HomeMy WebLinkAbout0429 OLD CRAIGVILLE ROAD il
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_ Town of _Barnstableitsunaing
rnna� rn Post This Card So That it is Visible•-F"rom the Street Approved'Plans Must be Retained ron Joli nd this Card Musf be Kept
MAS& Posted Until Final inspection Has`Been Made. . P
ermit
Where a Certificate_of Occupancy_s Required;:such Building-shall Not,be;Occupied_.until a Final lnspection_has been made- ..�
Permit No. B-20-1273 Applicant Name: Randall Riva Approvals
Date Issued: 05/21/2020 Current Use: Structure
Permit Type: Building.-Siding/Windows/Roof/Doors Expiration Date: 11/21/2020 Foundation:
Location: 429 OLD CRAIGVILLE ROAD;CENTERVILLE Map/Lot: 247-038 Zoning District RB Sheathing:
Owner on Record: FERRARO,CHRISTOPHER M& PATRICIA'�M Contractor Name:` CHRISTOPHER M FERRARO Framing: 1
Address: 88 WHARF ST#411 Contractor License: CS 060697 2
MILTON;MA 02186 - Est Project Cost $ 14,000.00 Chimney:
Description: Strip old wood siding shakes. Furnish and install new Certainteed Permit Fee: $71.40
Cedar Impressions composite shakes. Furnishand install new Tyvek Insulation:
Fee Paid:;' $71.40
as required, . s
ate. 5/21/2020 Final:
Remove all debris off site D
. " :" .-Y •�* -
GJ,('✓ ��y Plumbing/Gas
�
Project Review Req: Rough Plumbing:
"Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance.
All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street,or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. � .
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or footing
2.Sheathing Inspection 4 _ Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site
Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
��v(ai12d 1-7 �pl�
Town of Barnstable-
IKE ti I Regulatory Services
"+Y o" Richard V.Scali,Director BUILDING DEPT.
'" MASS. Building Division
MAY 0 9
Paul Roma,Building Commissioner 2017 6
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us TOWN OF BAP-NSTABLE
Office: 508-862-403 8 Fax: 508-790-6230
PERMIT# d"/ 3 % FEE: $35.00
SHED REGISTRATION
RESIDENTIAL ONLY
200 square feet or less
o Cc, lcf Vry 4�
Location of shed(address) Village
1 Y <( r5—OiC[
Property owner's name _Telephone number
Size of Shed Map/Parc #
9 -17
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
You must file with Old King's Highway
Conservation Commission(signature is required)
Sign off hours for Conservation 8:00-9:30&-3:30-4:30
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
Q-forms-shedreg )
RF-V:06/20/16 i
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Franey, Patrick_
From: Tricia Ferraro <pmf860@gmail.com>
Sent: Thursday, May 18, 2017 12:17 PM
To: Franey, Patrick
Subject:: . Re: sheds t
Thank you Patrick. I was told those measurements when I applied for the permits.
Tricia Ferraro
Sent from my Whone
On May 18, 2017, at 10:13 AM, Franey, Patrick<Patrick.Franev@town.barnstable.ma.us>wrote:
Good Morning Patricia,
This is just to confirm our phone call that the sheds at 430 and 429 old Craigville Rd need to meet 10,
foot side and rear setbacks.
Thanks.
....." ,Patrick
Patrick Franey
Town of Barnstable
Building Inspector
508-862-4035
k.
1 � i
4
1..
1
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel_V Application # �� I C)079 S
Health Division Date Issued 4 Z�
Conservation Division Application Fee
Planning Dept. Permit Fee �d '
Date Definitive Plan Approved by Planning Board pY_ &f)I
Historic - OKH Preservation / Hyannis
Project Street Address —z!-J2 OLO e--AAi&1rL"-%- /,0
Village
Owner RUAX A Fe i-x- Address 17 "A AL-d Ox.
