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HomeMy WebLinkAbout4061 MAIN STREET 7777777-,­ 15r-Twif RAT a Swiss a q gmu?Xs A to hills, tia"Tffo MUT flyllf xyd"Iy!"It" t-MIAT M,not; MCI pit? _g 4 oil,MIT A man W! tnow I 4—C a p"o"t oan vemn on; qZ1. IIsm WM= an PER A jam Id"A",MEW ey ERROR,IV,tow "W­ -4 tVIM W4 Rom DIV"Woo W-100 M% ;Wt Navy It -SWAM Alt A- ef - avdu. From Ia y UMMAOUID: Studio, $475. ,�• o _ All included, cable. Securi- ty & 1 st, no smoking/pets. f` Very nice. Call 362-36T&oI Q RFN �ricn ry yr ,7C $, �13/91 AZZ;o.,an, CV .g to le o,9 1�"Sf edC . - eoe e,�P •� w e (.( (r C tA,� S vv. y 0ec S CASE-O Yee �e �'C' CO�Sf'Sf f ;J { -e!'f 71 'j C e- II , Sra! 91- S 1-0� /20 x f n o�00 ,2 t Y a- a • OIlk + • ,. -: ,. - 1. r. • t :w r a a • ;,� ^. a :: - , c ao� so3 ��� Town of Barnstable *Permit# Expires 6 months from issue date Regulatory Services Fee 5 BMWSTABM + 16 9. Richard V.Scali,Director i63 �� rFD MIS� Building Division -ARES Tom Perry,CBO,Building Commissioner I' s � ��'� 200 Main Street,Hyannis,MA 02601 f,r� www.town.barnstable.ma.us V (� , ''rr Office: 508-862-4038 TOWnI Fax- 50�7 0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL &d4'1VSTABL _ Not Valid without Red X-Press Imprint Map/parcel Number — 5S o o. f Property Address q Ob l 0111w, fn I.. M VY)4j2 iJ I_ _i) Residential Value of Work$ C Z, q s y Minimum fee of$35.00 for work under$6000.00 T Uhut Owner's Name&Address LlA c ( a c 4o b l M!j1u Contractor's Name 1 t I qItk Mb"1 11 Telephone Number Home Improvement Contractor License#(if applicable) �6 86 6 Email: Construction Supervisor's License#(if applicable) 2Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name /7&tf;jf VtLZF dvgk"Tege Workman's Comp.Policy# 2 D 1 YOB) W10 q0 Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) /'' Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to�� ►71�Q !s!t bc� M tl ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) '7 ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#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: P e ner must sign Property Owner Letter of Permission. A 96 of he Home Improvement Contractors License&Construction Supervisors License is r ui ed. SIGNATURE: Al C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PI01 DHR\EXPRESS.doc Revised 040215 The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street,Suite 100 Boston,MA 02I14-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITN. Applicant Information TO Print Leidbly Name (Business/Organization/Individual): 13 Vt/1' C,D c L 1 ,16 Address: `2S(:'t ��Al►gTC- City/State/Zip:_ c f r C 12 10 Ne l)- Phone#: 5 c'8- Z 86- 01 5 t Are you an employer?Check the appropriate box: Te of project(required): I-XI am a employer with15' employees(fall and/or part-time).* 7. ❑Ne nstrvction 2.❑I am a sole proprietor or partnership and have no employees working for me in y capacity.[No workers'c insurance 8 emodeling an ca i comp. required.] 3. I am a homeowner do all work myself 1--yp . ❑Demolition ❑ � y (No workers'comp.insurance required.]t 4.0 I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12. Plumbing repairs or additions 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.t 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'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. tContracton that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. am an employer that isproviding workers'compensation insurance for my employees Below is thepolicy andjob site information. Insurance Company Name: Amt•G L('X, Qw.c a-- 6 Policy#or Self-ins.Lic.