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Home My WebLink About0031 PIRATES WAY TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 30 Map Parcel-,. Application # Health'Division Date Issued I ' Conservation Division Application Fee ,SV Planning Dept. Permit Fee �- Date Definitive Plan Approved by Planning Board P Historic - OKH Preservation /Hyannis tProjec-t.Street Add � l/ � T Village�ITt✓ t S ZOwnerUCt � C ��)t=�-1 N Address Telephone---= 2- ^Ce'7�3 Permi� t Request. (�r iA) e44 &>)(i ��9' Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Z ing District Flood Plain Groundwater Overlay tProjec .Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. DwellingType: in le Family ❑ Two Family ❑ Multi-Family # units Yp 9 Y Y Y ( ) Age of Existing Str ture Historic House: ❑Yes ❑ No On Old King.s:Highway""O Yes ❑ No Basement Type: ❑ F ❑Crawl ❑Walkout ❑ Other Basement Finished Area ft.) Basement Unfinished Area(sq.ft) '. '� Number of Baths: Full: existin new Half: existing t new` Number of Bedrooms: existing —new Total Room Count (not including baths): isting new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Ell ric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ exis ' g ❑ 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) Name VFC- 1� Telephone Number Address �,� eQOf em s' e License# y N� Ar Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /� FOR OFFICIAL USE ONLY a APPLICATION# DATE ISSUED + MAP%PARCEL NO. ADDRESS VILLAGE OWNER ' ti DATE OF INSPECTION: FOUNDATION FRAME ' . i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidenfs C (' Office of Investigations Y - 600 Washington Street c Boston, MA 02111 .'`y� www.mass.gov/dia Workers' Compensation Insurance Affi,davit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual Address:k-0 City/State/Zip: /lll�' Phone #: 7 23 '5 � Are you an employer? Check the appropriate box: Type of project(required): 4. [] I am a general contractor and I 1.El I am a employer with 6 Q New construction employees (full and/or parf-time).* have hired the sub-contractors _ listed on the attached sheet. 7, [Remodeling 2.❑ I am a sole proprietor.or partner- These sub-contractors have lo 8,. [] Demolition ship and have no employees employe-es and have workers' working for me,in any capacity. 9: ❑.Building addition comp.,insurance.1 [No workers' comp. insurance 10.❑ Electrical repairs or addition u required.] S. 0- We are a corporation and its 3.�'I a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additioi myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs insurance required.] t c. 152, §1(4),.and we have no workers' 13 employees. [No .❑ Other, 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.' lContractors 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. 1 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. #: ExpuationDate: iQ TF S �J �i City/State/Zip: H 14jvl ' G7-aC.1 Job Site Address:��/ /Cr' 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; fine up to$1,500.00 and/or one-yearamprisoament, as well as civil penalties in the form of a STOP WORK ORDER and a f 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. penal ' f perjury that the information provided above is true and correct.1 do hereby eerti under the pains an Si ature: !G� Date: z Phone#: 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): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Infor n for thcIf Massachusetts General Laws chapter 152 requires all employers to provide � ° kof an Pursuant Under°any contract pflh fees. Pursuant to this statute, an employee�s defined as ...every person'm [he Service express or implied, oral or.written.' her or any An employer is defined as "an individual,partnership, association, corporation tatives of aegal deceased,empl yew pr°theore of.the foregoing engaged in ajoint enterprise, and including the legal.repr receiver or trustee of a`n-,individual, partnership, association or ° and who r-s des her h'r legal entity, oein,or he occupant o Ff they the' w oner of a dwelling house having Dot More than three apartments Lich d1ling other who employ persons to do maintecnse of sucth'ctiDn or repair work empJoymentbe deemed n s dwelling house of an s to be ane house, employ j or on the grounds or building appurtenant thereto shall not ba 4 "every stal licensing agency shall withhold the iss MGL chapter 152, §25C(6)also sta uance or tes that ate.or local 'in the renewal of a license or permit to operate a business or to construct buildings commonwealth for any ran ce- applicant vvho has not produced acceptable evidence of compd. is politicalgubdI I ions shall •Additionally,MOL chapter 152, §25C(7) states. Neither the o onwealh nor any of t for the perforrnance of until acceplable eviden enter into any contrac cc of compliance with the rnsuranee requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers`.compensation affidavit completely, by checking the boxes that eir ertifi0ate(s)y to your lof on and, if _necessary,supply sub-contractors)name(s), address(es) and phone numbers)along with insurance, Limited