Telephone�_t. �
Permit Request =A 6T4f..Li4& /)aW V%J YL A41LAC,479:4 T GrAi;W k%1S7
r;-n CIA / 09—^— aalliAzrio
Square feet: 1 st floor: existing 1260proposed 2nd floor: existing 0 proposed — Total Rew R-`S®
Zoning District Flood Plain Groundwater Overlay
Project Valuation s Construction Type c=� rr itS
Lot Size ®2W Ac-A-f�� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(# units)
Age of Existing Structure 'V®Y,o-C Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: XFull ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 1 �
Number of Baths: Full: existing new Half: existing new —
Number of Bedrooms: C.) existing — new
Total Room Count (not including baths): existing new First Floor Room Count 6
Heat Type and Fuel: )Gas LJ Oil ❑ Electric ❑Other
Central Air: ❑Yes '*o Fireplaces: Existing O—New Existing wood/coal stove: ❑YesX'No
DetacheO ge: ❑existing ❑ new size_❑ existing ❑ new size _ Barn: O�existing :0 new :'size—
Attached"e: ❑ existing ❑ new size _ : ❑ existing ❑ new size _ Other;`_
t�
r 7Z
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ #
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION f T
(BUILDER OR HOMEOWNER)
Name P���J<< �� Telephone Number s 1 -3
Address �7 G P�u� AV-5 License # AR:
Home Improvement Contractor#
Worker's Compensation # �11
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATUR 1 s��Li,��Z2,C. ) DATE
c
F
FOR OFFICIAL USE ONLY
APPLICATION# r
DATE ISSUED
4 , ,
I
f MAP/PARCEL NO.
ADDRESS VILLAGE
t'. OWNER
r
r
DATE OF INSPECTION:
FOUNDATION
FRAME ® 0 f
Fr
$ INSULATION
ti
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
x GAS: ROUGH FINAL
FINAL BUILDING
4
f
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Massachusetts
1 Department of Industrial Accidents
• ! d Office of Investigations .-
t, 600 Washington Street rf
\°194 j- Boston, MA 02111
c=� www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Les;ibly
Name (Business/Organization/Individual): Qf$Aft, -t u
Address:
City/State/Zip: 441i941A-Z W7,4; Phone #: l 44/0U -?
Are you an employer?Check the appropriate box: Type of,project(required):
1.❑ I am a employer with 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•1 ❑ Remodeling
These sub-contractors have 8. Demolition .
shi and have no employees ❑ -
P
working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
officers have exercised their ]0..❑ Electrical repairs or additions
required.]- '
3><1 am a homeowner doing all work right of exemption per MGL 1 I.❑ Plumbing repairs or additions
myself.
[No workers' comp. a 152, §1(4), and we have no 12.0 Roof repairs
insurance required.]t employees. [No workers' 13.RLOther lJt'p,114gctigo<<
comp.insurance required.]
*Any applicant that checks box.#I 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.
tContractors that check this b=Must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. ;
Insurance Company Name:
Policy#or Self-ins. Lic. #: € Expiration Date:
Job Site Address: City/State/Zip: G.'C4e_,AC Lt,
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
I do hereby`certt y under th pains and penalties of perjury that the information provided above is true and correct.
4iunature \ lc; Date
Phone#: <�t�—-�&) _` �2. ''V i
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):
, Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector
-� 6.Other
Contact Person: Phone#:
Information. and Ins ructions
Massachus tts General Laws chapter 152,requires all employers to provi e workers' compensation for their employees.
Pursuant to is statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or im lied, oral or written."
An employer is d tried as"an individual,partnership, association,co oration or other legal entity, or any two or more
of the foregoing en ged in a joint enterprise, and including the legal epresentatives of a deceased employer, or the
receiver or trustee of individual, partnership,association or other I gal entity,employing employees. However the
owner of a dwelling ho se having not more than three apartments an who resides therein,or the occupant of the
dwelling house of anothe who employs persons to do maintenance, construction or repair work on such dwelling house
or on the grounds or buildi appurtenant thereto shall not because f such employment be deemed to be an employer."
MGL chapter.152, §25C(6)al states that"every state or local 1 censing agency shall withhold the issuance or
renewal of a license or permit operate a business or to cons ruct buildings in the commonwealth for any
applicant who has not produced cceptable evidence of comp iance with the insurance coverage required."
Additionally,MGL chapter 152, §2 (7)states"Neither the co onwealth nor any of its political subdivisions shall
enter into any contract for the perform nce of public work until cceptable evidence of compliance with the insurance
requirements of this chapter have been p esented to the contrac ing authority."
Applicants
Please fill out the workers'compensation affida 't completely by checking the boxes that apply to your situation and, if
necessary,supply sub-contractors)name(s), addre .(es)and p one number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Li ited Lia ility Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' ompe sation insurance. If an LLC or LLP does have
employees, a policy is required. Be advised that this aff it ay be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be a to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the perm or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regarding th flaw or if you are required to obtain a workers'
compensation policy,please call the Department at the number iste&6elow. 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. Fhe DepartmeriJ:has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of.Inves igations has to coo ct you regarding the applicant.
Please be sure to fill in the permit/license number which will be ised as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any give submit
year, need only one.affidavit indicating current
policy information(if necessary) and under"Job Site Address" a applicant should writeeall locations in (city or
town)."A copy of the affidavit that has been officially stamped o marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permi or licenses. A new affidavit must be filled out each
year. Where a home owner or citizen is obtaining a license or pe it not related to any business or commercial venture
(i.e. a dog license or permit to burn leaves etc.)said person is N required to complete this affidavit.