#:_ 10 1 y Ob ?.D tj- b Expiration Date: Job Site Address:CAo G � S City/State zip: r ��63� Attach a copy of the workers'compensation policy declaration page(showing the policy number and ez atiou date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage veri 1 n I do hereby rti the pains and penalties of perjury that the information provided above is true and correct I Si ature: p Date: Phone#: 5W-Z.Ed-1)1 St, [[6.0ther ficial use only. Do not write in this area,to be completed by city or town official ty or Town: Permit/License# uing Authority(circle one): Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector ntact Person: Phone#: POWER-1 OP ID: EL ,�►coRo CERTIFICATE OF LIABILITY INSURANCE DATE 09/11/2014Y) 09/11/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement- A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lacher&Associates Ins Agency PHONE FAX Lacher Insurance Group ac No Ext:215-723-4378 AIC No): 216-723-8604 632 E Broad St P O Box 64398 E-MAIL Souderton, PA 18964 ADDRESS: Chad Lacher INSURERS AFFORDING COVERAGE NAIC# INSURER A:Harleysville Preferred Ins.Co 35696 INSURED Power Home Remodeling Group, INSURER B:Harleysville Worcester Ins Co 26182 LLC INSURER C:Nationwide Mutual Ins Company 23787 2501 Seaport Drive,Suite B110 Chester, PA 19013 INSURER D:Pennsylvania Manufacturers 12262 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOLTYPE OF INSURANCE INSD SUER POLICY NUMBER MM LTR /DDIYYYY1 1MM/DD/YYYY1 LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED CLAIMS-MADE -)C OCCUR MPA00000089793N 10/01/2014 10/01/2015 PREMISES Ea occurrence $ 1,000,00 MED EXP(Any one person) $ 15,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PE O- LOC PRODUCTS-COMP/OP AGG S 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 Ea accident B X ANY AUTO BA 00000089796N 10/01/2014 10/0112016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Peraccident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 C X EXCESS LIAB CLAIMS-MADE CMB00000089794N 10/01/2014 10/01/2015 AGGREGATE $ 10,000,00 DED RETENTION$ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER IN D ANY PROPRIETOR/PARTNER/EXECUTIVE Y NIA 2014006620967 10/01/2014 10/01/2015 E.L.EACH ACCIDENT $ 1,000,00 .OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 g Mass Auto BA 00000018227P 10/01/2014 10/01/2015 Auto Liab 1,000,00 B NY Auto BA 00000074849R 10/01/2014 10/01/2015 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required( CERTIFICATE HOLDER CANCELLATION BARNSTA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Barnstable 200 Main St AUTHORIZED REPRESENTATIVE Hyannis, MA 02601 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ok� anuvsrABt.e. 1' : Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I Ll N eoiu V1,1 f6 ,as Owner of the subject property hereby authorize M prkk Mort-OI 11 to act on my behalf, in all matters relative to work authorized by this building permit application for: 4oW MA 14 S, Curnm��u�i> 1%0 (Address of Job) Signature of Owner Date L!�/C(7t N Ott l r I Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.0utlookUP101 DMEXPRESS.doc Revised 040215 Massachusetts -Department of Public Safety '✓ Board of Building Regulations and Standards Construction Supcn isor License: CS-057645 'J. MARK E MORDEq 18 NEWELL DR ' N ATTLEBORO MA Expiration Commissioner 09118/2015 c�l,/ie Tp usrecrl,(,� �P/�cz t arrvnwo z a aaac>lzuaell y �--office of Consumer Affairs&Business Regulation " i OME IMPROVEMENT CONTRACTOR .° Registration: 168616 Typr ` Expiration: 3/18/2017 Supplement POWER HOME REMODELING GROUP LLC. MARK MORDINI 2501 SEAPORT DRIVE STE B110 CHESTER, PA 19013 Undersecretary r �' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map F -� `S Parcel 7 Permit# Health Division = r�5 (lio cl Date Issued `o 6 . i Conservation Division y '22 `I C, Application Fee Tax Collector Permit Fe Treasurer IoN U, SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by �lanning Board ENVIRONMENTAL CODE AND �' Ic'' tilo `' TOWN REGULATIONS Historic- OKH J Preservation/Hyannis Project Street Address Village '��� � Owner •T �?�Lf�i' Ga �%3,i2— Address Telephone Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 2) Construction Type , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ 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 ❑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 BUILDER INFORMATION Name Telephone Number Address ✓���� 0` f License# �Li'/l��%✓�L�/ '� l/�-� ��� Home Improvement Contractor# Worker's Compensation# Xl/,�JC� /lLi j ZED ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `lw►� ��'fl�L✓Z.t� SIGNATURE DATE Z9 %O� FOR OFFICIAL USE ONLY F PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH m FINAL GAS: ROUGH Q O FINAL 1 S50 FINAL BUILDING m 21-K 'QL 1� stl e y mc� � � O � � a gMM cr to O DATE CLOSED OUT n p n T coASSOCIATION PLAN NO.no 2 s a�e L'urttIlNutllellG(i! [�� G(ltJJllC/t ttdC�l . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 003010 Birthdate: 12/25/1948 Expires: 12/25/2005 Tr.no: 11876 Restricted: 00 WILLIAM F SWIFT PO BOX 108 C.E« BARNSTABLE. MA 02630 Administrator B o ui d2n� ��� ��czc I u " f a� �a1a ons an Standards L� One Ashburton Place - Room 1-)01 ` Boston. Massachusetts 02108 Home Innprovement Contractor Re.aistratioll, Registration: 100110 TYDe: Private Corporapon Expiration: 61912W6 CAPE ASSOCIATES. INC, WILLIAM SWIFT PO Box 1858 N. Eastham, MA 02651 Update Address and return card.Nlnrk r&A on for change. Address —. Renewal Employment host Card DPs•t:at v Sp�'ryVryt-G i0121d - ti%/e/�- '(`c,ae�nuraukrra/!!f o��llasfae/:�su� \ Hoard of Suildin�.Regutntiuds and Standards License or registration valid for individul usr only HOME IMPROVEMENT CONTRACTOR befure the expiration date. if foand return to: Registration: 1Dal SO Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 6/9r2tRTti Boston.Ma.02108 Type: Private Carporation CAPE ASSOCIATES.1NG. WILLIAM SWIFT 345 Massasoit Rd N.Eastham,MA 02651 Adtoinistrttur )�iqt Vnlit)withOUt :tLUrC .tJ. .:fi'•:.:1:j[:1.,•f F':.,.is. -^ ss.Y.tt:':{t::..'J4.i:..1+Wt�MOt;�Yid" .•,f:;•;' TOTAL P.01 BIKE Town of Barnstable Regulatory Services BMWSUeL& ' Thomas F.Geiler,Director •r�&659- 1� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office. 5• 08-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder kRcFoEt:?,- , as Owner of the subject property hereby authorizep �SSO C/�%�S to act on my behalf, in all matters relative to work authorized by this building permit application for. Ga�mo u i h a 3 7 (Address of Job) S' tore of Owner ate Print Name Q:FORMS:OWNERPERMISSION -rIC3N O.F PROPEL Es AY-� NQ,-r g Acc ATE. STANDARD LEGEND NOTE:not all symbols will appear on a map Q=:::ZD GOLF COURSE FAIRWAY 'Y'f�•" EDGE OF DECIDUOUS TREES 4 6" EDGE OF BRUSH MAP 335 • 027 ORCHARD OR NURSERY v-7T— EDGE OF CONIFEROUS TREES # 4073 IMARSH AREA EDGE OF WATER DIRT ROAD DRIVEWAY --PARKING LOT PAVED ROAD 28 — — — DRAINAGE DITCH U ————— PATH/TRAIL • •'/Pkelq)'s 1,!\ _......................... PARCEL LINE** MAP326 E-- MAP# 021E-- PARCEL NUMBER #367 F HOUSE NUMBER 2 FOOT CONTOUR LINE —110 10 FOOT CONTOUR LINE Elevation based on NGVD29 1 /4.9 SPOT ELEVATION STONEWALL FENCE r RETAINING WALL i RAIL ROAD TRACK C K STONE JETTY 5 f SWIMMING POOL Pam MAP335 1— PORCH/DECK 0 BUILDING/STRUCTURE -`I'— -— 074 DOCK/PIER 0 HYDRANT U t' n 8 VALVE MANHOLE LV -� 0 POST CFI FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H I C I N F O R M A T 1 O N S Y S T E M S U N I T ¢ SIGN S STORM DRAIN e PRINTED SCALE:IN FEET Lational This ma a an enlarge of a **NOTE:The parcel lines are only graphic fe resenlations DATA SOURCES: Planimetiics man-made features were interpreted from 1995 aerialphotographs b The lames p g p Y g p p ( p Y 0 UTILITY POLETOWER hs by GEOD w Q 2Q QQMopalA<a�ory Stnd and ard�ot thismeet do of ool epwent aerty acNal relaf anshipsries.They are ifo phys hue lml abjedsd Corpor W. allon.a Plan met ay. �tapagvaphy a9dtovegefaorn weee mappdo o mee9Natianal MoprAaurary Stolards 1 INCH=40 FEET* d scale. on the map. at a scale of V=100. Parcel lines were digitized from FY2004 Town of Barnstable Auessars tax maps. v LIGHT POLE O ELECTRIC BOX �+ ;. � h �� f s �. s .,`� '�'� �� � q � �� 3 � �o �- � �`� �. .,x � � � � I +� I .._,..,.��.��..n... _.._.�..._�......_ i �'� �/� E J � � • � II �y 77 F7f } tr M f f � l � t p oF�HE f To-vAm of B arnsf able Regulatory.S ervides ' f B'0;1 AgL, . Thomas F,Geiler,Director MAsa p� Buildiugpr Division . • Tom Ferry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , Office: 508-862-4038 Fax; 508-790-6230 permit no. Date ' AFFIDAVIT HOME I1YIPROYEMENT CONTRACTOR LAW SUPPLEMENT TO PERM APPLICATION , MGL 0,142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or constriction of an additionto any pic-existing owner-occupied bu0ding containing at least one but not more than four dwelling units or to structures which are adjacent to •. such residence or building b e done.by registered contractors,with certain exceptions, along with other requirements, Type of Work: '2 Lie Address of Work %LJ�/ ,M.