Liability Companies(LLC)or Limited-Liability Partnerships(LLP)with.no employees other than the members or partners, are not,,required to carry workers' comperisatiorrinsurance. If anLL'C or LLP does have employees a policy is required. Be advised that this affidavit inay be submitted to the to the Department niThe affidaviilshoiild Accidents for confirmation of insurance coverage,' Also be sure to sign. be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents Shouldyou have any questions.regarding the law or if you arnsurged compa nessho should enter their compensation policy,please call the Department at the number listed below. self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly, The Department has provided a space at the bottom of the.adavit for you to fill out in the event the Office of investigations h.as to contact you regarding the applicant. Please be sure to fill in the penmii/license_numbcr which will be used as rieed only a,rCfCTencsubmit one affidavit indicating c nurriber�.In addition, an 'currtent that must submit multiple penmiVlicense applications in any given year, Y (city or policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in town)," A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the file for fUtllre permits or licenses. A new affidavit m applicant as proof that a valid affidavit is on ust be filled out each year, Where a home owner or citizen is obtaining.a license or permit not•related to any business or commercial venture (i,e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. advance for your cooperation and should you have any questions, The Office of Investigations would like to thank you in please do not hesitate to give us a calla The Department's address, telephone and fax number: . The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 4 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax 4 617-727-7749 RPvicr.ri 4-74-0 occ 7n�ilrllA Town of Barnstable woe W r�� r y o Regulatory-Services Thomas F.-Geiler,Director < BARNSTABC.E, - - - 7. N � Building Division rfD � Tom Perry,Building Commissioner. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: SOS-862-4038 Fax; 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: jd JOB LOCATION: village number street "HOMEOWNER": F.(JK—( l;(u �"r r'� k hone# work name home phone# p CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners''was extended to include owner-occupied dwellings of six units of less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as �. -_.supervisor. DEFINITION.OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends'to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures: A . Person who constructs 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 to the 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. gna r f Homeowner Approval of Building Official 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. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such. work,that such Homeowner shall act as supervisor." Many homeowners who use_this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix.Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,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 ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, e responsibilities of a Supervisor. On the last page of this issue is a form currently used by that the homeowner certify that he/she understands th several towns. You may care t amend and adopt such-a-form/certification for use in your community. "y Q:IWPFIL �FORMSIhomeexempt.DOC ES s �0�.'VKE rp Town of Barnstable Regula.tory Services qsaxrr �As[E$ Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Far: 508-790-6230. Property Owner Must Complete,and Sign This Section If Usin ABuilder as Owner of the subject property hereby authorize to act on rriy behalf, in all matters.relative'to work authorised by this building permit application for: . (Address of Job) Signature of Owner Date Print Name If•Property Owner is applying for permit=please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION BOESE" Double 1-3/4" x 4-1/2" VERSA-LAM®2.0 3100 SP* Roof Beam\R1301 BC CALCO 2.0 Design Report- US 1 span I No cantilevers 1 0/12 slope Wednesday,August 27, 2008 12:16 Build 276 File Name: BC CALC Project , Job Name: Description: RB01 Address: Specifier: City, State,Zip: , Designer: Joe Madera Customer- Company: Shepley Wood Products Code reports: } ESR-1040 , Misc: r 12 { 05-06-00 BO,3-1/2" B1,3-1/2" LL 330 Ibs LL 330 Ibs PL 672 Ibs DL 672 Ibs SL 825 Ibs t SL 825 Ibs 4 Total Horizontal Product Length=05-06-00 Load Summary Live Dead Snow Wind Roof'Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 05-06-00 15 25 12-00-00 2 %. Unf.Area(psf) Left 00-00-00 05-06-00 20 10 06-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment w 2,11 T ft-IlSs r 54.0% 115% 2 1 - Internal Completeness and accuracy of input must End Shear 1,384 Ibs 40.2% i 115% 2 1 -Left be verified by anyone who would rely on Total Load Defl. U333 (0.182") 54.1% 2 1 output as evidence of suitability for Live Load Defl: U527 (0.115") 45.6% 2 1 particular application. Output here based Max Defl. 0.182" 18.2% 2 1 on building code-accepted design Span/Depth 0.18 1 !