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TOWN OF BARfMABLE BUILDING PERMIT APPLICATION 2/ ,►3� Map Parcel q q Application #—, (0— l2 Health Division , Date Issued /L7 Conservation Division Application Fee Planning Dept. Permit Fee 1 D 1 � Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �-Z9 Lei dl 2�� Village �� ' L/ // __ - 02 Owner nJ,e—1 - ����rC� V Z'IC6 ,4'Y Address ���C5;� 7417 Telephone Permit Request f4-A -b Square feet: 1 st floor: existing proposed 2nd floor: existing proposed a Total ne Zoning District Flood Plain Groundwater Overlay 'Project Valuation 16 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documMtation. Dwelling Type: Single Family`k Two Family ❑ Multi-Family (# units) e e-- Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: U Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other a 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 t Heat Type and Fuel: UGas ❑ 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) t Name_ r ,r>> e_I Telephone Number Address 7 � �>�Jif� �- License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE FOR OFFICIAL USE ONLY APPLICATION # -QATE ISSUED MAP/ PARCEL NO. a ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �>✓51f�k1 S�P•nc.'-f'�rs�C: 33D ��sax s g95�4'� i� . ' _1151~ 1 oaia GCP.LL.OI.��S�Pn�►A,►�►C � �_ )s-vo5A,LPrr• use rcaa &AL.OiA Prc- WM4 1' CZU5fFCp T 5 r�Ewht.� _ Aux r wo sr. I�� �&?W-rN SosF CZG!s tom' o� S i .• � i�\ E..X�....,1.I' _.> i r � _ �•. M CwA.etrC°Ca3F 0- 1.0 So GPI ---�►- To.-ML. "p E616c 425 fsQ7 TOTAL "Dh1��{ F-►�ou 33o G'Pn ;'.�... �'t >r�Ca>,a.-r lath vs�ov i�.1 z r1►�.1.Ul ry R1CHAFID ►`s /n RETER o `� -71 A. BAXTF-R � Zr SULLiVAp9 No.7ao48a fro. 29733av TEST NoLE.. 76- 54 :a To�aF.FI.117 o `4/ u °I �10 J i ,r ♦ J i 411'P�G isr. ScH� �� ioao "G.�>�N lOZ7a ox r5`. NY �T+ll� 1 � c•h I N`/' G�•�b LEXFj � li•Il� 51�1„ ljk'�l'�G NY �i.-!.1 ri PTT lug 1HV Tai-tiC fA) CD ° 3q',o1�,W�sp C E:RTIFI ED PLaT P1.Ah1 pl-Au 'Rr-FE:RrNcG Nb YUAT �:R R E&1 s M:RtQ R-0. ( G F-l`T IF`C -n-AA-r T[-4 E 'L��11 ►.lE�1t l cLS Nr=.FEz7r.l c2:11-4P1-- 5 \',)I MA 774E 5 t=E I-1rAF: ANT� 51ZTFa Ave—K ZiEGX1.1 E tY41✓NT'S aF-T4-1 E �-acAJ IT14IQ -rHF- -FLa017F7Lh1),A. THIS RAn1 15 NOf'$a5Ep coNAN INSTRuM�Ni SuKYF-Y AND T HE OFF-SETS 5tAou/N 5HAatU TIoT 3E Ll' Ta EsrA�3L1sN LaT LI N E.S. i j I i ..... .,:..,#.'L'....M.1x....��.. ......_...., .. .r.:.r._..._.. FWr .. .....Y=c+u+.�s:'•..m,.a�_'�.�'''fY � _ 35" ( .,-.-'�,aam_.y.s�..�a -.._.. - 1 I 14 1 A _ Nq Lem 1 WL , 1111� • � Ii 1 � f I`S 1 � 1 1 1 P � �'I i �` � - - I r � - r - � �� � + i � _ _ - -� - - - -� I�� - � , � _ ,�� I � � _'� ' � � i -t -I - �I I '. - - 4 , � i - -1 �� _ � � x �F L-Y G ✓ 6P� a 4 A Ar 71 )�. k'M k✓aEF: 1,.�� du:F Il! � is 1 � 3 AAR ANY em x� �r 1 ti 4 k �r Town.of Barnstable *Permit# C � �VS" Fxpir n hs fce>7ttssue date ° fegulatory Services Fee ER � KAM s A,0$ Richard'V.Scali,Director o e e �.�!.�1R—Invision-- Tom Perry,CBO,Building Commissioner 1'OM OF BARNSTAS 00 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY r 2V ffi`" Not Valid without Red X-Press Imprint Map/parcel Number lJ -�lJ--rJ ;Zential Address q I S� 22i97k L.-��iQ Rx4� , eE�l .1fZ LC-C oZ �. 'Value of Work$ - Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address G—B-L b,0 / �1 Tq IN S''T C[g7—yyT /1/� ' Contractor's Name A)c Telephone Number of '7_:� Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) - ❑Workman's Compensation Insurance Che one: ®' I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance A 1 Insurance Company Name UIIO �� 1, 1 v Qr l e7 RT ( t� 0 p�, y. /A Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-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 ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: 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 required. SIGNATURE: �C�.