�iw S1 C �✓`�'`'/`�C2 v Owner's hate of Application:, �`' �—c I hereby certify that: Registration is not required for the following reaseu(s): []Work excluded bylaw , • []lob Under�1,000 []Building not owner-occupied ' []Owner pulling own permit Notice is hereby given that: OARS PULLING THEIR OWN PERIYIIT OR DEALING WITH UNREGISTERED CONTp-kCTORS FOR APPL104) E HOMM MUROYLIMT WORK300 NOT IdA•YE ACCESS TO THE AIt13ITRATION PRO GRAM OR GUARANTY YM UNDER MGL c,142A. SIGNED UNDERPENALTMS OF PERJURY Thereby apply for aparmit as the agexit of the owner: Date tractor Nine RegiS�afzonT(o. G • OR , Owner's Flame The Commonwealth of Massachusetts .Department of Industrial.Accidents Y == Bfhffl"dPffM 600 Washington Street - Boston, Mass. 02111 . Workers'. Com ensation.Jnsarance Affidavit-General Businesses e� / - address: s. 7. state' 2/i Zi hone# ci work site locatio3s frill address - (� I am.a sole proprietor and have no one Business Type: [l Retail❑ Restaurant%Bai/Eatin'g Establishment working le any capacity. ❑ Office❑ Sales �mcluding.Real Estate, Autos etc.) qn Io ees full & art time). ❑ Other I am a'a em toyer with / I am Tloyer providing:workers' compensation for my employees working oa this job.. ',r 4•S �• '�'{ L fi S� •f:L'M1 .i,•7. •iL )'1 'M1• ti ..5+'•►t•/��/y�.�yL►'r'••', ,'�f�•'• r:l� (./ dr•.'��„L;f•ty1•'tif� •' �I':F••O,ir yt.},�r."•:.�•.�i:tr.�,S. •L•..• YY�'• J.!•' '•'" �'1,�•f'r,T mod' . C .. , COlil��`Zle:--- y 4p r r r 5 ; ,• L„L ,�,r +• ,t,.hr• '�+,i ,y i�� L •rr -•.r.J f': ' y•/r L M1,w i • J r J t t 7 rt [[ j r ' .ryL I,. •J• •1 .4: � !. V '.j.•:r� :{,'• '-,�.tC.: :'+': .IG+:T L Ir r'• •• ' • 'l.i �i'' .','.;'•':•fF,i,M1 '; :.,:.+�»3:::: J/...r,.LA,. r,{;Ir. y.;:�t��S,•f+. •V r7'-f'...r !a•i• f• ead1 r i a7 r +.. f r t S x t M1 i �.i i +, ': L,11.•(r i ;tt ..h:. ' .t .,, ttI/'�y/�,t'`j..`//t���../•�.RL�LZy.•��.�� t ,IJ'�(�/�/�.r.••.+1e C,1�S;?:'r Ll:i•• � .. ., i. J�•. �.�f/,�' ,1'J .Y .r• •2 1J..'rl .,y � ... J7'J-.'• ,r l�/+ /S/ Vv.Y/� �i '� .," t ... r•� 1LLOII�.tr�".i'J- y .t •.�":'' .. L.IL �-};�tj� L,`f ��' •' • . I • t r ; r . p.�J•j• r r c-q,y�W••: eN.r :,r+k`�� V�� � .�i /S'1 ?. �I��`.�.1,'• o . •#' :li`1 tr %!4. rJ ,[] I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: ..i�t. L1'�' :t.^ta7:^t' :4;� �,hhLt-'�,�J•,, .•��rr.tjr.l;i,y�. ,1.f •'•', ..fr,. :L•"r t�t�i:.;q;i:'.ti• :,,*,x�tr:.r'L•hh.�t, �:j7::'��.:' •,L COIN n IISI[Ie. + ;�J,' 'rt'gxiy''r 1h: t%•��;"I''r't;?.r \?M1 j _, f. J��ir�r ..)r',..•:r��' r:.�+L.� •.r' :i 31+:+" •: Y;'• , i"11;r{, :L'. .,.t:?r. .r •�• �� '�� .•t. ~ •, '• r r r 'fit}r: r• +• .. .•�i.�{, �1. .f`. i ' ',.. ','l:r 'f'i;�• * �i;• .t •f. 1 +'. 't'�...v.f !�: .i..'...:..yt'.. .� :'.a;';. •r•°'•�� �. �• •r.l %..:y;!'i i.,� :1•n..:... 'r + r •J:.' 'r;•r:. y .. atldre"$s•. t'' •t• ' :• -'.• •r,•4'.s• •,• . ' • �. : .t {•;. : •' dt:•r�S _ r.t,:r,}•:+` L•' ,.. +,�,. •r .t+;,'.+ '4 ,Li•,:: •i• t rr •� ":�.fr1M1 .f .�i. ,f.; a .ti-. d r 7!.•,. W V1• ,,: h�t'• r, 4''• •�•..'1'v',-, L pp r L t, .M1 ,!r 'n.•'j••r•'st•t" •y, i�:.•'•rn .t"f i.r•!.til��i,' rt"�{i�'' Lr::`, •.1:' 'r.. y'.� 1+'tr�nS lj- ,iZ�. ir, r. '•,:il,"t'ttr',. Jr„r, •: M1 t( wit ...``.. :: y•:l"u�J •Lh'S.. 1.rJ�•, ;^+ 4 yt'•' ! �1. J., •• •. .. :,; y.,tt.(.r.. •v.�' ��,.•y}''.r;,^7;,' . L'l.1ti}: ',:.•.r:•• ••O•i�C :ff'' .47r:2'1•r.:�•'.i•S� r.r•.:•"ir':a;i, ;'>.L`F�S.�i,'r;•� :.. fiistirance'eo. -'"'•: fr %%/////%�//////// :t F� M1:p•l.l•• :tl t•J:t •!�' •(.. ' :L, i*. •� !i: - � •'1:: •�k' ,1.F.1•y� ,•16 r.t'•,•,'i••,f•u,r :'jM1�'i' ••_• •'�'�.Lr,• '�X + ':' •' i •r:,5r.,.:'.. . 1 'L .'• d S.J t'y M1 {.• ry.M1�•(,� ''r L ryrM? ''V.' `t,J;h'.}•t{_iX:;J.f Si l• .i��f�:• y�:' Y'•M1•J.i��..:i. •a• •M1• t: J!. .♦ Y -J::i J'••. :r:. t .t. COlII 9D 7IlBIIYYE: K r it tL. •:"!• y r .it. �.' J t•• address..r f t , . :. i ,•'�.t .gu..`�; , , .J ., t:..