� properties and analysis methods. p p n Installation of BOISE engineered wood y products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Mate'rial building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" -1.827 Ibs n/a,, 17.3% Unspecified or ask questions,please call p B1 Post 3-1/2"x 3=1/2" 1,827 Ibs n/a 17.3% Unspecified (800)232-0788 before installation. ` BC CALCO, BC FRAMER@,AJSTA9, Cautions ALLJOISTO, BC RIM BOARD TM, BCIO, BOISE GLULAMTSIMPLE FRAMING For roof members with slope('1/4)/12 or less final design must ensure that ponding instability SYSTEM@,VERSA-LAM@,VERSA-RIM will not occur. r PLUS@,VERSA-RIM@, For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow VERSA-STRANDO,VERSA-STUD@ are surcharge load. trademarks of Boise Wood Products-, r L.L.C. Notes t Design meets Code minimum(L/180)Total load deflection criteria. Design meets Code minimum(U240) Live load deflection criteria. w , Design meets arbitrary.(1") Maximum load deflection criteria. " ' Cut from: 1-3/4"x 9-1/2"VERSA-LAMO 2.0 3100 SP;t Connection Diagram Vfo • i ` • a minimum=2 c= 1/2" b minimum=2-1/2" d=24" 4 Member has no side loads. Connectors are: 1/2 in. Staggered Through Bolt Page 1 of 1 /J'6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application#�OZ`�76 (,r,) -A51 Health Division Date Issued 0 (o 151 Conservation Division Application Fee ��e) ® 66 Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address ,PINA 7,e-T U/14 Village Y Nnl i& Owner E UC -E N E (f�A V5 L I N E Address 31 L01Gf"A Z-Es' 41/A Bi Telephone 7 7� —'c� 2,, f Permit Request To co S 7N Li�,T �c /6 5C 1 C� ��TI-� 6�®c'�1 /L--A UAt0 Q -0/71g AJ Square feet: 1 st floor:existing proposed/yo 2nd floor:existing Al 0 proposed Total new-,- Zoning District �B Flood Plain wy Groundwater Overlay ya ( �, Project Valuation4* ' , Construction Type Wgr-P FRAM` C_n , Lot Size t 2 2 00 Grandfathered: ❑Yes 0,No If yes, attach supporting 'documentation. Dwelling Type: Single Family N Two Family ❑ Multi-Family•(#units) Age of Existing Structure gam— Historic House: ❑Yes WNo On Old King's Highway: ❑Yes 0 No Basement Type: ❑ Full ❑Crawl ❑Walkout W Other �=z L , I�5'6 2 ,SIo -,— 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 -VA-A&F Heat Type and Fuel: .Gas ❑Oil ❑Electric ❑Other Central Air: W Yes ❑No Fireplaces: Existing / New Cam' Existing wood/coal stove: W Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:9existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use BUILDER INFORMATION i Name Telephone Number * Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �V S •�� T��•t2- �. 4� SIGNATURE DATE R f \ - . : FOR OFFICIAL USE ONLY . . * APPLICATION# � DATE ISSUED - ,� MAP/PARCELNO y/ : 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 Pik NO. 2 « The Commonwealth of Massachusetts Department of Industrial accidents Office of Investigations S q 600 Washington Street �< Boston,MA 02111' www.mass.gov/dia ' Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Prin egibly t L Name(Business/Organizatiowlndividual): Address*� City/State/Zip: 14 Phone.#: Are you an employer Check the appropriate bog: :Type of project(required):. 1.❑ I am a employer with 4. [] I am a general contractor and I 6 E]New construction . employees(full and/or part-time).* have hired the sub-contractors listed on the-attached sheet. 7. ❑Remodeling 2:❑ I am a'sole proprietor or partner- These sub-contractors have g. Demolition ship and have no employees employees and have workers' avorking for me in any capacity. 9. Building addition o workers' co insurance comp.insurance.$ [N comp. lo.❑.Electrical repairs or additions required.] 5. We are a corporation and its 3.[�I am a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs or additions ' right of exemption per MGL 12,0 Roof repairs myself.[No workers comp. c. 152, §1(4),and we have no sur inance.requited.]t 13.❑ Other 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. 1 Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. . tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have empioyees. If the sub-contractors have employees,they must provide their workers'comp.policy number. insurance for my employees. Below is.the policy and job site I am an employer that is providing workers'compensation information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers°compensation policy declarafion 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 covers a verification. I do hereby certify under the pains an penal ' of perjury tha a information provided above is true and correct. - - Date; �G.• r Si tore: Phone#: Official use only. Do not write in this area, to be completed by.city or town offzciaL City or Town: Permit/License# Issuing Authority(circle one): -1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ' The Commonwealth of Massachusetts Department of Industrial accidents Offlee of Investigations ' d 600 Washington Street Boston, AM 02111 www.mass.gov/dia Workers`Compensation insurance Affidavit;•Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 'tn— V (�r-t Kr_— G L 1 t= Address: City/State/Zip: �4° 4/U'V s/ 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 employees(full and/orpart7fime.).