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HomeMy WebLinkAbout0176 CLAMSHELL COVE ROAD �� cz,tgIshe'll Town of Barnstable - \ Building }Post This Card So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept bSW ;Posted Until Final Inspection Has Been Made. ;Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit .-_:. ,._._�_ _._ ._.r �_ v �_-�_--...� _ . w _ ..- ... �. _.._ _ Permit No. B-19-1068 Applicant Name: David Crosbie Approvals Date Issued: 04/03/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/03/2019 Foundation: Location: 176 CLAMSH ELL COVE ROAD,COTUIT __. -Map/Lot: 005-031 Zoning District: RF Sheathing: Owner on Record: MENOUNOS, PETER Contractor Name: OCEAN EDGE CUSTOM HOMES Framing: 1 INC. Address: 176 CLAMSHELL COVE RD 2 .Contractor License: 184418 COTUIT, MA 02635 Chimney: Description: Patch roof Est. Project Cost: $3,000.00 Permit Fee: $35.00 Insulation: Project Review Req: Fee Paid: $35.00 Final: Dater 4/3/2019 Plumbing/Gas Rough Plumbing: Final Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: j All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open.fd�public inspection for the entire duration of the ` work until the completion of the same. - - - - Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT � .� Town of Barnstable _ _ Building ? Post This Card,So That it is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept AM `� Posted Until Final Inspection Has Been,Made '..° Y'. r, p�y�mlt 39. Where a Certificate of Occupancy is Required,such Building-shall Not be Occupied until a Final Inspection has been made. Permit 111111 Permit No. B-18-3079 Applicant Name: David Crosbie Approvals Date Issued: 09/19/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 03/19/2019 Foundation: Location: 176 CLAMSH ELL COVE ROAD,COTUIT Map/Lot: 005-031 Zoning District: RF Sheathing: Owner on Record: MENOUNOS,PETER Contractor Name.,OCEAN EDGE CUSTOM HOMES Framing: 1 INC. Address: 176 CLAMSHELL COVE RD y 2 COTUIT, MA 02635 i --�-Contractor License: 184418 y Chimney: Description: Replacing(5) like for like windows and(3)with expanding headers Est. Project Cost: $6,050.00 Insulation: of 8" f � Permit Fee: $35.00 Project Review Req: ter,,.�� Fee'Paid $35.00 Final: r Date:' 9/19/2018 -� Plumbing/Gas Rough Plumbing: Final Plumbing: ' Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by'this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ` ' f Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: i Work shall not proceed until the Inspector has approved the various stages of construction. g h "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT .f. Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Peter Menounos Name of Applicant 176 Clamshell Cove Rd. Shoestring Bay Cotuit Project street address Waterway Cityrrown Description of use or change in use: Construction and maintenance of a pier, ramp and float for private marine recreation accessory to a single family residence. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." o a1 o Printed Name of Municipal Official Date i -gt ignature of Municipal Official Title P2� CitY/Town � lea CH91App.doc•Rev.6/06 Page 6 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Important:When filling out forms A. Application Information (Check one) on the computer, use only the tab p Simplified lified ter NOTE: For Chapter 91 Sim License application form and information see the Self Licensing key to move your Package for BRP WW06. cursor-do not use the return Name (Complete Application Sections) Check One Fee Application# key. WATER-DEPENDENT- General (A-H) ® Residential with <4 units $175.00 BRP WW01a ❑ Other $270.00 BRP WW01 b For assistance ❑ Extended Term $2730.00 BRP WW01c incompleting this ......--.._..-....._..-..-..-.--••--............--••--•--.-••----.--..-..-.---•-•.......-•--.---•-•--.--..-..-.--••----..-..----.._.._..-.._..--.......-•--.