� r S: :'.t •. .,.r6.. .a. � i'i�•SI:�M( 'Lt.J'1; t•'�'�••�4,f1/. r •y'w -}'f,',�t• .`L: • L' •M1J'... t�„•. r,•;.: t':,'r. �. 'L:'r4i •j•'. '� �Y'lOLE•n�• .....�•. r:r.... ... Ci y. L.. r�:^ .ir(J•p•.e, �C l ••�(. i.h ',f'S3. j . L }' :Lri• '.�. :'':i rl';• .!.;;a• :l:;' +.! '«� r '1A.4p f' ra:,,. :]•.r. .;: •`;. r„ s •,�y- L ft .•f.rL.; _ •+ te. ,,. •G,,k,,':.� '�•''' 'tv. h:•A'.i:. "�`.• :a:.;� ?. bS°•y•J' •'0'itC�'+tf i'•_ t '•'S'' !•'•: ' iiisurancelcb:1 Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the foim of it STOP WORK ORDER and a fine of$100.00 a day against me. I understand that 1L copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify u er the pa' a d penalties of perjury that the information provided above is true and correct Date /d Phone# Print name =J official use only do not write in this area to be completed by city or town official ermitllicense it []Building Department . city or town: P. ❑Licensing Board E ❑'check if immed;.ate response is required ❑Selectmen's Ofiii e 01lealth Department phone ❑Other contact person: ; i '(:ev9edsioL2003) Information and Instructions ? ' Massachusetts General Laws chfapter�152 section 25 requires all ers to theservi e of anotherunder any contract rrriployees. AS quote(i from the Ian , an employee�.defined as every p of hire; express d� lie� oral or written d as an individual, partnership, association, corporation or of An employer is 'define her Legal entityy,or any two or more of the foregoing engaged a joint enferprise, and including the legal representatives of a deceased employer, or the receiver or artnershi association or other legal entity, employing employees. 'However the owner of a trustee of an individual,p . P�. t more.than flue apartments and who resides therein, or the.occupant,of the dwelling house of - dwelling house h aving IIO another who eirrploys.persoris to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such_employment.be deemed to be,an employer. ..; MGL chap 152 section�5'*Iso'states that every state or local licensing agency s�aall withhold the issuance or renewal of a license or permitto op&ate a business or to construct buildings in the.cominonwealth for an a licant who has coverage,requir6d. Additionally, not produced acceptable evidence of compliance a11 enter into anwith the insuranc ye ontractfor the performance of publictwork until commonwealth nor.any.of its political subdivisions sh Y evidence of compliance with the insurance requirements.of this chapter have been presented to the contracting . acceptable authority. Applicants Please fill in the workers'compensation affidavit completely,tb3 checking the box that applies to your situation.:Please supply.company name, address and phone numbers alo tion of insurance coverage. Also be sureanceda sign vits may and be s the u. tted bn to the Department of Industrial Accidents for confirt a affidavit The affidavit should be returned to the city'or town that the application for the permit or license is being requested, not the Department of Industrial A.cciden,ts. ould you have any questions regarding the"law" or if you are required to obtain a:workerS.,.compensation policy,please cell the Department at the number'listed:below. 1. City or Towns . f Please be sure that the affidavit is completetndprinted legibly. The D u hnent has provided a space at the bottom of the affidavit for you to fill out in the event the Office' of Investigations has to , nact you regarding the applicant. Please be ruse to fi11.in the pe1rrnt/license number.vhich w�l be used as a reference, umber. The.affidavits:may.be.returned to the Department by.m of FAX unless other'arrangements have been made. The Office of Investigations would ae to thank you in advance for you cooperation and should you have any questions, please do nothesitate to give us a is address,telephone and fax number: The D ep artMen The Commonwealth Of Massachusetts, Department of Industrial.Accidents UMGe of favestjltabons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext.406 SHE A Q� v � s + BARNSTABMMASR • 1639. ��•� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner tr O 1 November 30, 1998 �V O I Mr.Anthony Kroeber 4061 Main Street Barnstable MA 02630 RE: 4061 Main Street(Mail#335 Parcel#028) Dear Property Owner: Our records indicate that your house at 4061 Main Street is currently being used as a two-family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either: 1) apply for a building permit to restore the property to a single-family home 2) apply to the Zoning Board of Appeals for a variance 3) prove that this is a legal two-family You must contact this office immediately to tell us what direction you wish to take. Sin l , Gloria M. Urenas Zoning Enforcement Officer GMU/kl t981130a 1f1! The Town of Barnstable— KAM Department of Health Safety and Environmental Services BuiIding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Dear Property Owner- Our records indicate that your house at/,4' �t2ee is currently being used as a family home contrary to Barnstable Zoning Ordinances. You must contact this office as soon as possible to either. ;•�""`" . 1) apply for a building permit to restore the property to a, single family home 2) apply to the Zoning Board of Appeals for a variance 3) prove that this is a legal family You must contact this office immediately to tell us what direction you wish to take. Sincerely, Gloria M. Urenas Zoning Enforcement Officer GMU:lb ®70311 a Property Location: STATE HIGHWAY CUMMA MAP ID: 335/ 028/ Other ID: Bldg#: 1 Card 1 of 1 Print Date:11/30/1998 C1RRENTOWNER TOPO, UTIITlES =STRT/ROAD._ LOCATIONCURRLNTASSESSMENT-" OEBER,ANTHONY P Description Code Appraised Value Assessed Value S LAND 1010 59,700 59,700 801 061 MAIN ST RESIDNTL 1010 106,300 106,30 UMMAQUID,MA 02637 BARNSTABLE,MA ccount# 247165 Plan Ref. Tax Dist. 100 Land Ct# er.Prop. #SR VISION Life Estate DL 1 Notes: DL 2 _ . Total 166,00 166,00 RECORD OF OWNERSHIP_ BK I!OL/PAGE.-Sf1LEDATE /u';v/t SACE.PRICE V C ': . PREYIOCXS ASSESSMENTS- ISTDlt _ _ _ . .. ._._ _ - _ _. ._ _. _._ _... . OEBER,ANTHONY P 8252/326 8/15/93 U I 1 A Yr. Code Assessed Value Yr. Code Assessed Value Yr. Code Assessed Value OVELL,HERBERT M TR 8252/034 10/15/92 U 1 A OVELL,HERBERT M 823/21 Q OVELL,VALJEAN C M-792 8143/031 U I 1 A OVELL,VALJEAN C M-792 P0611E1 U I 1 A OVELL,HERBERT DEATH CFT 8724/324 U I 1 A Total: 160,204 Total. 160,200 Total. 160,200 F EXEMPTI©NS. = OTHER ASSESSMENTS _, This signature acknowledges a visit by a Data Collector or Assessor Year TvpelDescription Amount Code Description Number Amount Comm.Int. APPRAISED VAL UE SUMMAR,Y Appraised Bldg.Value(Card) 104,000 Appraised XF(B)Value(Bldg) 2,300 -- Total. N_(J TES.. Appraised Value(Bldg) g ) Appraised an Value 59,700 REMOD'L EXISTING Special Land Value 0 GARAGE TO 1ST FL &NEW GARAGE.... Total Appraised Card Value 166,000 Total Appraised Parcel Value Valuation Method: Cost/Market Valuation Net Total Appraised Parcel Value . T BUILDIIVGPER1VIT RECORD YISIT/CHANGE HISTORY_ Permit ID Issue Date Type Description Amount Insp.Date %Comp. Date Camp' Comme nts —Date--- —ID—-.Cd.- —Pur ose/Result— — --B29601--—7/1/86 —AD— — 15,00 1/15/87 100 BA ADD'N LAND`LINE VALUATIQN;SECTION B# Use CodeDescrDepth i lion Zone D Fronta a De th Units Unit Price I.Factor S.I. C.Factor Nbad. Ad'. Notes-Ad YS ecia ricing ". Unit Price an Value 1 1010 Single Fam RF2 1 1 0.59 AC 135,000.00 1.00 5 1.06 76AA 0.7510 1BLDG.SIT 101,250.00 59,70 Total Land Units 0.5 A Total Land Valud 59,70 Property Location: STATE HIGHWAY CUMMA MAP ID: 335/ 028/// Other ID: Bldg#: 1 Card 1 of 1 Print Date:11/30/1998 CONSTRUCTION DETArL - SKETCH . ..�T _,. Element Cd. Ch. Description Commercial Data Elements Style/Type 1 Ranch Element Cd Ch. Description Model 1 Residential Heat&&AC 16 48 Grade - - Frame Type Baths/Plumbing tories 1 Story ccupancy 0 eiling/Wail 14 16 ooms/Prtns 2 BAS 2 Exterior Wall 1 14 Wood Shingle %Common Wall 2 Wall Height 12 Roof Structure 3 able/Hip �BAS 6 Roof Cover 3 sph/F Gls/Cmp CONDO/CO-OPDAA .. _. _ . .. ,' , .lement ode escription actor Mnterior Wall 1 8 ypical omplex 5 168 6 2 Floor Adj Interior Floor 1 0 ypical Unit Location 2 Number of Units 14 Heating Fuel 2 Oil Number of Levels FGR Heating Type 9 Typical %Ownership 2 6 C Type 1 