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0042 BAILEY ROAD
'� A '�. I:a. ;�Y _ r .i _ rE�,-r�:.��^ � �°�r�i / l�" .�F� .i: ES D�phr.'R d� "ems �F i sI ,:S t i 5 it 00 � 1 f t - �a 'i i' 7 tia� TOWN OF'BARNSTABLE L73D Permit No. ------------------------------- } NAU�L Building InspectorSTAM cash • rua --------------—---------- --- °b ,639 0 urf". OCCUPANCY PERMIT Bond --- Issued to wirlcfai-p- T,1 nvry Address 40 Bdiley Pitt, Ccitiu Wiring Inspector , Inspection date Plumbing Inspector /l Inspection date Gas Inspector - s"i} ` Inspection date ,Engineering Department '�`.`,� ! �, �, * Inspection date Board of Health 0,4uA 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 BUILDIINNG CODE. y' Building` Inspector JOSEPH D. On�uz {TELEPHONE, 775-1120 i Building Commiuiontr EXT. 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 i MEMO TO: Town Clerk , FROM: Building .Department i DATE: i An Occupancy Permit has been issued for the 7buil-ping author' d by ; i Building Permit # Y-6�-issued to i Please release the performance bond. Agse;sor t map and lot number ..... .- ........e.3...... .... Ilfni.95TC e`Q'yp GTHE TO Sewge Permit number a OW r ......... ......... ........ I I /� • !�L CO � ��i-�C�l� t BAUSTAILE, i Ho a number ........-5ze............................................7A !.ram>LL�f� 1Np �o00,"6 9 0� i�J f r:'� TI �k 'Fp MAI 0i�0 TOWN OF-BARNSTABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO ......... Q!�5'f�(�G'� -�uJL:`-L. . �4?.......................... ......................................... ................................... TYPE OF CONSTRUCTION ..........N 6,D..... .t.f.................................................................... ..../�•L.. �.......�1'../..........19...v.•• 1 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for te�a,,permit according to the following information.. Location A�.�r.L�. .....1 !/?!? .....©. !""....V.(! .`>!lA ....R.+�.! Q .......................................... Proposed Use ....... ��.-tom` .� l�r.�(( � ................................................................................................................ . ..... ............. Zoning District r ................Fire District ....GQT4.(..1.... ... ... I 4 ho0 C�7H �►� :41lam At/&. �(.VJ, Name of Owner `.... ................Address kA4DL!.#...c^ICr.'�O!�.�r..f�.r. ............Z.arp.!.4,0.... Name of Builder .....Address ....�S71�a�. �.�r...... . ....................................... Name of Architect . ......... //��,, 2 2a.J /l-[ �� �....1 r... .tJ[4i(e-. ...............Address ....(„ �.............�........ ..'.................................... Numberof Rooms .... ......................................................Foundation .... .! Ge4-Z�...... .................................... Exterior ....RYA`! ...............................................................Roofing .... 1�-� �.C.......S.S......................................... Floors .....fi r . .........................................................Interior ......7/ ................................................. Heating .�. ..I.t�.��p ................. `� .f' ....................................... ................................Plumbing .......... ...... . Fireplace .....l..L.... Approximate Cost ............... �'��• Definitive Plan Approved by Planning Board -----------_-------------------19_______ . Area 7 `r'� ©d Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH O -4?� 0 i- x ST If.