • _ - _ January 9, 1985 MESSAGE <- Work has been colro let�ecl under PP,rrnit #26851 Qmin Co. ,.Inc..).-. ' t s-. Y w .ws t i�v..yp:x-w R F Y•Br e.a!'R+ T ygf,:�91•!N'+• .f>f'AF hF.#i!YF es'.R+"� 4^.'.f t-P�s, v::R f!.i Y _ _ s.,• Please release Bcnd. +a•p�..r,.�Yzr��e>a....,a...^�.�*.wY�:r...�ev�-ems«„-,a,�..�is�x�� " , ..- " SIGNED - DATE ... REPLY f( r p ` .. • ' SIGNED • ,.i Nei-RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY - PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW,COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. t � i VI �S 10 ----------------------------- r ahtl) �ti'vty "- CE,�T/�=/EO LO6.47io,ymac- / C,�e2 7-/,C7>! 7WA7- TL1E ►J p a T� / N CD�'t�L YS k//Tfv SC,�1 L _ �D S,vaw h' 7-,�.�� ,S/OE,C/.�/� A,(/O SETBA C/C zE�JvieEiL1ENTS of THE 7'owA✓aF i r5k. .—0CA T�'!� Ls//T.//N T�/E �.000ZDPLA/iS� S I OA T.E-. ,2EG/STE�F� Tf�//S �,[..9/✓/S �t/oT' BASSO Ate(/ -c%T g� A�G,� Assessor's map and lot number ....//I'............ ?t . . !f, w dry} aY Sewage' Permit number ....... ....................:... : STAL.LED �I - aY BE / ! C[ House number :aZ oz% j.......1(zt.!7......... , ski/9r'3G'Li;��c �!Y C,5 Ar!!r } B aaK c itch'.IL 0YA`l 6. TOWN OF BARNST.ABLE BUILDING INSPECTOR �� T- 771?6lg4-,,, APPLICATION FOR PERMIT TO .... �.; .....:.. s 3— � l TYPE OF CONSTRUCTION; ........... ........ .:.....7:...IR A.i"... ..I.L......................................................... j TO THE INSPECTOR OF BUILDINGS: \ The undersigned hereby applies for a permit according to the foll ing' info ion: .— ............eLocation .:.................................. C �2V L LIL ......p ....... l, ..... Proposed Use S ...... eir C:................................................ Zoning District .........../- C..................................:.:..............Fire District .............:..:.....:............................... ........... Name of Owner..AM.U. .......G.0......V..4C�.........Address b 2 . . .1�! .......�,1.:� . Name of Builder l•Y'! / �.'Y..CPJy Address ...ld. ..... 1•N.� Sl : .�?,�� tS p, .... ................... . . Nameof Architect .....:.. ....`.5.�...............:.... ......................Address ......:........................::......, .:........................................ Number of Rooms ........... .....................................::,.........Foundation ...`-tJ.N.�1.R . .. .j k'.......`.....TV ....... . Exterior .Gj+A 'a2 ....CA..k+11 Roofing ...... ��.. .-.................................... Floors ...4rQS' .�. :. ...l-E' .� Lvt'L1�U 2� `1 ...... ........................Interior .................... #.......... ..%......!I... . �..... Heoting ....... : ,—fx1r.C,.....Plumbing ............ .............................................. Fireplace ........ Ar.:.S.. ..........................................................Approximate Cost .... .: �S. .U� . ..[b�.....:.......................... Definitive Plan Approved by Planning Board _______.___"____:___19________. Area ..... ...:(..3..�0.......... Diagram of Lot and Building with Dimensions Fee '.°ZS SUBJECT TO APPROVAL OF BOARD OF HEALTH • 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 ......... y`/Y .:44".."../! : ,...' q..�..�.......Construction Supervisor's License !:.Q . r1 JAMWi CO. INC. '! - No .26851..... Permit for .One,Sto. _ .......... FamilY..Dwelling........ _ s _ Location CentervillQ................. ? \ .. :.. Owner Jamun Co InC�.:....................:............ �+ r }- ......... ...... .. ..... TYPe:of Consiructiori .k'Z,dWE=................................ f - _ ,'Plat ' • Lot '_ IN- Permit'Granted ......Aug.p.-'..t..1.6.............•19 84 '..�Date 'of Inspection ................ 9 Date Completed :/Q...�.>°.�......:!......19o � ,l 640M I j�f^y'�" Lac. �. �,_. J. ram- •..' a - _ \• /% •— — . , - _ _ _ . = y } , ,..; 4_ x `.`_.1.. 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