* have hired the sub-contractors 6. ❑New construction . 2.❑ I am asole proprietor or partner- -listed on the-attached sheet. 7. []Remodeling ship and have no employees These sub-contractors have g. Demolition workingfor me in an capacity. employees and have workers' Y P t3'• $• 9. �Building addition comp.insurance. [No workers' comp.insurance required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised.ter 11. Plumbin re '3.'�I am a homeowner doing all work ffi hhi ❑ g airs or additions P myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance,required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp. insurance required.] , ''Any applicant that checks box#I must also fin 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 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 Piave employecs,they must providb their workers'comp.policy numbcr. , Iam an employer that isproviding workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins,Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 MGM c. 152 can lead to the imposition of criminal penalties of a fine vp 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Xdo hereby certify under thepains andpen es ofperjury that the information provided above is true and correct: Simatuzre: Date: G Phone #: Official use only. Do not write in this area,Yo be completed by city or town of ciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.PIumbing Inspector 6. Other Contact Person: Phone#: Taa1c JJ:z1D(eeattaae� ' Prucrigtivc Packages for Onr and Txo-Famr'}y Resldentlal Balldioge Rested with'Fvn91anls ' 11iAXf1HIIM � MINIMUM . GlazingGlazing Ceiling Wall Floor, Bl=nrd Slab iicsting/Cooling ent Emd=, Area'(`l) U-vatne= R-valuer ' R-value' R•Yniue° Wall Persrnda F-q�Pm Cyll • Pie R-vatue� R-valuer . 5101 to 6500 Heating begrer Days ' 17% 0.40 31 13 19 10 6 Normal R I2Y. 0S2 30 19 19 10 6 Nomsal g 12% 0.30 3E 13 19 10 6 iS7ifVE T 15% 036 3E 13 23 N/A NIA. Normal al 15% 0.46 3E 19 19 10 6 Normal y IP/I 0.4.4 3E 13 25 NIA NIA 113 AFUE Rl 15% 0,52 30 19 19 10 6 is AFUE X I S% 032 3E 13 n. N/A NIA Normal 0.47 3E 19 25 NIA NIA� Nmmil Z 11% . 0.42 3E 13 19 10 6 90 AFUE AA 13% 0.30 30 19 19 [0 6 90 AFUE 1. ADDRESS OF PROPERTY: ! �y &I/. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3, SQUARE FOOTAGE OF ALL GLAZING: 2 y • r • 4, %GLAZING AREA(43 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): ; NOTE. OTHER MORE INVOLVED NO'THODS OF DE!MUy NING ENERGY REQUMEMONTS ARE AVAILABLE. ASK US FOR THLS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q_��s-B803303a . f �oFTHE Tpk, Town of Barnstable Regulatory Services BMWSTAB[.E. : Thomas F. Geiler, Director KAss. �p 1639• .m� Building Division rED MP't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE LICENSE EXEMPTION Please Print DATE: JOB LOCATION: t!—�L� � �' i4� �}n(/�/ t number street village "HOMEOWNER": �U G,i= FQ\V FL //4.la 2 name home phone# work phone# CURRENT MAILING ADDRESS: 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 license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs 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 to the 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. The undersigned`.`homeowner"certifies that he/she understands the Town of Barnstable.Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and reg9j ements. ignatu Hm oeowner Approval of Building Official 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. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,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 ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. P�opTME Town of Barnstable Regulatory Services RAMMAM SrABM Thomas F.Geiler,Director g'prEo; 6. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ,71 �� OM 1',e IAa P19V 400//C/Estimated Cost YP 9�.1 . Address of Work: Owner's Name: CJ6rl= R1 Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ROwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR _v7 mot/ Date Owner's Name Q:forrmhomeaffidav 4?/- 1-84 L0 A10 SEWAGE PERMIT NO. �11' c,�� VILLAGE I S T A LLER'S NAIVE i ADDRESS SUILDER OR OMIMED DATE PERMIT ISSUED �oli3/8i DATE COMPLIANCE ISSUED i •� � day Ley I�� I�ds�aJ f I t t _. Town of Barnstable *Permit# �2W-7(�CQ 7a Expires 6 njondis trom issue dale -PRE S PERMIT Regulatory Services Fee 0 C T - t 2007 Thomas F.Geiler,Director Building Division 'OWN OF BARNSTABLE Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town,barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �� Property Address �� IFS U � [j esidential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address ECJ&l^RE CE 0 fk V I:t Contractor's Name Telephone Number 2 2 rZ� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: , ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side o A. ® Replacement Windows/doors/sliders. U-Value b3 maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home pro m Contractors Li se is required. SIGNATURE: Q:Forms:expmtrg a�� Revise061306 l The Commonwealth ofMassachusetts Department oflndustrialAecidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers"Compensation Insurance fi Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):. JE fU V" L f l> Address: .S City/State/Zip: * Phone.