The Office of Investigations would like to thank you in advance or 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 o assachusetts
Department of Industri Accidents
Office of Investiga ions
600 Washington Street
Boston, MA 02111.
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-774.9
Revised 5-26-05
www.mass.gov/dia
Town of Barnstable
�ppTHE Tp�y
o Regulatory Services
sAsxszAsLX Thomas F. Geiler,Director
MASl ¢ ,�� Building Division
'"rEn y�.t"' •
Tom Perry, Building Commissioner
200 Maio-Strcet, Hyannis,MA,02601
www.town.barnstable-ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOT�fEOwNER LICENSE EXETrIPTTON
Please Print
DATE:
JOB LOCATION: Tie--1 �
number street 'p- village
-HOMEOWNER"; L+�I�i14 i � 6�)j /T6����
name home phone,# work phone#
17
- CURRENT kfA]LING ADDRESS: 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 lic-case..provided that the owner acts as
supervisor. /
DEFINITION OF EOMOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to residZon which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory tTsuch use and/or farm structures. A
person who constrgcts 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 toathe 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. }
1
The undersigned"homeowner"certifies tha:t:he/she understands the Town of Barnstable Building Department
minij u�t ection procedures and requirements and that he/she will comply with said procedures and
r ementsl
Signature of Homeowner
Approval of Building Official r
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. ,
HOMEOWI ER'S EXEAfPT'ION
The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section,(Scction 1 D9.1.1 -Licensing of construction Supervisors);provided that if the homrowncr rngages a persons)for hire to do such
work,that such Homeowner shall act as supervisor.
Many homeowners who use this exemption arc unaware that they are zssurmng the responsibi;ities of a supervisor(sec Appendix Q,
Rulcs&Regulations for Licensingen Construction Supervisors,Scction 2.15) This lack of awareness oft results in serious prablcros,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 cnsure.that the homeowner is fully aware of his/her responnbilitia,many communities require,as part of thepermit application, `
that thchomcowncr certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
scvcral towns. You may care t amend and adopt such a fonmt/cetvfication for use in.your community.
Q:forms:homccxcmpt
r
Trti Town of Barnstable
Regulatory Services
uttxsrtis[-E.
y tr�aa Thomas F. Geiler,Director
:659. m
16� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Us in A B uil r
I> , as Owner of the subject.property
hereby authorize to act on my behalf,
in all matters relative to rk authorized by this uilding permit application for
dress of ob)
Signature of Owner Date
Pnnt Name
If Property Owner is applying for permit please complete:the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:0 WNERPERMISS]ON
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map and lot. number ..�; . ../.. ..................:...... ,M TIC SYnTE-�?i F-ia.1ZT Si
�f�flH •�i a4 .^r t � ±
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je Permit number ........ .... . -N
yFTHEr�� OWN OF BARNSTA LE �.
T
� Z 89$,B9TODLE, •
M6 UUILING INSPECTOR
APPLICATION FOR PERMIT TO ..# d...GWs7...(. .)...bQdr.D.ams...and...bath.............................................
i-
TYPEOF CONSTRUCTION ....W99A........... ..........................................................................................................
...........Deaember....4..........19...7. .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Cl
Location .ZQ ...�, �': � t � �r��a
49 .01d..�r.ai�uille. . .c..... ................................................
Proposed Use .....Re 9 ide nti al„de l lng................ ...>.................................................................,.........................
........................... ................
Zoning District .................(�....................................................
Fire District ... 0-s.4teS:ville............
Adel n
Name of Owner Y......Vara
................................................Address ....R,1C1... .rr1.g.V. .J.le...Rd..................................
Name of Builder ..Tan.as... .....................Address -Lake...Ei-11 ..Drw.................................................
Name of Architect G�....Vara................................Address .Old...Ora•igV'iTh...............................................
Number of Rooms ..2..be.drjaoms.-...1...ba.th................Foundation ...C.OMPuft...black...........................................
Exierior .Wood...shingle...................................................Roofing .A.sphalt...s.h nglas.........................................
Floors ....Sub...f.loans...w,ith...e.artpe-t I ng................Interior ...........................................................
Heating hot a.ir. ...extended. . . ........................................Plumbing zopper.................................................................
.. .. .. .. .... ....... .....
Fireplace ..................................................................................Approximate Cost ...$500.0•..0.0............................................
Definitive Plan Approved by Planning Board -----------------__-----------19--------. : Area .. �.............................
�—
Diagram of Lot and Building with Dimensions Fee .. ........................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
INII
hereby agree to conform to all the Rules and Regulations of the. own of Barnstable regarding the bove
construction.