•- application,please Amendment(A-H) ❑ Residential with <4 units $85.00 BRP WW03a see the — "Instructions". ❑ Other $105.00 BRP WW03b NONWATER-DEPENDENT- Full (A-H) ❑ Residential with <4 units $545.00 BRP WW15a ❑ Other $1635.00 BRP WW15b ❑ Extended Term $2730.00 BRP WW15c Partial (A-H) ❑ Residential with <4 units $545.00 BRP WW14a ❑ Other $1635.00 BRP WW14b ❑ Extended Term $2730.00 BRP WW14c Municipal Harbor Plan (A-H) ❑ Residential with <4 units $545.00 BRP WW16a ❑ Other $1635.00 BRP WW16b ❑ Extended Term $2730.00 BRP WW16c Joint MEPA/EIR(A-H) ❑ Residential with <4 units $545.00 BRP WW17a ❑ Other $1635.00 BRP WW17b ❑ Extended Term $2730.00 BRP WW17c Amendment(A-H) ❑ Residential with <4 units $435.00 BRP WW03c ❑ Other $815.00 BRP WW03d ❑ Extended Term $1090.00 BRP WW03e CH91App.doc-Rev.6/06 Page 1 of 13 i Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program x228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment B. Applicant Information Proposed Project/Use Information 1. Applicant: Peter Mensounos_ Name E-mail Address 17r1�4Y6'Clamshh Q_1 C ve`.Rd Mailing Address Note:Please refer n to the"Instructions" Cotult -MA 02635 City own State Zip Code ME WON Telephone Number Fax Number 2. Authorized Agent(if any): ro'i .PF'.'%:sx+� a t'SptS`.f+�-""11.r�Xrag4cYv'dtnY o •d.�eh.^A �\'.pr'^'rhA'•�oM Yt..�:.-� R:^. ta,:•;n MWllson'gssoclates�Inc �a arnwllsonassoc@amwllsonassoclates:com Name E-mail Address 20�Rascallyi�R'abbit�`R'�dUn�it�3 Mailing Address Ma stops M.ilis MA 026 City/Town State Zip Code 5084209792 50�8,4=2g9795' Telephone Number Fax Number C. Proposed Project/Use Information 1. Property Information (all information must be provided): Owner Name(if different from applicant) OMNI,, 41036'11" 70027'38" Tax Assessor's Map and Parcel Numbers Latitude Longitude 1�76,CIa'mshell;Co�eRd }Cotut M"A 026:35 Street Address and City/Town State Zip Code 2. Registered Land ❑ Yes ® No 3. Name of the water body where the project site is located: Shoestring Bay 4. Description of the water body in which the project site is located (check all that apply): Type Nature Designation ❑ Nontidal river/stream x Natural ❑Area of Critical Environmental Concern x Flowed tidelands ❑ Enlarged/dammed ❑ Designated Port Area ❑ Filled tidelands ❑ Uncertain ❑ Ocean Sanctuary ❑ Great Pond ❑ Uncertain ❑ Uncertain CH91App.doc•Rev.6/06 Page 2 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program x228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment C. Proposed Project/Use Information (cont.) Select use(s)from Project Type Table 5. Proposed Use/Activity description on pg.2 of the "Instructions" Construction and maintenance of a pier, ramp and float for private marine recreation accessory to a single family residence. 6. What is the estimated total cost of proposed work(including materials & labor)? $50000 7. List the name&complete mailing address of each abutter(attach additional sheets, if necessary). An abutter is defined as the owner of land that shares a common boundary with the project site, as well as the owner of land that lies within 50' across a waterbody from the project. • William and Brenda 7 Deerfield Dr., Medfield MA 02052 Prescott Address William and Kathleen 33 Father C_a_rnev Dr., Milton MA 0_218.6 Fitzgerald Address Name Address D. Project Plans 1. I have attached plans for my project in accordance with the instructions contained in (check one): x Appendix A(License plan) ❑ Appendix B (Permit plan) 2. Other State and Local Approvals/Certifications ❑ 401 Water Quality Certificate Date of Issuance x Wetlands SE34749 File Number ❑ Jurisdictional Determination JD- File Number ❑ MEPA File Number ❑ EOEA Secretary Certificate Date ❑ 21 E Waste Site Cleanup RTN Number CH91App.doc•Rev.6/06 Page 3 of 13 I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment E. Certification All applicants, property owners and authorized agents must sign this page. All future application correspondence may be signed by the authorized agent alone. "I hereby make application for a permit or license to authorize the activities I have described herein. Upon my signature, I agree to allow the duly authorized representatives of the Massachusetts Department of Environmental Protection and the Massachusetts Coastal Zone Management Program to enter upon the premises of the project site at reasonable times for the purpose of inspection." "I hereby certify that the information submitted in this application is true and accurate to the best of my knowledge." A.M. Wilson Associates, Inc. Applicant's signature Date i Property Owner's signature(if different than applicant) Date Agent's signature(if applicable) Date CH91 App.doc-Rev.6/06 Page 4 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment F. Waterways Dredging Addendum 1. Provide a description of the dredging project I i ❑ Maintenance Dredging (include last dredge date& permit no.) ❑ Improvement Dredging I Purpose of Dredging 2. What is the volume(cubic yards) of material to be dredged? 