-, U'� oun 6� TEI.G`Fr�p,J� WELL O� ip To to l-o" 0i,e-r Z L6*r-N PITS Soo c,..l_ SfP-{r c -rANIC H O 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 . +--r•- '•............... Construction Supervisor's License ..111,6 -73- ....... LLOYD WINGATE VT 7N ...2-085..Permit for one Story............... Single Family Dwelling ................ .............................................................. Location .40 Bailey Road .............................................................. cotuit ............................................................................... Owner ... .................................. Type of Construction ..F.-rarlle.............................. ................................................................................ Plot ............................. Lot ................................ Permit Granted ........October...............12,.................19 84 Date of Inspection ................19 Date Completed ..... -10;..... . ............19 r Al 2-3 C Assessor's'Office(1st floor) Map Parcel 4 /4ermit# Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) AJ(Al ZA Date Issued Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:45) - rj -A �� T � //t/ Engineering Dept. (3rd floor) House# As . °� 'b'�� S PC ABLE. UST BE D d 19 INSTALLE PLIANCE WITH TITLE 5 TOWN OF BARNSTABL ,IRONRIENTAL CODIF �a Building Permit Application T0111,9 P ec tre Address 4 $A I``r 9-+OAt> Village ODTV IT Owner W(W &A^t`t` l..__LO�Ip Address ')C' Telephone k • 202 2 44 • kAIA Permit Request C�1J5-1►��. -1 �3> .4�re� WOK\ .�t�Dl'1� � -�1•`� 20aClk CCO�eCnelea -M 40%-Zt tL( A CCS4 t� > TJP�! -:�S G First Floor cjJQ square feet 5crMt.0 90Y44J 1 2.5C3 Sq F'i Second Floor (pW square feet J5rL5,_->cvbtiavi -6 oa S9 FT Estimated Project Cost $ qO Ooo_ Zoning District 9(: Flood Plain A13 Water Protection V rO Lot Size 1 1 • 54 ACOVE S Grandfathered ? NA Zoning Board of Appeals Authorization Recorded N A Current Use SI Gu: Proposed Use Construction Type \�.COob :F(2AM`?-- Commercial t%t 0 Residential Dwelling Type: Single Family ✓ Two Family Multi-Family Age of Existing Structure l Basement Type: Finished Historic House IJO Unfinished C, L. Old King's Highway NO Number of Baths f 2) ��lO No. of Bedrooms Total Room Count(not including baths) ' rw R-Cee First Floor ON`G Heat Type and Fuel V--- 1.E:C TJ2A C. Central Air N O Fireplaces N O►JIE Garage: Detached E- & Other Detached Structures: Pool W ok3t Attached 1J0NE Barn None Sheds Other Builder Information Name QC)G j- . 4 In&r.,Q t.1,4i �JC Telephone Number Address ?0 en't* 17:�1 O License# 0(01 Ct 19 ) l l,l M1 pI ES2(flFr� Home Improvement Contractor# '3!A Worker's Compensation# 957 q R 003 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 12� • 5 BUILDING PERMIT DENIED F HE FOLLOWING REASON(S) S FOR OFFICIAL USE ONLY ' PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH. FINAL FINAL BUILDINGel DATE CLOSED OUT ' I ASSOCIATION PLAN NO! �� 1 L f • : r r. irk s4 .SECiUb FLCCP PLAwI a ... A / a44 ~r,e1i•.fir, - - - - � - nAA \ .. n'"`�% �..'' a Deuo¢�erwc ec R«�•- co¢tYm�o M,u."e d alr�.Ytv,l. .� r e e , . -/ i 4 PYex. TY,aa!rvs ry v/wYCG xrenD re.era. PIRST_FLOOR PLAN T er.e a.o/,wa axnaoa m a anTewr°LL - -\ a IYfil.ra.le a.rac,nr.w Yercowt aa.n.y.r. -IDr4 ar aes,waw:� - �/\ .. � j s Yne°m.s��n'e'�we•n a wu.m Drr.e cores_-�.ua To veer. - CYr^y .uu ea YD xwilne ut punier wec {wu�tuus nearati a°w, a ,�4 a a"°vcaS p e neeseuae�.Yee°a� e4ovaa Nmi • ,r��`✓+„nA Tn M na �d.Torul TwueuSrtSnr.f wuT°M - Sp l O et pyrrSa,ao eY A enarre,W �npr,aro auMn eoY Armf nre•iaM L{ea4rt voaearwar[AnKa.?" 4 YU rur.o ru e.vl 40.1. ' nYl IaMrw W-4r NnaauM.uM�. . s ncn.rroa m.rau ros�m.mnllm ... - MR,•MRb WWGATM L.AYD '-• 42 DAILDY RD:CONIT -' °e11 r -l1•A .PROPGOGD DGDROOM ADDITION " ' _R06GRD.