��L- /VA Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 SMOKE_ DETECTORS REVIEWED _ ! _ g UILDING DEPT. DATE II FIRE DEPARTMENT BOTH SIGNATURES ARE REQUIRED FOR PERMITTING GA o©VR � \ . - r �TFIE lo Town of Barnstable Regulatory Services � ' ts� Richard V.Scali,Director- i639• Building Division Tom-P-erry,-Building Cem�nissioner �� 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, i5 ;as Owner of the subject'property hereby authorize & 21 L? _ / to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) 4, ""Pool fences and alarms are the responsibility of the applicant. Pools ' are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature o Owner Signature of Applicant Print Name Print Name t= , . Date r i Q:FORM&O WNERPERMISSIOA'POOLS Town of Barnstable Regulatory Services �oF rOsy� Richard V.ScaIi,Director P °^ Building Division Z SARNST"M Tom Perry,Building Commissioner 1619. ��� 200 Main Street, Hyannis,MA 02601 QED a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 1/ number street .._ _ village t / "HOMEOWNER": j name home phone# ✓ work phone '\ CURRENT MAILING ADDRESS: y city/to state zip de The current exemption for"homeowners" exte ed to include owner-occu i dwellings of six um or less and to allow homeowners to engage an individual for hire o do not possess a lice se, rovi ed that the owner ac as su ervisor. D ION OF HO, EOWNER Person(s)who owns a parcel of land on which he her ides or intends/to reside,o which there is,or is tended to be,a one or two- family dwelling, attached or detached structures ac sso to such us and/or farm s ctures. A person o constructs more than one home in a two-year period shall not be considered a me wner. S ch"homeowner' shall submit to the uilding Official on a form acceptable to the Building Official,that he/she shall be es nsibbe for all such work erformed under the uildin ermit. (Section 109.1.1) \V The undersigned"homeowner"assumes responsibility for c ance with the State ding Code and oth applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she un rstands ih Town of Barnstable uilding Department inimuramspection procedures and requirements and that he/she will co m ly with said ocedures and requir ments. Signature of Homeowner Approval of Building Official Note: Three-family dwellings ontaining 35,000 cubic feet or larg`'.z will be required to comply with th State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMP N The Code states that: Any homeowner performing work for whi a building peru'lit is required hall be exempt from the provisions of this se 'on(Section 109.1.1-Licensing of constructio Supervisors); p, ovided that i the homeowner engages a persons)for hir to do such work,that such Homeowner shall act supervisor." M/Ru ers who use this exemption are unaware that they areas wing the responsibilities Tf a supervisor (see Appens &Regulations for Licensing Construction Supervisors,Sec 'on 2.15) This lack of awareness often results in slems, particularly when the homeowner hires unlicensed perso In this case,our Board cannot proceed aglicensed person as it would with a licensed Supervisor. The hom wrier acting as Supervisor is ultimatelyTt the who is fully aware of his/her responsibilities,many co munities require,In part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. the last page of this issue is a form currently used by several towns. You may care t amend and adopt s a formlcertification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Asses o is office(1st Floor): -1 m���T1C S'V Assessors map and lot number d ! j �f mci ���w��� �� � TNc to Conservation �UE) IV ®� Board of Health(3rd f r. EN�nONP61ENZAL C sesi3rLntt: Sewage Permit number Engineering Department(3rd floor): ly�'C-GUL House number ��� p Y1,r►• Definitive Plan Approved by Planning Board 19 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,�S- G�t�S�' TYPE OF CONSTRUCTION e) 'e7 IfS yc: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �5— Proposed Use. ��t/i✓ .C'�/�J Zoning District Fire District Name of Owner C!4 1,7 �6/fR161 Address oyy� /lL Name of Builder ass-' Address 7— Name of Architect Address Number of Rooms Foundation Exterior Roofing 4D44 �i �„Fi.