#:_�Od -7 Are you an employer? Check the appropriate bog: -Type of project(required):• I.❑ I am a employer with 4. I am a general contractor and I + have hired the slib-contractors 6. El New construction . . employees (full and/or part-time). . 2.❑ I am a•sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 E]Building addition [No workers' comp,insurance comp.insurance.$ required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.[ I am ahomeowner doing all work officers have exercised their . 11•❑Plumbing repairs or additions myself [No workers' comp, right of exemption per MGL 12,[PolRoof repairs C. 152, 1 no insurance required.] t 4 ,and we have( ) employees, [No workers' •13.0 Other3�/�p 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. #Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number, Iam an employer that isproviding workers'compensation insurance for my employees Below islhe policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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 tip 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 do hereby certi under the pains and Ides of perju that the information provided above is true and correct Signature: Date: Phone#: '--� Official use only. Do not write in this area,'tb be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building]department 3.City/Town CIerk 4. Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: w Bk 22175 Pa245 *4417663 07-10-2007 a"1 11 = 16u Massachusetts Quitclaim Deed by Corporation Deutsche Bank National Trust Company;as Trustee on behalf of the Certificateholders of GSAMP Trust 2004 ARl, having its usual place of business at c/o Countrywide Home Loans, Inc., 7105 Corporate Drive, Plano, TX 75024 for consideration paid, and in full consideration of Two Hundred Ten Thousand and 00/100 Dollars($210,000.00) 0 �o o Grants to: Jeffrey C.Golarz and Pamela J. Golarz, M As Husband and Wife as Tenants by the Entirety of 2076 S.E. Larson Ct.,Hillsboro,OR 97123 W Property address: 418 PitcWayHyannis,,- Ba stable C ty, Massachusetts 02601 With W Quitclaim Covenants x 3 The land together with the buildings thereon situated in Barnstable (Hyannis), Barnstable County, Massachusetts being shown as Lot 2�on a plan of land entitled "Plan of land located in Hyannis, Mass. Prepared for a Kip Diggs", dated Sept. 10, 2002, Scale: 1"=30', prepared by Cape & 00 Islands Engineering, 800 Falmouth Road, Suite 301C, Mashpee, Mass. 02649 and recorded with the Barnstable County Registry of Deeds in Plan a� Book 577,Page 5.' w b Q Said land is conveyed subject to the rights, reservations, easements, restrictions, and agreements of record to the extent they are in force and applicable. 0 a For Grantor's Title see Foreclosure Deed recorded with the Barnstable County Registry of Deeds in Book 21628,Page 174. - The Grantor herein certifies that the premises do not constitute all or substantially all of the assets of Deutsche Bank National Trust Company or Countrywide Home Loans, Inc. situated in the Commonwealth of Massachusetts and that the transfer is being made in the ordinary course of the grantor's business. In Witness Whereof, Deutsche Bank National Trust Company, as Trustee on behalf of the Certificateholders of GSAMP Trust 2004 ARlhas caused its corporate seal to be hereto affixed and these presents to be signed, acknowledged and delivered in its name and behalf by Janice Jones,its Assistant Secretary, duly authorized,this 3rd day of July,2007. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 07-10-2007 0 11:16am Ct14: 653 Doc:: 40663 Fee: $718.20 Cons: S210r000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 07-10-2007 i 11:16an Ct14: 653 Doc4: 40663 Fee: $478.80 Cons: E210,000.00 Bk 22175 Pg 246 #40663 Deutsche Bank National Trust Company,as Trustee on behalf of the Certificateholders of GSAMP Trust 2004 AR1By Its Attorney-In- Fact*: Countrywide Home Loans,Inc. O By: ce Jon i n Its: At start Secretary**-'o oy' . .' *For Countrywide Home Loans,Inc.'s authority on behalf of Deutsche� 1*t National Trust Company, see Power of Attorney recorded with Barnstable County Registry of Deeds in Book 21628 Page 164. **See Assistant Secretary's Certificate recorded herewith. STATE OF TEXAS Collins, ss. July 3`a,2007 Now before me,the undersigned notary public,personally appeared Janice Jones,as Assistant Secretary for Countrywide Home Loans,Inc., attorney-in-fact for Deutsche Bank National Trust Company,personally known to me OR provided to me through satisfactory evidence of identification,which was her drivers license,to be the person whose name is signed above,and acknowledged to me that she sig t vo nt \ for its stated purposes on behalf of said corporatio Notary Public Valinda Pickens VAIINDA PICKS" My Commission Expires: May 3, 2011 µy cojr1 NNIOn EY4*0 may 3.2011 BARNSTABLE REGISTRY OF DEEDS - s Assessor's map and lot number ............................................ �oF THE to Q t Sewage Permit number ............................... Z BA"STAIILE, i House number ............................. ......................................... 'oo MU 0� 639- a OR a\ TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......p::•:.C,0......an...additmor to existing house:® a ........................................................................................... TYPE OF CONSTRUCTION .......... rP. e................................................................... Aug13 19...$� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............3.1...nirate........... ...Hyannis Mass: ...................................................... ................................... Proposed Use .......Living. room.....Half-.bath........and...Hall............................................................................... ZoningDistrict ............................................................ ........Fire District .............................................................................. Name of Owner Eugene S Graveline .Address 31 yirates Wad ..................................... ..................................................................................... Nameof Builder fill..............................................Address ............. ............:................................................. Nameof Architect ............Sigme...........................................Address .................................................................................... Number of Rooms ...........................................Foundation ..Po%COricrete ......... ................................................................... Exierior .. C1aA... d..A..Text.....1.1.1...............................Roofing ......A,>S .p....Sh ..E1 ? .P ............................................ Floors ...........OAe .... . ................. . ...............................Interior ...........GyP° ..Wall...board............................... Forced Hotwater- Bath onl Heating .. ........ .........Plumbing ............ Fireplace ....... �fl/®gcl:/.GQa�,..� 4►.�L�'...-r , . ?... .Approximate Cost �..._.�}..�. ............................................ Definitive Plan Approved by Planning Board -------------------------------19________. Area ...........3A8... ft....... Diagram of Lot and Building with Dimensions ;1, ,.� r� Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r r _ 1 I I I il- k ` -� - -- TF I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . t� '� p'�' ... f •� /t r'`! '; rP �; GRAVELINE, EUGENE S. 23370 ADDITION No ................. Permit for .................................... ..........Single...F.ami.ly. ...Dwe.1.1 i.nS[........... .. ....... ..... ....... .. .... .. Location ...............................................................31 Pirates Way ... West Hyannispqr:�................... .......................................... Owner ..... S . Graveline'� ........................................... Type of Construction ....Frame.......................... ................................................................................ Plot .............................. Lot ................................ August .13, .- 81 Permit Granted ............................... .. Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ............................................. .................. 19 ..................................... .........., ................... ......... ............ ........... ........................... ............................................ l.4 ........................................ ........... Approved ................................................ 19 ............................................................................... ................................................................................. Assessor's map and lot number + /1 LC,.6� YS 'U4� Y SEPTIC SYSTEM MUST BE IPdSI"ALLED IN COMPLIANCE Sewage Permit number .......1f!,1-elft. ...Pl ..el '� _ V:'I"I"`H ARTICLE II STATE TOWN �) R /� �K1 N C T /�S� ' T� R' "ODE AND TOWN THE T® •10 1 \ OF' B A 1.1 \ ►J 1 S'l�lai 4iii E S. e d� t^ Z 89HBSTABLE. i �.' r4 9 MIABI. Cl o�pYa,.� BU L01NG INSPECTOR: Ar c APPLICATION_?FOk�PERMIT TO �L.N... a !e�+r ....: fi�... eL��!�..��. . 7� .. �1..� e!! ...7� �... !v.�t.'... J\1 TYPE OF COyNSTRUCTION ...lrs/GU�.. .l... N2 ... ....................................................... ..................... Z...........19.. 0 TO THE INSPECTOR.OF BUILDINGS: The undersigned hereby applies for a' permit according to.the ,follllo�wing information: Location .............3.1......RI 7-jOS- ..W ��..!t! ....1. ........................................ �....... ...................... ......... r�r!? 'iNL ?4hCF..... !. ..