HomeMy WebLinkAbout0042 POINT LANE - 16354 yjAssessor's map and lot number ...... ...I .... $r�'
,/SEPTIC SYSTEM MUST B�E -
ED 1N.COMPLIAN O�
Sewage Permit number ....... ..: . INSTALL STATE
.........�1`fH••ARTtCLE••41•
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CODE AND
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APPLICATIONFOR PERMIT TO .............................................................................................................................
TYPEOF CONSTRUCTION ��................................................................................................:............:..:....................
................................................19..✓...j
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applie`s�for a permit according to the following information:
O//V�
Location � �S
ProposedUse .......................................... .......� .�r.....................................................................................................
/�j . ...............................................Fire District /� ,��
Zoning District ............::..?�:. . ..................,...:.......................................................
/f'�T�le� Gf�/�sil�wsJr� �.N 4 c
Nameof Owner ................................. . ................................ Address ............................... ............................
Name of Builder ..�....�.......... '!�.' `......le'..................Address ..`b/ C ✓�....��...... �t � ° ........
Name of Architect ° � ,� ° �� ............Address `� �' G 41
.........................................� ........ .................... .Jy.............................
Number of Rooms . /C .........Foundation .........�.
Exlerior ....................................................................................Roofing ......................................................... ........................
Floors / /N U�-P c/)� a. J;o�e"tT
.................................................Interior .. e
....................................................................................
Heating �a . ...........................Plumbing .. .. ... .°./ .... %{
Fireplace ..........................°......................................................Approximate Cost ........!!F.............................
Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ......1..7/.....5:�/:........
s Diagram of Lot and Building with Dimensions Fee ► ``tom ! f
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstodregard regarding the above
construction.
N .......Y. ... ................................................................
Wasilewski, Paul & Patricia
No ....163r.�. Permit for .........dd to single
fami],p..dwelling.....................................
Locationy a Pqj nt,Lane
........................ .......................................
Owner .........jaUl.&.. ktdc a„Wasilewski
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Type of Construction ................... r=o............ i
................................................................................
Plot ............................ Lot ................................
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Permit Granted .........June..29...............19 73 {
Date of Inspection ....................................19
Date Completed ....... :.... ..........19
PERMIT REFUSED
................................................................ 19
............................................................................... r
................................................................................
i
............................................................................... f
1
...............................................................................
Approved ................................................ 19
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