✓� a Floors Interior Heating Plumbing Fireplace _ Approximate Cost Area (dau Diagram of Lot and Building with Dimensions Feea OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the a construction. Name _ 6�✓1 � f 6-M Construction Supervisor's License lr*w McCABE, VERONICA Z� ENCLOSE PORCH No-, Permit For - Single Family Dwelling Location 49 Seth, Parker Road " Centerville - Owner Veronica McCabe . i Type of Construction Frame + �, r } J �: � t r I n. •r 4 Plot s Lot t t• r - Permit Granted 'June 9 t 93 19 f Date of'Inspection 19 Date Completed It `tom 19 q , R.t �aFi • - I , . 5 1 S� A,Pflrl+-T 1, I { of Ems° TOWN OF BARNSTABLE Permit No. ...9897........ ° BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash ......... >..... °�ciuv H`.�ANNIS,MASS.02601 Bond X lb �� �j CERTIFICATE OF USE AND OCCUPANCY Issued to Alan E. Small Address Lot #654^ 49 Sp th Parlor Pond Centerville May�a�I2,x�attG USE GROUP FIRE GRADING OCCUPANCY LOAD 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. ��ctQber,2?..,.. "....... ........................................ 19...... ? ........ Building Inspector , I 1 TOWN OF BARNSTABLE,MASSACHUSfTTS ;; BUILDING PERMI" �1�lJu-Yu2 AT/1 LV DATE SP I)tat+.h.��711�19 y6 PERMIT NVT'. �2cl APPLICANT AI?n n:. Smr•II ADDRESS' (:,+n Yr•YV i T Ic. IN0.1 (STREET) ( S3OCENSEI PERMIT TO i.Ti.C( UWtYl LjT1✓ (�) STORY t NUMBER OF .r�ylyl-.5 (TYPE OF IMPROVEMENT)• NO. c'1-- EI pR OP0 lE01U SE) DWELLING UNITS ZONING AT(LOCATION) 3:pkX 1 n ,E l,r I__ }U Seth Y:�rka?— Rnnrl (;�;11'er 15,E's DISTRICT t'((� IN0.).1 (STREET BETWEEN AND (CROSS STREET I� (CR099 STREET) LOT I S'UBDIVISION LOT BLOCK SIZE i BUILDING IS TO BE FT.WIDE BY FT.LONG BV FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: Sewage #36--855 Bond AREA OR VPE OLUME 2160 6Q• ft. - ESTIMATED.COST .$ I5Q.(111(t-oo FEEMIT tUb•Uu (CUBIC/SQUARE FEET) ` OWNER AL$D. E. Small .:entervil a BUILDING DEPT. ADDRESS BY •.r.%? i9 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF.EITHER TEMPORARILY OR PERMANENTLY, ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PRO VED BY THE JURISDICTION, STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE,OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND I.FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). FINAL INSPECTION HAS BEEN MADE. 3.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 O 2 2 ' 2 • ,.A e p P �- 3' a HEATING INSPECT) APPROVALS ENGINEERING DEPARTMENT I _ BARNST,ABLE CT E x n. sS-® OTHER U O—I'V b e r _Z ARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATEuidN THIS CARD CAN BE j TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT START EO WITHIN SI:MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTIOP'- - I PERMIT iS ISSUED AS NOTED ABOVE. NOTIFICATION. . L ►.lA C-stitra�G G�i��a~ J I t t o x 3 = "33a 6t?I] S E'P'nc.'Ths`t�C: 33D n�saX,A956,F Q USE 1 Oaa Ptsvos&L."Prr, use t;ooe EmLtogPrr vt(im-I 1' GRt.lS+}G'17 '6T0I�i v. •u T AMA _ Iwo sr. I I FLR.E/l � SObF j �•� �";1,I f.� >--;r=�Ti, ,...I I � L'1lPA.CIT`(•6pSR� ►.O = So C�P� -._._ _; TaT4�.. '17 fib t erkA FLo v./: 425 ExQ7 1 IOTA r.. 'ph►L?C Avc t ' 33o Ec PD �1 �.MLAT11>)4 pg of —-- ...-�--—[— -- ---- - - - RICHABD A. aAxYER SJLLiVArJ �+ v Na 24045 U f 0. 2 7 O 9 3� #�� $�� t oa 9T TE.-ST Not_ . Fuv WIN (vlt-- IODa ox rNV G�� LEA�H WY �r„� IAJ�! 1NV TAUK ERTIFI ED Wa6n � pl-0-T PI.Aht 1 I i•.; S'T�uE I, EL l. O ATIoN: --- $ 'P)-Ax RF-Ff Rr=Nc-G 12.p `H:o ,�Vic. r•a`.?� -. ,t t L-�IV I���•'!-L�l-- ;'-T�.�FT "i....-^.t`T.J�? _. .. -Tr R EEr l-67ERE 12 �- C-'EK )Tr < "1 HA'r T14 I?. j ti't l-)C'1�'sHt7vSrl•l �tvt L_ FJ.lErlc.1�25 AN� 5�`r'Fs, K "REGX1� Ety4�NT'S vF nAE i h� A 1. -0 let, c% - � I_I CP.I�IT: 61!