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Policy# 7- 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 114 t k&W, --�, -1FA&0-X, ❑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 "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 require . SIGNATURE: C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doe Revised 072110 ,r,, f 3 9. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry.('RO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 .r ropel—Ly V W 11C1 1r1 UMI L Complete and Sign This Section If Using A Builder i, A. C. �I=Mft , as Owner of the subject property hereby authorize - l 'r7 k�4'�1 eI G to act on my behalf, 111 atl 111"c'LLLCLJ Icrauvc to wvin auuivu�cu uy uua uuuuuir,pciifiit apput,auvil WE ZZr- if &�r, 0 octkrk 63 d (Address of job) Signature of Owner Date A. C. `Z:M1+or-t= Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse.1'iLLC. C:\Users\decollikWppDataEoca1\Microsoft\Windows\Temporary Intemet Files\Content.0utlook-\DDV87AAZ\EXPRESS.doc Revised 072110 'Ts ` � I , nQ � �3�+ � Wrs �.yp Zor 3.5-Zov I 50 �G s L5 : I 47 " /8 I CERTIFIED PLOT PLAN LOCATION B,9,C !ST,gBGt—� M�9 s5, SCALE . .. .... DATE PLAN REFERENCE .9Z-7n!G. .47" '&/4 . . of s -Siva w•� a/ P� Boo 2-2- Z �o E A 9o�N /a�G , , �S. . . . . . . . . . . . . . . . . . . . . . . . . KELLEY ^'i No.26100 vi ��C'�STEP�O _ � ANC SUB'l I CERTIFY THAT THE n/DA770�•/5 4`x� 'uC. .. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF . . . . .WHEN CONSTRUCTED. DATE :s&% :. zoo i. .. n �, J.t/�ZC�/— PE7-77-10lVG--/Z. REGISTERED LAND SURVEYOR • � sN�? / o` Z °jSyE�TS �j � I / PRoPosc� w,9rg,Y Svicb- 0 9S—'/ N ii� tLacN r 00 � H � 9 Tt/d z sbnnc P Lo T eQ------ J3 36--Zo o ,eesenvr ��' PRopo s N� 2>/2 11 d- v zs'f ok 1 Lo7 '°E/8 I No7z-- bti Assv�s� DA,rtj.y WCATION AfA s s SCALE . / ,•=4c!. . . . DATE PLAN REF�EFtENCE . . .y . . . . . . . . . . . . . �eva9�z Sr-o,N/.v D/V PL.4.t. A60 6�G 2 Z Z KELLEY ^.j NIL 26100 H 0 t�21STEA�e I CERTIFY THAT THE . .. ..... . . ... . .. SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF WHEN CONSTRUCTED. DATE . . . ✓��F.z�}/ h, wEZ�N' /��T7T/ON�"X. REGISTERED LAND SURVEYOR TOP OF FOUNDATION CONCREtE COVER CONCR&E COVERS 3,9/ ,e o 4' CAST IRON 2"MAX. ' OR SCHEDULE 4� 4"SCHEDULE 40 PV.C.(ONLYJ 12"MAX. P.V.C. PIPE PIPE- MIN.. LEACH ' PITCH 1/4"PER. . PITCH 1/4 PER.Fr PIT 1� PRECAST e;o `—INVERTo ;: LEACHING PIT OR EL..... . .`,�.. PIT INVERT INVERT P • EQUIV. n', SEPTIC TANK EL.f,7/: . . WST' > ��: INVERT BOX -= O ,�. . .. .. GAL. INVERT INvEar �' ~~ 3/4 TO I i/2 a 0: :.. �o WASHED p' e / ;� w STONE (v ez.7z.7o D I A.----►-��'co..rya esv PROrl LL Or GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE /°- 3/0¢ S01 L LOG _ WITNESSEb 8Y : . DATE !`�?Q•. �4Wlt TIME. . . . . . . . . . . �/o�/„i . �Aco� !�S•: BOARD OF HEALTH TEST HOLE I TEST HOLE 2j/?(3/ !/G ENGINEER ELEV. , B/,0o. . . . / sus o L S -TO/a- b ES I G N . . .DATA �2,=7%.0o cz.=78,7o NUMBER OF bEbR00MS �� . . . . . . TOTAL ESTIMATED FLOW . .3,3P . : : GALLONS/bAY 51e-7)/ C�N BOTTOM LEACHING AREA 78r-`70.. : SQ.FT. /.PIT/GSCP.D, SAr�p M��iv�y /86',.SS C,R D -S a SIDE LEACHING AREA , . . . . P. . . . . SQ.FT./ PIT/-T77 GARBAGE DISPOSAL NPfv4(. .(90% AREA INCREASE I TOTAL LEACHING AREA ; . ?47o p. , SQ.FT PERCOLATION RATE Gas. ?f/� MIN/INCH /l8� [SZ=G7.00 iS6" G�=G7.7v LEACHINO AREA PER PERCOLATION RATE .'