None . COST%MARKET[!A�UATION 3 0... edroomt 2 2 Bedrooms nadj.Base Rate 48.00 Bathrooms 1 Bathroom Size Adj.Factor 1.00311 Grade(Q)Index .13 0 Full dj.Base Rate 4.41 26 Total Rooms Rooms ldg.Value New 118,233 Bath Type Year Built 947 Kitchen Style ff.Year Built 1975 16 rml Physcl Dep 2 uncnl Obslnc UXDE con Obslnc pecl.Cond.Code da 1010 Single Fam 100 Specl Cond% 0 Overall%Cond. 8 eprec.Bldg Value 04,000 OB-OUTBUILDING&&YARD ITEMS(L)/XF] t7ILDt1VG EX7R�4 FE�4TURES'(B) T T Code I Description LIB I Units Unit Price Yr. DP Rt %Cnd I Apr. Value FPLI Fireplace 1Sty B 1 3,000.00 75 1 100 2,30 _BUILDING SUB AREA;SUMMARY:SECTION. .. ..m . .. m_.. .. Code Description Livin Area Gross Area E .Area Unit Cost Unde rec. Value BAS First Floor 1,708 1,708 1,708 54.41 92,93 FGR Attached Garage 0 530 186 19.09 10,12 FOP Porch,Open,Finished 0 40 8 10.88 43 UBM Basement,Unfinished 0 1,356 271 10.87 14,74 Ttl. Gro-NLs LivILeaseArea 170 3 63 2,17A B al• 118 23 RESIDENTIAL PROPERTY MAP NO LOT NO. FIRE DISTRICT SUMMARY STREET State Highway Cumynaquid ;J35 B 73 LAND BLDGS. OWNER TOTAL -3 LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: BLDGS. Of Lovell, Herbert & Vallean V. "4"X'-)' TOTAL �3 13 LAND 59a BLDGS. TOTAL LAND BLDGS. TOTAL 1z, LAND BLDGS. TOTAL LAND at BLDGS. TOTAL 7 3 LAND BLDGS. "Za �2—,d I-- TOTAL LAND INTERIOR INSPECTED: BLDGS. TOTAL DATE: LAND ACREAGE COMPUTATIONS BLDGS. LAND TYPE # OF ACRES PRICE TOTAL- DEPR. VALUE TOTAL HOUSE LOT 7 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. 0) TOTAL LAND 2 1 BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT Fr. PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. TOTAL TOWN OF BARNSTABLE. MASS. UNITED APPRAISAL CO.. EAST HARTFORD.CONN. FOUNDATION BSMT. & ATTIC PLUMBING PRICING LAND COST ' nc.Walls Fin. Bsmt. Area Bath Room L Base _ — EILDG. COST ne. Blk.Walls Bsmt. Rec. Room_ %%`/ St. Shower Bath_ Bsmt. 'l _._. PURCH. DATE c.Slab Bsmt. Shower Ext.Garage St. Sh ._ Walls _ PURCH. PRICE ck Walls Attic Fl. &Stairs Toilet Room Roof RENT ne Walls Fin.Attic Two Fixl. Bath ------ , Floors rs INTERIOR FINISH Lavatory Extra --- t. F t/ 1' 1 2 3 Sink -- Attic Plaster Water Clo. Extra ..... XTERIOR WALLS Knotty Pine Water Only Bsmt. Fin. ble Siding Plywood No Plumbing _ —. �•�� ,/,! , Is Siding Plasterboard Int. Fin. -- Shingles ✓ TILING _ I �-�, ___. • Blk. G F P Bath Fl. Heat Brk.On Int. Layout L/ Bath .&Wains. </ / Auto Ht. Unit _L_. Veneer Int.Cond. / Bath Fl. &Walls Fireplace .f_- lk I Brk.On HEATING Toilet Rm. Fl. Plumbing Com. Brk. Hot Air Toilet Rm.Fl. &Wains. Tiling `(� Steam Toilet Rm.Fl.&Walls ket Ins. f/ Hot Water +. h ✓" St. Shower Total Ins. Air Cond. Tub Area •i Floor Furn. f ROOFING / ' c cc ✓ COMPUTATIONS `- Shingle / Pipeless Furn. S.F. d Shingle No Heat ,} S.F. Shingle Oil Burner / S. F. Coal Stoker S.F. Gas S. F. OUTBUILDINGS ROOF TYPE Electric a ✓ Flat S. F. 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 MEASURED Mansard FIREPLACES S. F. Pier Found. Floor brat Fireplace Stack We found. 0.H. Door LISTED FLO RS Fireplace Sgle.Sdg. Roll Roofing �- LIGHTING Dble.Sdg. Shingle Roof h No Elect. DATE Shingle Walls Plumbing wood ROOMS Cement Blk. Electric Tile Bsmt. 1st/ TOTAL 7,; /j Brick Int. Finish /?PRICED . le 2nd 3rd FACTOR __ Z REPLACEMENT 6 Q d 7 OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep• PHYS. VALUE Funct.Dep. ACTUAL VAL. f TOTAL ;:tom K� :-, (� � ✓'"' � / �� -'f' zrk ��'� a�..+•i r.�rr qC!`y* �� 4�- y{'"•� �"�,, ,'^y' ��.tSWF t -� yr H�, 4 � Vet i f ` ,Tk'i "�:3.sb Ar t ! �y -. jh x 4 '}`.'�k•. n' `+ ,v' ' +��'. r{s riz `4s MMADUID: Studio, $47$ *". . /III included, Cable. SecurF �' g ty 8 18t, n0 Smokin / is '- h�` z,..,r� a.0 '�A^T"x z`,s�' 4;•a.•x` ``'� M- `�` { .,,: a _ .r �%! ,4.. a�fJ 4x: �"td •'y- wN very nice. Cdll2 M1 5 `.'., r R`•� hp .S5 � ,.y �15. ,.Y�Ff^ K i.ri;f'`,,. . lj� r. YYF x Y,T 9y ; r y •&mot.. �;,� ^ ,yy�.''a � '7 �. i � :i- e� �✓`a�4 'wF�a _� �e tFE,,-7 moo;. zl1y � .# a ��� �x• i. f� :ram..• f��+^~�L•i� r.,s� � i. � ��;^'L 3y,. `rie V' q t � r-P suA 1>(C> 2 c9 7�Ski I�P a►Qe�2,tQ� •� we ( ( ID --� o � ST u 1O �t��, v x �� o^, �e�'► o2.P�- CONS rS`�-I ,, ��` '.