��^' ....QEI�Ra?!v�.....F�?oN� iz�cto �p iz�c18� Proposed Use .... .................... ..... � r ZoningDistrict ....1 ........................................................Fire District .............................................................................. Name of Ownerj&/4j1,5. ! ..�,.�. V�LIA/E....A�cTresg.. . 1..... �! ! -r.....1�� Nameof Builder ...�� ........I...................................Address ................................................... Nameof Architect ..... U'!'Y/..........................................Address .......:............................................................................ Number of Rooms jffx/4.14 t s°.... oundation. ......fit w�/C"t�7/ ............................. Exierior ..�%1 :. �i/� :..5! llt�l.L�'r ........Roofing ... .5,,/®� .... FloorsQ................................................................Interior ......PAer......4!'n G t:........................................ Heating ...... ..... ..................................................Plumbing ..e-- T�r................................................................ Fireplace ............Approximate Cost . z. ?(_)t ...................................................................... ......................................................... Definitive Plan Approved by Planning Board -----------—------—-----------19 -- Area �...................... Diagram of Lot and Building with Dimensions Fee / ' SUBJECT TO APPROVAL OF BOARD OF HEALTH -- -C E-S S R0 O•L l 7 12iC$� .$p��TJ'� o r G og\1 A' o r �? s I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin the above construction. Name ........ .. ... . . Graveline, Eugene S. 20053 add to dwelling No ................. Permit for .................................... .. ................................................................................ Location .........31..P.i r a.t.e s..Way................... ........ .. ...... . .... .. . .. West Hyannisport ............................................................................... Owner ...............Eugene S. Graveline................................................... Type of Construction ................frame .......................... ................................................................................ Plot ............................ Lot ....... ......................... March 29 78 -Permit Granted .......... ......... .............. Date-,of Inspection .... . ....... 109`bate, Completed .... . . ....... ........ PERMIT REFUSED ......*.......................................................... 19 .................................... ....................................... ..................................................... ..................... ............................................................................ ................................................................................. Approved .................................... ........... 19 ............................................................................... ............................................................................... Assessor's map and lot number "i '' ' ?T Sewage Permit number ...................................... r Qy0F711ET 'OWN OF BARNSTABLE Z BMa A$LE, i ° o 39. BUILDING INSPECTOR APPLICATION. FOR PERMIT TO E .4 k r ��`%>��1 r 4,261,71Q.v 7L. /106, 'F ............................................................................................................... TYPE OF CONSTRUCTION ... v I~ .`` A..i... . . '... .. . .. ............................................................................................... !:............................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............... ........... /f .............................7f� l. ................ f .`....................................... ................................... r, , ProposedUse ... r..-../......? ...../.............................................. .!.n,.`'.................................:..:...:` ........ .�............................ 7 '"7 ZoningDistrict ....................I...................................................Fire District .............................................................................. Name of Owner/-/�C!f"..1 `~5-C. QA VC L I ti Address ..................................%: , Nameof Builder .....' !!. ...................Address.......................... ................................................. ................................. Nameof Architect . ..............................................Address........:..... .................................................................................... Number of Rooms/... L �!�' :� F.....�4f�F.5./.4 7..�?4 Foundation � '-�'��.... .............................................:............................... Exterior .. Gi j....... ..............Roofing ........C...r../-... /.........�f// r`E ems............ Floors f.. (?il� 17h�- ice.--;1 i Interior .................................................................................... f 1 .... f/........................................................Plumbin Fireplace ..................................................................................Approximate Cost .. ....:J:................