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0109 OLD TOWN ROAD
TOWN OF BARNSTABLE i i MAMSTAHL$ i "6 9 Ar BUILDING INSPECTOR O,�OIIPY APPLICATION FOR PERMIT TO .......... ....... !4.' ..................... .`.�. ..:e..................................................... TYPEOF CONSTRUCTION A "'......................... ....................................................................................................... ..................0.C.7z .......19.... s. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....../. ...1..........©`L .... 0�`'.`!.... <I.:............. p°J.�.....��j ..................................................... Proposed Use 7!9 �� le `� q 'V� ...� ..................................................................................................... ZoningDistrict ................................................:.......................Fire District .....................................-.................j�....J................ Name of Owner 0, Uf/�. a, 74`7 .....Address ..�� l� / '`' �"'v " y.................. Name of Builder .'" -....................................Address Name of Architect ©.^'n a. .......................................Address ............................ .................................................................................... Number of Rooms ................Foundation ... ..... ' Exterior —. . p7 ..............Roofing '. .............,... Floors ...... ..............................................................Interior ..................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Type of Chimney .......................:............................................ / Diagram of Lot and Building with Dimensions 55 �4.° o�oSCc/ r k4) 116 l 1p,(ePJPy �4 r� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . -. :... `!....� � ............... 83'O 97 � 60o r.vG• s%dtt, � � No .1�27/.. Permit for .................................... ............... �1 .......1-.4...e:... ............................ cv�v Location f ' +d.1 ........................ ................... i y.. J "Owner .. ..�.......... .�.i?................... , Type of Construction ...ems .. l u ............................................................................... + Plot ............................ Lot Permit Granted ..f..................C..�`�... ?...19 67 ; Date of Inspection 19 Date Completed ..../................................�� PERMIT REFUSED r ................................................................ 19 ............................................................................... r ................................................................................ .................................................... ....................... s r Approved ................................................ 19 ; ............................................................................... ........................................................................ . �\