� comes / /aeTl A- /OJT) e . I / �5 7(y11/��+ - L.•� - 1 ,J�Ss•• �„ _ r t � � `G .���iC.G� � ✓lam_��,!-��� _. -- --- - -- -- --- -- ---- - - --- --- --- ---- -- -- - - ,� pb �310 "EpTI Assessor's office (1st floor): C SYSTEM Iaf1UST B FTHET sessor's map and lot n er ..... .^.�R.e... INSTALLED IN CplypLl�4 oard of Health (3rd floo 3 �,�' _ C WITH TITLE 5 Sewage Permit numbe G . S ;:. ........... ......... ENVIRONMENTAL CODE aEB4TsnLE, • Engineering Department (3rd floor ,/O �C fj TOWN REGULATIONS o' MAX Housenumber ............................... ........... .............................. ar a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and' 1:00-2:00 P.M. only . - � TOWN O ARNSTA LEF B � � B BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... . .....:6- ..... ...... ... .......................................... ..............TYPE OF CONSTRUCTION � Ly. ... ............................................ ....... ... .. V..//N..e ....... ..........19.R� '-- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for. a permit according to the following information: Location ..........1'QCO. ...../ .I..eY.........-5.T...........6.L/. 14........z.1,14,......0.,..6..3..7................. \ 01- Proposed Use .:..�:... ...e �1� ...... .. .............. . ......... Zoning District ........../4 F.�........................................Fire District ST/�rQ Name of Owner ...#Cl;?4315�(:....... -.. .1rELf ......Address ...........fv*.....IV j/1� ssr. �L/!''I�? 1//0 Name of Builder .................. Address ..........................................................................:......... Name of Architect .... � V1 1•. .. ..i�..�. ....C-E...........Address ..!.!4 �P.1�� '�Q v��.......\ C.,:.P(. `e Number of Rooms .. Foundation .... oCT .6.2- Exterior .............�.V..�. .. .17� .L4:,,.1.........Roofing ..�4. —`V` T..... <Tl/V ..� .......... Floors �� V vt.�.�. 0 ..-4.p. ..:........ ' . ....Interior �/2.X...4�A G .e-. ........................................ Heating .......................................Plumbing d................ ��/l Fireplace ...............M/U.f...... ...................... Cost ...................../..................:........................... .. Definitive Plan Approved by Planning Board ______�/_a _____________19 __ . Area o.�...... ..... . Diagram of Lot and Building with Dimensions Fee /�� SUBJECT TO APPROVAL OF BOARD OF HEALTH e �I 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. #ek`�� Of &"X Na me r✓ .t.... Construction Supervisor's License )/)& ..."".... LO,V,-E,LL, HERBERT M. 29601Z� Remodel Garage No ................. Permit for .................................... k ................ 1st Floor/Build. . . ...Garage. . .............. . ........ . .... . ...... . . • 4061 Main Street -Location.................................................................. Cu uid .......................................... � !' - � ' /_, .. "' - J ` Own6rF .......Herbeft M. Lovell Type of-,Construction .........Frame......................... ............................................. .. ,1 Plot ....................... Lot ............................. J 3, 86 Permit Granted ............uly I.................... ......19 r Date of Inspection ......... ..............19 ?A Date Completed ........... .%..............19, Ix t I I I I i Lr Lu Av ca tA f d � , � . f L�4-a h _.- ti <�� ...�� y ..Vti/ �/� is T.a I.'S(• } A 4 y 1: I '� � ;� .,-al S;��i),� '�-� -'�'.', �, '�a_..,y. ,? Y.`=1�•i. ,i,1 1 ,a �...�..,`.."'_j � i �,�� ,�•-./ + �,� f.:.�. �;' ,•� 1 -7171 1 ij l ; 1 ` I 1 �_- -a•r, 41 i 1 � I tom— � •{ . ' fitt ', � J ��� . � -�x} f••.( j"'. } •.- I _ �"�Ib f -. r Lr,y!,_. T..- ,�.��"'1 '1.+L Y i f ( - i yy t t D -r r f r I I I . t �T K �»4 ' ti. I t ,I ri I I I I A 1 l- 1 I a , Iz �._� _�—i--1. I � � !, i -. ._ I 11 1 I � e... ' :- ', a '•. .� ._, ,. .. r I ( l j � _ I _.t___ � :. -T:• 1 I• -I •{ '°fir r s- = "�., I - - - 1 .. I I. I -,, I I � •r.'1 i ' 1`1+� -�. i,O. t > _ i ',� ..:1 •• a ,'' ♦� .� 1 ,' , ��_ � in r,9 yq� I i \ • I f ( _ � r _ I . I / j , �•��• F J I I , So I _ • r , r I I M- , 111t I � t I I , µe} i