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ........................................ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH CiESS POO L ' Of 1 1 E 1 ) } J { I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............ .r,f :... .........:'..... '. .'....... Graveline, Eugene S. A 268-50 4 20053 Aidd to dwelling No ................. Permit for .................................... ............................................................................... ' Location ................31........Pirates...............Wa y West Hyannisport I ..................................................... Owner Eugene S. Graveline .................................................................. frame f Type of Construction .......................................... ................................................................................ { Plot ............................ Lot ................................ IMarch 29 78 Permit Granted ........................................19 { Date of Inspection r Date Compte ...................................19 PE IT REFUSED ..................... A. 19 ..........t... ...... .. ,. ........... ............................................................................... F - Approved ................................................ 19 ............................................................................... ............................................................................... qj- isse ; :s map and lot number ......... .S t C SYSTEM �+ F M MUST 5�� 0��6�1�rA §Y��B �� b�Qb�fTHET��o Sewage Permit number t /.. �� 8T LLED W COMPLIA C R e r r : •, t LE 5 i B9HB9TAXLE. i House number ........................................................................ r,ODE AN V, NAM 039.•F),fvS 'FOYPYa' TOWN OF BARNSTABLE BUILDING INSPECTOR (APPLICATION FOR PERMIT TO .... .Er. . ...an...additin....to existing houa*, . .. .. ................ . ...... ............. ..... ........... f TYPEOF CONSTRUCTION .........Frame..................................................................:............................................ _• �, - -� ........Aug..13.........................19... ...� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............3.�...P.irates WaY..�....Hpannis. Mass: ........................................:............ Proposed Use .......Living..room.,...Half-bath and ............................................................................... Zoning- District ........................................................................Fire District .............................................................................. Name of Owner .....Eu erie......GraVeline.................Address .....��...rlrat i.r.at.e.s..Nay......................................... Name of Builder ........Address r�.. ...........Same...................................... ..................................:................................................. Nameof Architect ............Same...........................................Address . . ............................................................................... Number of Rooms . Foundation PO�COTICT'e..e ............. ........................ ....... ...................................................................... Exterior ....Gl,ap...B.d...$ ..Text.....1.].1...............................Roofing ...... sp.,....Shingl..e.s............................................ Floors �ne................................. ...............................Interior ...........GYP.o .'..wal1...board............................... Heating .... .. ... ...�wa'Ir..r.....Bath ,.o..n1:1T...........Plumbing ............ .................... Fireplace ....... WQ.Qd/.qo.l..toxe...-Tlivi rig...RMApproximate Cos ........................ �J ............................................. Definitive Plan Approved by Planning Board ________________________________19________. Area ............348..gq...ft....... Diagram of Lot and Building with Dimensions 11 �7'7#C.C,(��D Fee ................ ........................... SUBJECT TO. APPROVAL OF BOARD OF HEALTH v V I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... .. GRAVELINE, EUGENE S 3 fry4,iio.:.2.3370 Permit for .....BUILD ADDI kN rr r ss Sincfle Family. Dwelling • _...... ....... ., _ Location ....3.1...P•irates...Ti 4y y •{jT ..... .:. r West Hyannispoort o S . Eugene S. Gravelne ti y rOwner ..................................................... ..•............. s. ` w +� o ! Frame y x: 4 �. 0 �; r Type lof Construction .... T, " c a ti.................... i e) h t. o 'rob 3 ......... .�............. ................................................ -N L Plot ....................... Lot ............................... CIA 0 . r V y' Fr C i t ar-+ r hermit Granted tq 81 , H t-) c n: Date of Inspection ...c^ ...19 ....Date Completed `�. .. ........... .r...19 z PERMIT REFUSED 19 y / , x _ i F t 4 }r J ........................................ 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