.............................
Adelyn Yarn
.. 4.rt.)t fi3 �i FEF
3
'°
a TOWN OF BARNSTABLE, MASS. _
b�
a b 1 Aac roibc i s 74
m
THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED .TO
O p y
',a• O. ........ ..I...... ......... ......... ......... ................._....».._.. ..
�,y , (PROPERTY OWNER) (ADDRESS)
t~ ad4f#>E1 4 !O{xklf "tt t11[%r?�
TO ... ......._. ...._ .... _
H+�y3b (BUILD) - (ALTER) (REPAIR) •»• ...ram
ul R.r..040 .. ....._ ........ ......... ..........q/7
....... .... ......................................................... .. .. ....
N (TYPE OF BUILDING) (APPROXIMATE SIZE)
O O
LOCATION .... ._...._ ......... ..._....»....... ._...0 ... -
(STREET AND.NUMBER) (VILLAGE)
will NAME OF BUILDER OR CONTRAC OR r..rrrrr�°`�''� -
APPROXIMATE COST 93 600 0
o bo� - 1 HEREBY AGREE TO CONFORM TO ALLY THE RULES AND REGULATIONS .OF THE TOWN
M u3 OF BARNSTABLE, EGARDING THE ABOVE] CONSTRUCTION.
IA aa: f
d (OWNER) - (CONTRACTOR) -
0164 a _................_....._..._._
� t BUILDING INSPECTOR
� g• 1 to Approval of Board of Health.
Subject
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Assessor's map and lot number .: `..1.../.. ............. EPuT� s:-. .::1.
..... ......
t� .ant..
-sewage Permit number `i..`../. ......
t BARIF�'T LE
�, ro�'PyOf 7N E tp�yow TOWN OF .-BARNS'
1 `INS
Z 9ARNSTODLE, i
q .e0�o w RU11101NG INSPECTOR
� ar°'•
APPLICATION FOR PERMIT TO ..Add...tft....(2.)...bedraoms...and...b.s.th.............................................
f
TYPE OF CONSTRUCTION ....W99d....
........ ................................... ..
...........D.e.aember....4..........19...7.4. j
TO THE INSPECTOR OF BUILDINGS: .The undersigned hereby applies for a permit according to the following.-information:
Location ..LQt.s...#..2.8........29...jSo. 1dvie?T...ancl...0ld..Crad.gmi1.1e....................................................................
Residential dwelling
ProposedUse ..............................................................................................................................................................................
Zoning District ................. ......
..........................:{...............Fire District ... ....Sate rVA.1 le............
Adel V '
Name of Owner ............... ..n.............ara......................................Address ....Q�,C�...Q.I'a�.g.V.�.7.�D...Rd..................................
Name of Builder .jan.p_s...K.....F.e.te-raon.....................Address .Lake...E•13Z••Drw.................................................
Name of Architect ..Aural.i.ca....V.ara................................Address .01.d...Crta'igV'i'1'1L''..............................................
Number of Rooms ..2..be.d.rtaoms.-...1...bath................Foundation ...Gement...blo.Ck...........................................
Exterior .Wood...shingle...................................................Roofng .A.sphalt...sh.3ragle.s.........................................
Floors ...Sub...f.l,0o.ra...w1-th...a-arpet ng................Interior 3Xle.e.tact=). ...........................................................
Heating hot...air extended ...........................Plumbing .topper......................................................
..................................... ............
Fireplace ..................................................................................Approximate Cost ...$&00.0...00............................
................
Definitive Plan Approved by Planning Board ------------------_____---------19________. Area ...:��.............................
Diagram of Lot and Building with Dimensions Fee ..,,1.......60..................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
1 FIt
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I hereby agree to conform to all the Rules and Regulations of the. own of Barnstable regarding the above
construction.
,,Name ...... . ... ....../. .... .. ..............................
Adelyn Vara
w _ ,
No 1.7.47.4...... Permit for ...Add.II......................
i[
4 .................................. ............... ...... . _A..........
G..
4 Location ...Lots..428....... dv'1'E ..........
rai ville Centerville
Owner .........+pAdelyR..p8r ................................
Type of Construction ..........flood....................... -
.. ................................................................................
i
PlotM..247....38.... Lot ..............:................. E
Sewage 478
t
Permit Granted .......... December,..,5 1 q 74 a
' Date of Inspecti on . ��..1
d 9.
Date Completed .!!� .�71...75...............19 .
f
PERMIT REFUSED
........................................ ........ ,........... 19 "
...............................................................................
...............................................................................
Approved ................................................ 19
...............................................................................