►MARNCY, IM1G -' 11! L 1/ 1 J7U �1. GL L6LL_ . LL11 •J _ .r ��� � r _.d .+.. A� 1 7 4500 Cathedr al Ave. NV. Washington, D.C. 20016 November 29, 1995 Mr. Ralph Crossen Building Commissioner Town of Barnstable 367 Main Street Hyannis, MA 02601 Dear Mr. Crossen: We hereby provide the folloN�ring affidavit with regard to our property at 42 Bailey Road, Cotui.t: 1 . It is our intention to keep this house as a single dwelling. 2. We will never install a kitchen in the addition to be built. 3. We will, never remove or detach -the breezeway. Please let us know whether any additional information is required. Sincerely yours, Janet W. Lloyd Wtngat Lloyd 4.r,__ �• ./-✓�6 dC::��'_'r,JC7�.�-V�C_l`/•'��'` wlF� Asse4p"'map and lot number ......,"..3 ` �7.........`.G �! �.....►�� __ ---- %T ETOE Sewage Permit ....number .................................................._ d c ' Z BABH9TSDLE, i House number ....... ��........:........................1................. .... 9�0p,M639 e�0 'FO MPY A,. ` C, TOWN � OF,• BARNSTABLE -INSPECTOR BUILDING APPLICATION FOR PERMIT TO .'....:.. � '� �btJ L��I��"�......................................................................:.................................. t 'TYPE OF CONSTRUCTION ......... '� !� 4.11 �"�.... ...............:....................:..:.................................................................... ...;AI-:.,..... r............ ..........19... •• t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........r�?/ !. .`.�.....f��rGr%/�1 .....©M=ec...v! f- t .t .... f ............................................... Proposed Use ....... ,F,� a t (,i/ L-............................... ............. ..... ........................................................................................ ZoningDistrict ........ ...................................................Fire District .......G ..1.41T.............. ..................... Name of Owner '�IIII N tL .� V7..............Address ��F?r,` !-l�R(lr'x"�n 1 O . ............. !?c�.!. .... Name of Buildera �5....` ... K1t .....Address .... Name of Architect U�P`(.. LtJi�i�.�?..............Address .... ? ' C�'�-� �-1-� ............ .......... ........................ .................................................................... Number of Rooms. ... _:.- ' ::................................................Foundation ... © 7;_t'"e Exterior Roofing w ..l�lc ? ............................................................ ... _• •C.. 5.`a......................................... Floors Interior ...... . Heating C51(, " #'1! .................................................Plumbing _.. ..........�f S.. . Fireplace .... . ' ...............................................................Approximate. Cost ............�. G��.Coo, ....................... Definitive Plan Approved by Planning Board -----------_------_____ J..,19 Area =:%J.Diagram of Lot and Building with Dimensions Fee r 1E SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 A WaLL T��to�rr \� TO ............... - b Z LCso.rak PITS 2 �P-fr c -sANhC. . ,o O � `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. Names;.4 � \ �'� , =r�-- �!:............... Construction Supervisor's License . ........ Lloyd, Wingate A=3-4 Nd 27085. Permit for .$1A7.d .11slling.... !. Single..F �y.J�W�.1.17.ri ..................... ' 02 Location ..... ... .ley-Road.............................. .................!;Qt;L.t................................................ Owner ..........Wingate Ll 'a.......................... Type of Construction ..... i........ Plot ............................. Lot ................................ I Permit Granted ....october 12i............19 84 Date of Inspection 19 Date Completed ......................................19 6 - OO� . �r Assessor's offioe (1st floor): 003 Assessor's map and lot number �... '" oFTMETo` .............................. . 7�C SYSTEM M� . 0 Boar of Health (3rd floor): ^t I� ,LED IN COM _ y��, �., Sewage Permit number ............... ..:...... L'J°.. WITH TIYLE 2 BAEas7onLE, i En 'ineering Department (3rd floor) Z,"UPRONMENTAL CO "�}a6\e� House number ........... Q� ... ...t1`7 /^ TOWN REGULA goo APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only r� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ......Z...CCa .. �.Q.......c ��......................................... .... °S, . ...................................................................................... TYPE OF CONSTRUCTION ..........." TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... ')........ ?Cj.its.. ... �cJl............ ProposedUse ...... .0 e........................�� ...�. .......1........ �7 !�..................................................................... Zoning District ....R.... .........................................................Fire District .. t13 i.......................................................... Name of Owner ...IRJ�.hS�. :1 ........... •9Qb.cg. .................Address ...� .....d 1.. . . ... ......4�4. .................. Name of Builder .. Cd QcK.` c9�r .....� Q,....Address ��,�Q......� \1 Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....... .........................................................Foundation ca.-k1e-,................................................ .............. 14-5f Exterior .....4r�cAc6.81.............................................................Roofing ...... �1 ....................................................... Floors ....... ...............Interior Heating ......-.�N.O....................................................................Plumbing ......;)b..................................................................... Fireplace ....... 0....................................................................Approximate Cost ....... fJ Definitive Plan Approved by Planning Board --------------------------------19-------- . Area �Z-1 �_ Diagram of Lot.and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH !mot` 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 ........ ...................................... Construction Supervisor's License .6.4/73................ LlOYD, WINGATE No Permit for ..p��ild Garaqe ............................. Accessory to Dweili!jg............. ....................................................... 42 Bailey... .......................... Location ........... . Cotuit ........................ ...................................................... Lloyd Owner ................................Wingate LL.. ............................... Type of Construction ......Frame......................... .... .. .. Plot ............................ Lot ................................ Permit Granted .....August....1.0.; .19 87 Date of Inspection ....................................19 IA Date Completed ....... ..........P.19 00 Assessor's offioe (1st floor): `�� � 10 jTWEj0 -,Assessor's map and lot number ..—.-.+..... ......................::..... e�P.. �o t�oarp of Health (3rd floor): SeWitige Permit .number .............. C!5.-.(...: ...�. .. 2 Baaa�a LE, Engineering Department (3rd floor)' p� Hovse number ..... . . ..... t. ............:.!..0 ......'.�!...!ti / ` OO,£�YAYA►,�e� APPLICATIONS PROCESSED' 8:30-9:30 A.M, and 1:00-2:00 P.M. only. TOWN OF BARNSTABLE '(PS U 11 DI N G INSPECTOR APPLICATION FOR PERMIT TO ....... .....Z• c c..G�J. !.t.).Q-...... A.-Y .............................................. TYPE OF CONSTRUCTION .........��Cj....' ,Cr1 .� .......... ./. . TO THE INSPECTOR OF BUILDINGS: . The undersigned hereby applies for a permit according to the following information: G�� ���.............L.0._�` K.. ......................... Location �?.,.......... ....................................... Proposed Use �'�!c.G�q�.....................:... .................... .............................:.........................::.........::.... ZoningDistrict .............-'.......................................................Fire District ... Q`) ......................................................... Name of Owner ...Wj.rto.1. .. .I �.S�.................Address ... c .... �.E .. A....... ................... Name of Builder .. G(4. .�!G :�. 5? ....... ....Address ..e �0...... 1\\�A................................ Name of Architect .......................................................:..........Address Number of Rooms ........I.........................................................Foundation ....Cot. ............................................................. Exterior ...... .............................................................Roofing ....... --01N17....................................................... Floors ......Kati, ..................................................................Interior ............................................................... Heating .......NO.................. ...................................................Plumbing .:...., ! ....,................................................................ Fireplace N)0.....................................................................Approximate Cost ........ .... ®ate... . ........... ...................................... / fl Definitive Plan Approved by Planning Board ________________________________19________ , Area �?.Zy � ... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH p ; i r 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 .................................................... Construction Supervisor's license .!0zAI7_T................ FYD, WINGATE A-003-004 N o Permit for .....Build...Garage ........Accessory...t...o.....D...w...e..l...l...i..n...cj .......... 42 Baileyj�c��....................... Location ......................... . ......................q.0t.U.i.t.......................................... Owner ...... ......................... Type of Construction ............Frame...................... ....... ............................................................................... Plot ............................ Lot ................................ ust 10 , 87 j% Permit Granted ........Auci ......A..;.....................19 Date of, Inspection ....................................19 Date Completed .............. ............. .........19 I b R o gg I �F ' N �LI i. 6 k o 0 o 4 O a4 0 I i 1 I —t— ;g IZ t9 i I.I e g. 2 i 9` Ln 4 jf I i �i —.44.i 11 Lj, '.J. 7. � . jli;,j,l ii• ; � ,� it i I. I _- I I I I;aII Ii 'I 'i�•� I� ' •I '.i �r ��� (I�I�II:I ill I• ! - : , = - -: •j illy �! i e:ri •. Lit • A - g > o o a i w' The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Sheet,HYanais MA 02601 Ralph Ciassen Office: 508-?90�ZZ7 Building Col Fax 508 775-33" For office use only Permit no._ Date__. . AFFIDAVIT HOME DWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. I42A requires that the"teoonstruction,alterations;renovation,repaiG ntodemization,cOn MMOn, impmvement,remo%-4 demolition. or construction of an addition to nay pscasfmg Ow er O=LtP'cd building containing at least one but not more than four dwelling units or to along with other adjacent to such residence or building be done by registered contractors,with certain C=cPtiOns,a. g requirernents. T of Work: Q -St t��rJ-T 1AL �b�tl10 0 ESL Co 2 O 1 O40, Type Address of Work: AZ eAWE--{' 94D400 • �'TV l'T Oaner.Name: Wit�iCoA"lti `c1 LLo�iP Date of Permit ApPlication: ��•'Z�1 •aS I hereby certify that: Registration is not required for the following rcason(s): Work excluded by law Job under S19000 _Building not owm oocupied Owner polling own permit Notice is hereby ghen that: OWNERS PULLING THEIR OWN VAT WORK DO DSO NOT HAVE -ACCESS FOR APPLICABLE HOME IMP 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 owrner: co V34 Date Con name Registration No. OR __ _ Owner's name •� r T ,} �. 1 ,r L 4 a• J _ .. son S , t. - a' f I - d. T ` s�c�#w,y.,`s .r:>. _n-::hv!:r_ n r• .,, .h °L ' +�+ f 7;r:} '` :�w s �..-:: �+�+fi•��'... "'w ,s' �1:.,.�-, ,,.J. ++.,y..tC r. �.'tr• - t -�q 'y.. v.. :v m' ,i3+js,,+o.. ) as�'�,�T�•.'�Fs..i`:=ii=:� - 9; s DEPA TM�+fi TOFFUBLICSAF 7<. ;, fir'. >., t:• COCOMMONWEALTH•, r - R,_,. „ h._ YCf, ti y �d !O rr y A�HBORTON PLACE� , •, •c. a- t= :;?>C_ -3'0• ,a`sY`;�a:..-��z _i <, rS :i.r ;BOSTON'.M A02108 �k ` MASSACHUSETTS �, _: fs,.�E ,�r 3 �•�z �rt�:.,.r.c_ �,,I ..v:s s^:•4 '3,'i�'.a Y +.r� .-_!E. S,._T•'t+. �y�`b �I ;art. .r' ::-v• v ?- ? 4ih+ _;.Z,s- 4+� K ,IF•2Y,- •:�- a< `..:a` ..a .y i� _ a._ ,x.. :-•• �1�- SE - .a I CAUTION.,;�,r1,- '.,i.� 'F:•:.5,' + T} w tiL+ "'� rt-i=ti.:i!•»::V:'a ...- ',..•�f•1,y'� - c,.;.- t,t.,:;i'- m�, •�ys s�. . ✓ b. f_dy / t �`�. f._1-"r i?,-, t _l,•.Yi j .'c3','.i ..t. YRows - -'EXPIRATION DATE-, 08��_�a/ _. ->-•,.,.._.,rya s t :r:� roty s> �;h,K� 4 -f rFOR•PROTECTION AGAINST TIVE'DATEh � :LIC: z PUT RI THUMB, a ;i, •: :.. ..r a� ::EFFEC �:,,., ,THEFT;,, w'�."'�?,.. 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'r 33 �}p...t,,:�,6�,krL, �a ;.� -`•.`THIS DOGUMEHit;MUST,BE; I r{t -g .�-`d-ir;.y,�;^'.:,..=' �' yt- ' �'S^"r�'4'..„'r`„-fit Yx�-�4 �"1 sa .OgRRIE00NTHEPEFiS01� S T ��4i��. •�.r,�a ..� '1 l y,� - 'a - _ • L•� '�/L }, x�`••te'f "s,:r r� THE'HOLDER,j,WHE � '+ ''; Sm OTHERS RIGHT-THISMB PRINT GAGED INTHISOCCUPA N-. •� �'"-n v r 'f 'a" t v 'S .:� ��la:"t Y"rY.c..�cr. y... �r-.,< y�" �'�'�+ ems.'.. r.