3. What method will be used to dredge? ❑ Hydraulic ❑ Mechanical ❑ Other 4. Describe disposal method and provide disposal location (include separate disposal site location map) 5. Provide copy of grain size analysis. If grain size is compatible for beach nourishment purposes, the i Department recommends that the dredged material be used as beach nourishment for public beaches. Note: In the event beach nourishment is proposed for private property, pursuant to 310 CMR 9.40(4)(a)1, public access easements below the existing high water mark shall be secured by I applicant and submitted to the Department. i I CH91App.doc-Rev.6/06 Page 5 of 13 i Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program x228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment G. Municipal Zoning Certificate Peter Menounos Name of Applicant 176 Clamshell Cove Rd. Shoestring Bay Cotuit Project street address Waterway Cityrrown Description of use or change in use: Construction and maintenance of a pier, ramp and float for private marine recreation accessory to a single family residence. s To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans is not in violation of local zoning ordinances and bylaws." Printed Name of Municipal Official Date Signature of Municipal Official Title City/Town CH91App.doc•Rev.6/06 Page 6 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment H. Municipal Planning Board Notification Notice to Peter Menouno_s Applicant: Name of Applicant Section H should 176 Clamshell Cove Rd ShoestEi _Bay Cotuit be completed and Project street address Waterway City/Town submitted along with the original Description of use or change in use: application material. Construction and maintenance of a pier, float and ramp for private marine recreation accessory to a single family residence. To be completed by municipal clerk or appropriate municipal official: "I hereby certify that the project described above and more fully detailed in the applicant's waterways license application and plans have been submitted by the applicant to the municipal planning board." Printed Name of Municipal Official Date Signature of Municipal Official Title Cityrrown Note: Any comments, including but not limited to written comments, by the general public, applicant, municipality, and/or an interested party submitted after the close of the public comment period pertaining to this Application shall not be considered, and shall not constitute a basis for standing in any further appeal pursuant to 310 CMR 9.13(4) and/or 310 CMR 9.17. CH91App.doc-Rev.6/06 Page 7 of 13 i I , . Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program x228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix A: License Plan Checklist General View ❑ PE or RLS, as deemed appropriate by the Department, stamped and signed, in ink, each sheet within 8 1/2 inch by 11 inch border ❑ Format and dimensions conform to"Sample Plan" (attached) ❑ Minimum letter size is 1/8 of an inch if freehand lettering, 1/10 of an inch if letter guides are used ❑ Sheet number with total number in set on each sheet ❑ Title sheet contains the following in lower left: Plans accompanying Petition of[Applicant's name, structures and/or fill or change in use, waterway and municipality] ❑ North arrow ❑ Scale is suitable to clearly show proposed structures and enough of shoreline, existing structures and roadways to define its exact location ❑ Scale is stated &shown by graphic bar scale on each sheet ❑ Initial plans may be printed on bond; final plans due before License issuance must be on 3mil Mylar. Structures and Fill ❑ All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses ❑ Cross Section Views show MHW*and MLW*and structure finish elevations ❑ Dredge or Fill, actual cubic yardage must be stated and typical cross sections shown ❑ All Structures and Fill shown in full BLACK lines, clearly labeling which portions are existing, which are Proposed and indicating Existing Waterways Licenses ❑ Cross Section Views show MHW*and MLW*and structure finish elevations ❑ Dredge or Fill, actual cubic yardage must be stated and typical cross sections shown ❑ Actual dimensions of structures(s) and or fill and the distance which they extend beyond MHW* or OHW* ❑ Change in Use of any structures on site must be stated * See 310 CMR 9.02, Waterways Regulations definitions of High Water Mark, Historic High Water Mark, Historic Low Water Mark, and Low Water Mark. Note: DEP may, at its discretion, accept appropriately scaled preliminary plans in lieu of the plans described above. In general, DEP will accept preliminary plans only for non-water dependent projects and projects covered by MEPA to address site design components such as visual access, landscaping & site coverage. Anyone wishing to submit preliminary plans must obtain prior approval of the DEP Waterways Program before submitting them with their application. CHMpp.doc-Rev.6/06 Page 8 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix A: License Plan Checklist (cont.) Boundaries ❑ Property lines, full black lines, , along with abutters' names and addresses ❑ Mean High Water(MHW)*or Ordinary High Water(OHW)*, full black line ❑ Mean Low Water(MLW)*, black dotted line, (.............) ❑ Historic MHW*or OHW* ❑ Historic MLW* (..._... _..._) ❑ State Harbor Lines, black dot-dash line (—. — . —. —)with indication of Chapter&Act establishing them (Ch. , Acts of) ❑ Reference datum is National Geodetic Vertical Datum (NGVD) or(NAVD). ❑ Floodplain Boundaries according to most recent FEMA maps ❑ Proposed & Existing Easements described in metes& bounds Water-Dependent Structures ❑ Distance from adjacent piers, ramps or floats (minimum distance of 25'from property line, where feasible) ❑ Distance from nearest opposite shoreline ❑- Distance from outside edge of any Navigable Channel ❑ Access stairs at MHW for lateral public passage, or 5 feet of clearance under structure at MHW. Non Water-Dependent Structures ❑ Depict extent of"Water-dependent Use Zone". See Waterways Regulations at 310 CMR 9.51-9.53 for additional standards for non water-dependent use projects. Note: Final Mylar project site plans will be required upon notice from the Department, prior to issuance of the Chapter 91 Waterways License. CH91App.doc•Rev.6/06 Page 9 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CnnR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix A: License Plan Checklist Cont. w Registrar Stalement CID 31/2 inche 5 inches NO Locus Map First Sheet 0 my 3 cDzM y�Q +711 U u G 1 „ -21/4 inche U Sample Plan U i 81/2 inches P.E. or R IS Scamp 3 3/4 inch e Plan Accompany irg Petition of... D EP Stamp First Sheet Only 3/4 " Border CHMpp.doc•Rev.6/06 Page 10 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix B: Dredging Permit Plan Checklist For projects applying for dredging permits only, enclose drawings with the General Waterways Application that include the following information: General View ❑ Submit one original of all drawings. Submit the fewest number of sheets necessary to adequately illustrate the project on 8-1/2 inch X 11 inch paper. ❑ A 1-inch margin should be left at the top edge of each drawing for purposes of reproduction and binding. A 1/2 inch margin is required in the three other edges. ❑ A complete title block on each drawing submitted should identify the project and contain: the name of the waterway; name of the applicant; number of the sheet and total number of sheets in the set; and the date the drawing was prepared. ❑ Use only dot shading, hatching, and dashed or dotted line to show or indicate particular features of the site on the drawings. ❑ If deemed appropriate by the Department, certification by the Registered Professional Engineer or Land Surveyor is included. Plan View ❑ North Arrow ❑ Locus Map ❑ Standard engineering scale. ❑ Distances from channel lines and structures if appropriate. ❑ Mean high water and mean low water shorelines (see definitions of"High Water Mark" and "Low Water Mark"at 310 CMR 9.02, C. 91 Regulations). ❑ Dimensions of area proposed to be dredged or excavated. ❑ Notation or indication of disposal site. ❑ Volume of proposed dredging or excavation. ❑ Ordinary high water, proposed drawdown level, and natural (historic) high water(for projects lowering waters of Great Ponds). Section Views ❑ Existing bottom and bank profiles. ❑ Vertical and/or horizontal scales. ❑ Proposed and existing depths relative to an indicated datum. ❑ Elevation and details of control structure (for projects lowering waters of Great Ponds). CHMpp.doc-Rev.6/06 Pagel 1 of 13 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program x228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment 3 Appendix C: Application Completeness Checklist Please answer all questions in the General Waterways Application form. If a question does not apply to your project write"not applicable" (n/a) in that block. Please print or type all information provided on the form. Use black ink (blue ink or pencil are not easily reproducible, therefore, neither will be accepted). If additional space is needed, attach extra 8-1/2"x 11"sheets of paper. ❑ Proper Public Purpose: For nonwater-dependent projects, a statement must be included that explains how the project serves a proper public purpose that provides greater benefit than detriment to public rights in tidelands or great ponds and the manner in which the project meets the applicable standards. If the project is a nonwater-dependent project located in the coastal zone, the statement should explain how the project complies with the standard governing consistency of the policies of the Massachusetts Coastal Zone Management Program, according to 310 CMR 9.54. If the project is located in an area covered by a Municipal Harbor Plan, the statement should describe how the project conforms to any applicable'provisions of such plan pursuant to 310 CMR 9.34(2). ❑ Plans: Prepared in accordance with the applicable instructions contained in Appendix A-B of this application. For initial filing, meet the requirements of 310 CMR 9.11(2)(b)(3). ❑ Applicant Certification:All applications must be signed by"the landowner if other than the applicant. In lieu of the landowner's signature, the applicant may provide other evidence of legal authority to submit an application for the project site." If the project is entirely on land owned by the Commonwealth(e.g. most areas below the current low water mark in tidelands and below the historic high water mark of Great Ponds), you may simply state this in lieu of the"landowner's signature". ❑ Municipal Zoning Certification: If required, applicants must submit a completed and signed Section E of this application by the municipal clerk or appropriate municipal official or, for the ' initial filing, an explanation of why the form is not included with the initial application. If the project is a public service project subject to zoning but will not require any municipal approvals, submit a certification to that effect pursuant to 310 CMR 9.34(1). ❑ Municipal Planning Board Notification:Applicants must submit a copy of this application to the municipal planning board for the municipality where the project is located. Submittal of the I complete application to DEP must include Section H signed by the municipal clerk, or appropriate municipal official for the town where the work is to be performed, except in the case of a proposed bridge, dam, or similar structure across a river, cove, or inlet, in which case it must be certified by every municipality into which the tidewater of said river, cove, or inlet extends. ❑ Final Order of Conditions: A copy of one of the following three documents is required with the filing of a General Waterways Application: (1)the Final Order of Conditions(with accompanying plan) under the Wetlands Protection Act; (2) a final Determination of Applicability under that Act stating that an Order of Conditions is