-.- -. +, �aCAZ� W ITVAitJ-T-NE T'L.aU1 pl ht>.),'. THIS R�� 15 NUT�AStj� DNAN IN MEN( 5uP\\/E\f AND 1 HE OFFSETS 5HOWN SHAU1,'D A14T t3E usEQ Ta ESTP��3L15N I_CIT t.I ME:S i i I F..— !t GU,UL LINE l �j v 5 ---- - `44- -- �o f T,�t5 7oSA,L-PfT— USE rc>C)e>`ErA .t.oq t�rr - W1"st-1 1° e.QddS §�Z7 uTO Eti7r�f1 ='t> C�Qreetr(�ass= t.o ' S'o GPu \ --- - - - + Tt1T4j...��51��4 t=tr�vJt ?S ExFi7 'S30 C[TC p J. OF 4 ----- ----- — -- - - PACHAM TER a BAXTE.R =,3, SULLiVA"3 2n(i}4E� �; a U NO. 29733 G 7u 411?vc- scN� roDo )ODDAe ER71 F'i E-D t a t-I i L LO CAT t TJ,,4: T -ram: p l-A ly 4110 EErI 5 1E�C.Q I ;;�)Z��t,! cr..��•Cp�-`�S �tTFI �-k� 5lrs� t-t�a� �t�rt t_ �►Exltis�tCS A 4t� 5�'T�>�K E�XIt!�E�4t=NTS t�F E �� ��1 l- �-�^-- r-•��� , Tovc/t.� �F ?,LA'P—5TA i�-1 AQ-Z2 tS c _A ICA,NT !1T►AIQ —j-HE. -Fi-�oQrpl1.t>,-j. THIS R.&u tS tAaT C)NRN INSTRUMtNi AND T HE: OFF5FT5 5t-ov/N 5N,!)t.:tD ?qpT 3E !s Eq -t-b E5STk 3USH La I 7 1,IUE S. LIH[---._-_ Assessor's map and lot number .... ...... .. ......... / E toy . , � CaC 9 F TN Sewage Permit number k� ....... re WITH TITLE 5 !� I `BABHSTADLE, 4V q �.J S ENVIRONMENTAL CCDE House number ...........................7..1.............'........................ .;. s►o TOWN REGULATEOM 39.O�e00 TOWN OF BARNSTABLE 1t BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...4 .. .. .. .... .................................................................................................... TYPE OF CONSTRUCTION ................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accor g to the following information: Location .....C`� ."..K..... `4"...... ... .......... .....� .e .....//` ProposedUse ..................... .. ............................................................. ............... ... .........,. .................... Zoning District ......................................................Fire District .... ... V.......... Nameof Owner ....... ...... ..............................Address ................................... ............... ............ r � Nameof Builder ..........:.........................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Room .... ........................................................Foundation .... ......................................................... Exterior .. . ... ................ ...... ................................................Roofing ...... .. . ... ,..................,. Floors " Interior .... . .. . ..: .. .......................................... Heating /.... ..'.% ......�..................................................Plumbing ......... ..................... ................................. Fireplace .... ........... .... . .. . .. Approximate C st Q Q—d-� ....:/... ../............... .............� ........ Definitive Plan Approved by PI nning Board __ ____________ _________19_______. Area ��.......... L3............. Z Diagram of Lot and Building with Dimensions Fee . .,� ..V.e......... .............. 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 .. ..... ................. ...... ............... ..................... Construction Supervisor's License _.; •SMALL, ALAN E. .r i • ?Jo ..29$97.:.. Permit for ..One StorY............. Single Family Dwellin .. ............. .................... ...................... Lot 4� 4 Road Location ..................654...........9..........Seth....Parker...................o. _ r �• Centerville ...•••.•• ................................................. . ............. , ` Owner ........:....Alan E. Small ....................................:................. z Type ,of, Construction •.Frame __ Plot ............................ Lot................................. y �* Permit. Granted .....:.. 10...............19 86 .� Date of Inspection!.....................................19 Date Completed ....;............2.0........... R N 1