�z.. SQ.FT/C,P,D, N.4? ,WATER ENCOUNTERED on/� NUMBER OF LEACHING PITS . . . . . . .P/T, Gt/i7-# APPROVED . . . . . . . . . . . BOARD OF HEALTH -t7AI0 `Ee-7T GF -S`7'a!✓!� ON ,9Z.L DATE . . . . . . . . AGENT OR INSPECTOR of fie E04RD oho a ``Go ' v KELLEY -"4 a 5� . . . . . . . . . . . No.261 M Z; ' G/STEW' %% S U R V Er _S� SANRAM faiPETITIONER J�=`�trV 17. k/ - i Assessor's�Tap and lot number...............................s UFTNEr - Q U eL Sewage Permit number ....r `...Z .Z( .. E SEPTIC SYSTEM L • ' _ House number .....:. .' '�..../....... ;. ` !� E�NST LL. UV T8E TITL OMP.-A. TOWN OV BARNST � �t � BUILDING TASPECTOR APPLICATION FOR PERMIT TO .b'4.1 -L-Q.L..: aL.t�....hfiy...0. ..... ........................................................... TYPE OF CONSTRUCTION 'S,-... 4�CA�`T.�l, ....... X�7E.... a ` U • k TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according"to..the following information: Location .kcr+:... 1.t. l 11'A.................... Proposed Use .Q.0 r�. .`(' Q: 1J..�. .. aY G��✓................ ........................................I......................... Zoning District ..RE .1......................................................Fiirre District ............. ........................... i Name of Owner .Y.A.11.9.411:..Url. te. .......Address,?.c),.. .\/...5k:3.....lA?�.. 1n. �,.�.!"►�, Name of Builder � 1�-�\,/x�...:1"I.j.... .:.:..:...Address, a - t Name of Architect ......................................................:............Address ....... '.4................ ...... Number of Rooms ...7........................................ .................. Foundation 4DO YQ.ct.... ...............:....... Exterior W.b1+_L_. �L!t:....�.�'11 1 .j•flq• .b&Roofing .� ...�,?(�ll (/Tp•� ,5 ` .................................................... Floors aCat T} hQYIQ.O �L9 .Interior, ..4F �..W.t I C n Heating 3. ...h.ot..�,,ir....................Plumbing :..A....b .h.�s�.................................................. V Fireplace ..I..............................................................:..............:Approximate. Cost 0Q.}Q.qp.................................... Defin:itive_Plan Approved by Planning Board _______;_____________________19________. Area jro Diagram of Lot and Building with Dimensions Fee • • SU CT. TO APPROVAL OF BOARD OF HEALTHd T 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 '... .. ,ea.. "" '!.............. ' Construction Supervisor's License .... .1l ............. ATEI,CH, VIVIM URIG '• ' 27012 12 Story 'No .............. Permit for .................................... Single+•Family Dwelling y............................................ location .Lot• 16,. 228 Salt Rock Road Barnstable ....J..... ................................................................ 't. M �-•'\_ L RC' .r.•+n• - - _ Owner Vivian,Urig..Welch. Type`of Conatructlon ......Fr ... `` .`+ ua tD `Plot `J....... lot :I..................k .? ........ .P i fir, -�%t � f� 7• :... yt • - - A..� _.3: yL:: : _ JSeptembbr 26, 84 Per, mit Granted ... ... .. .T9 .,. y Date of Inspection .....................' ..--19 a i ,Date Completed f,? .....1.9. 7{ ru I. `.1 ••ice y. � .:.r..'� �. '`y�� � - -� �'(. � r.. � ,,,�,• I TOWN OF BARNSTABLE permit No. -----------=t'_ -- ---------- } Building Inspector Cash -- --------------------- ■Nl OCCUPANCY PERMIT Bond I Issued to ;wry Ux-13 `v :.l!L Address Wiring Inspector Inspection date Plumbing Inspector ��. �_r Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. s ,�/;� '+Y. Building Inspector