not required for the project; or(3) the Notice of Intent for the initial filing (if the project does not trigger review under MEPA. ❑ Massachusetts Environmental Protection Act(MEPA): MGL 30, subsections 61-61A and 301 CMR 11.00, submit as appropriate: a copy of the Environmental Notification Form (ENF) and a Certificate of the Secretary of Environmental Affairs thereon, or a copy of the final Environmental Impact Report(EIR) and Certificate of the Secretary stating that it adequately and properly complies with MEPA; and any subsequent Notice of Project change and any determination issued thereon in accordance with MEPA. For the initial filing, only a copy of the ENF and the Certificate of the Secretary thereon must be submitted. Note: If the project is subject to MEPA,the Chapter 91 Public Notice must also be submitted to MEPA for publication in the"Environmental Monitor". MEPA filing deadlines are the 15`h and 301h of each month. CHMpp.doc•Rev.6/06 Page 12 of 13 r Massachusetts Department of Environmental Protection Bureau of Resource Protection - Waterways Regulation Program X228342 Chapter 91 Waterways License Application -310 CMR 9.00 Transmittal No. Water-Dependent, Nonwater-Dependent,Amendment Appendix C: Application Completeness Checklist (cont.) ❑ Water Quality Certificate: if applicable, pursuant to 310 CMR 9.33, is included. ❑ Other Approvals: as applicable pursuant to 310 CMR 9.33 or, for the initial filing, a list of such approvals which must be obtained. Projects involving dredging: ❑ The term "dredging" means the removal of materials including, but not limited to, rocks, bottom sediments, debris, sand, refuse, plant or animal matter, in any excavating, clearing, deepening, widening or lengthening, either permanently or temporarily, of any flowed tidelands, rivers, streams, ponds or other waters of the Commonwealth. Dredging includes improvement dredging, maintenance dredging, excavating and backfilling or other dredging and subsequent refilling. Included is a completed and signed copy of Part F of the application. • r Filing your Completed General Waterways Application: ❑ For all Water-Dependent applications—submit a completed General Waterways Application' and all required documentation with a photocopy of both payment check and DEP's Transmittal Form for Permit Application &Payment to the appropriate DEP regional office (please refer to Pg. 10 of the"Instructions" for the addresses of DEP Regional Offices). ❑ For all Non Water-Dependent applications—submit a completed General Waterways Application and all required documentation with a photocopy of both payment check and DEP's Transmittal Form for Permit Application & Payment to DEP's Boston office. Department of Environmental Protection Waterways Regulation Program One Winter Street Boston, MA 02108 i i ❑ Application Fee Payment for ALL Waterways Applications: Send the appropriate Application fee*(please refer to Page 1 of the"Application"), in the form of a check or money order, along with DEP's Transmittal Form for Permit Application & Payment i Department of Environmental Protection P.O. Box 4062 Boston, MA 02211 * Under extreme circumstances, DEP grants extended time periods for payment of license and permit application fees. If you qualify, check the box entitles"Hardship Request" on the Transmittal Form for Permit Application & Payment. See 310 CMR 4.04(3)(c)to identify procedures for making a hardship request. Send hardship request and supporting documentation to the above address. NOTE: You may be subject to a double application fee if your application for Chapter 91 authorization results from an enforcement action by the Department or another agency of the Commonwealth or its subdivisions, or if your application seeks authorization for an existing unauthorized structure or use. CHMpp.doc•Rev.6/06 Page 13 of 13 I l TOWN OF BARNSTABLE _______- Permit No. ------- Building Inspector roa Cash ----------- 1639-- OVO 5 OCCUPANCY PERMIT Bona "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." //f�'xt f r Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. .....................................................1 19...... ..................................................................................................._