+�-• �;� -o -rr• A! j' Otis{ 4. :� 7 _r c �) tt 1 VIC r 1 r: -e- • .. - - - - s R raHOME IMPROVEMENT CONTRACTORS REGISTRATION oard of Building Regulations and Standards One Ashburton Place - Room 1301 , Boston , Massachusetts 02108 - i -- ---------- HOME IMPROVEMENT CONTRACTOR ------------ Registration 100ation O6/O9/9b 134 Expir 04 Type - PRIVATE CORPORATION i HOME IMPROVEMENT CONTRACTOR Registration 100134 i s Type- PRIVATE CORPORATION Rogers & Mar ney , Inc . i Expiration 06/09/96 . Charles D . Rogers i 445 W . Barnstable Rd/Box 310 Rogers & MaTney, Inc. Osterville MA 02655 Charles 0. Rogers Barnstable Rd/Box 310 ,,AINIsTRATOR Osterville MA 02655 i I The Ci mmon►+•ealth of Atassachusettt Department of Industrial Accidents �'-k ;� �" �� 011/ceol/ayesl/gal/ons 601) Washington Street Boston.Alas. (12111 Workers' Compensation Insurance Affidavit ARnlica—nf nfnrmatin'n- PlestsePRiNTI t�ly "�. name, location: cite- nhnnc/! ❑ 1 am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ® I am an emplover providing workers' compensation for my employees working on this job. comnam,name: a is cl_r_css: f' C e3ok 'Bic . nhone#: insurance co. policy# I am a sole proprietor<9enera contractor r homeowner(circle one)and have hired the contractors listed below who have the following w^^orke��rs' compensation polices: comnam•name: a(ldressC7 ci T* �51 t' I MU.)Ike . I 1 A 62'S�J�o phone#: -�C) 09 ( insurnncc co. 9ANIG4ecr, �t oeAQC.E nolict•# UZW Q 49 k A A 6") ,. 2 Yore:.:7a�os��7'�"�T•Rt'Nfj'TjF'se^3=• Oil'Ir►rR2'W't �h'�"�R!�"Y�R4 +T�?�'�.^ #S comnam•name: C'�o�o►.1� l.f/iUL 4Ee/ns address: J 1 i'1 e-L Al G city: CZsr1E,9— ) 1 '02 P, O a L nhone E� - Ua -5� 77 insurnnceco_ 12r� // UG2)9I1�� L—�J antic,# :Attach additiond sheet if rice - Y - w' Wit._�� ., r+," ,,,,,.,,.�,; Failure to secure coverage as required under Section 25A of AfGL 152 can lead to the imposition otcrimittal penalties of a fine up to 51.500.00 and/or one%cars'imprisonment as well as civil penalties in the form of a STOP IVORI:ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the ORcc of investigations of the DIA for coverage verification. I do herebt•certifj•antler the pains and penalty erjurr that the inforntation provided above is true and correct. 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PLAN VIEW 5' 1t' S' (hatch eh .land N. T. S. 21' =• Thatch I. DETAIL LEACH FACILITY .4 �, •� C�+ � 4, 3, 4. END SECTION 1'. 4" SCH ED 40 PERFORAaED PVC PIPE (TYPICAL) N T. S. LOCATION MAP PLACE CAPS AT ENDS COTUIT QUADRANGLE = 1 SCALE: .1: 25,000 ASSESSORS LEL 3.34' N/F AMNON ROSENTHAL, ET MAP 3 PARCEL 4 = N 88'42'26" W ZONES: 906' t ANGLE POINT TO POPONESSET BAY q s P. EDGE OF WETLANDS GROUNDWATER PROTECTION OVERLAY DISTRICT -� /4.6 RF - BUILDING ZONE MINIMUMS � 6 SEE DETAIL�RIGHT AREA = 43,560 S. F. 4.7 FRONTAGE = 150' ABOVE FRONT SETOACK = 30' 8 SIDE SETBACK = 15' \ 4+,; �1 os� 8' WIDE VEHICLE TRACKS I REAR SETBACK = 15, BUILDING HwIGHT = 30' - ��` -10 DIRT DIRT DRIVEWAY (OR 2.5 STORIES IF LESS) A% �?� o� , .� __ x 10 x 1 .5 X FLOOD ZONE. A13 (EL 12) lv o`� r .4 " x4 1':4V 1.1 WELL 11.1 12 x 2.3 I' COMMUNITY PANEL No. io 250001`:0022 D C7 o0 04 8.1 PROP 5 15 14.1 I REVISED: JIiLY 2, 1992 0 O�<v 7.2 ADDITION , x 1 .1 x x 2.1 14 UNDERGROUND ELECTRIC METER x 11.1 118 x 10 I x 2.3 4 X ^NouT x 11.5 x 1.9 I o i 12.0 Qr�j#Z \ o m cos, x 2. r 3 I A TP a_ a 10 x10. 110 10 TOP OF BANK Sr u,-n 2.2 Q1 0 q TOP ST EL = 11.3' 12, 12 EXISTING SEPTIC SYSTEM 13.Q PER INSTALLER TIES GAR _ TOP FD EL =9.3' SCALE: 1" 60' 500.00' IBM ® CB N 8537'55" W [EL = 11.29' NGVD 180.22' 1080, t ANGLE POINT TO POPONES, NSF H. GATES lL0 YD, ET UX" SITE PLAN AT #4.2 BAILEY ROAD COTUIT, BARNtTABLE, MASS. FOR WINGATE LLOYD, ET UX. USE 11' x 41' LEACHING SCALES AS NOTED OCTOBER 17, 199 (2) 4" DIAMETER DISTRIBI REMOVE UNSUITABLE MATERIAL FROM BENE.i k'Ems( I�Lov Zz� I �' OVERDIG 1' INTO MEDIUM BAXTER & NYE, INC. 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