..._._._ Building Inspector a,,.- R-Ar- G/%/wJ •. Assessor's map and lot number ....................................I....... SEM SYSTEM MUST of THE Toy �,y �j... INSTALLED IN COMPLIA wage Permit number WITH TITLE 5 i BAMTULE. House number ....�, �..... ................................................... ENVIRONMENTAL C;. 9,0,Maee TOWN Qc(-' TOWN OF BARNSTABLE SUBJECT TO A;'.'. -ABLE - CONSER BUILDING INSPECTOR CSARNSTCOMMISSIw4V,., APPLICATION FOR PERMIT TOt� LE •••, .... . .... ....... f ..................................... TYPE OF CONSTRUCTION ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ,�j Location .���T. S 9.....4-.` 1.:?..�� /. /<L....." .! /. ....9d........... �1.�..../..:././ ss......................... ProposedUse .......1,lvU:S/ .................................................................................................................................................. Zoning District ................. .........................................Fire District ....... .. /.e��....................................... Nameof Owner ..kp..............1�12�l� .................Address .................................................................................... .1�s Name of Builder .. 11.... ...y...............Address .................................................................................... Name of Architect �� �lS��... �. 1.................Address .................................................................................... Number of Rooms ..............G•.•...............................................Foundation /...�Gl�..."....> � ?.g 'G.................... Exterior ....(1.1i .,r.-rw..... lC !.. ........................Roofing � �<�,�,. Tis �.`�L..7..fJ �Z Floors � �7.- / - r .....f��2!� .�......Interior . 'lh.Z�z.T.�tA! �f................................... Heating Tl�//T�,�2.... �.. ..........................Plumbing ..... P.,�rG?.�/�...t......��G ..� l..G,,:. Fireplace ... .................................Approximate Cost .Drv.................................. +►, Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ...../zl=.................. . Diagram of Lot and Building with Dimensions Fee P. .1 ....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH n d, .x� f \ V hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name (..... .................... ................................................ . � - ~ � - - 23230 Two Story No — � Single Irami Dwelling .—.---.------.--.��-----.�l --'.- Location .....Lot...#.5.9...l.76...Cl lI../Cove Rd. Cotuit � —'—'—~----^—^^'---^—~'—^—'--'--'- Ovvner ....Gerald..A��ti��________~_ � Type of Construction ...9?�4MQ......................... . ----'------'--'-~^'-----'^---- Pkz ............................ Lot ----------'' ^* Permit Granted —. ..24.^—..` —.]A ' 3I � Date of |nspec� �on,�� 6.='/— .. —l9 °~ Date C �q��� - ` . . - PERMIT REFUSED _ _. .____._------- lV — .�---.-----.___--.--- � --------.—^---^------ ' .—..------..--'+................................ —�).{r................................................................... � - ................................................ lR . .............................................................. . ' --'~---~'- � � i o a . CIO MARIA �a .4:14 O 7- pL ASV OF L Oq"AO lO CA?T'EO A5o9oe.0'VS 7.AVA64 E', ^1,47 S S. PQE.as*.Q�o .coR '�S CERT/FY T.�,iE F����/D�.'7'/o-'✓S,S/Oi✓N ON '.�/�/y7L AO A71V TI� Ti4�/S oG.rTN /S .9L5''/T EX/STS /�7NO TiS//gT/T �q,�� � _�,� `��/ Sc�►cE' /"� �' CONFORMS TO .�'O/�//iV Q REGVG.�7 T/�iVLS. �� ,! ��,�' _ cs�,a�• � �sc�w.vas st/,P��-Y�nrC -��9'1...+t.,C�L- �G� _ �L•S: s~�'�57'Tr G`�''�"7' _, ,v��.$�S, a r of Town of Barnstable *Permit Expires 6 month om' Regulatory Services Fee • sntuasTAele, 16 9. Richard V.Scali,�Director i63 �0 RFD MA't A Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY r, Not Valid without Red X-Press Imprint Map/parcel Number V Property Address /7 h—t�/CcHnc-�P r�11� f Cf' Residential Value of Work$ �8aa•° Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ;pe-je-t— powoun65 I (-Ave- Contractor's Name /� r Telephone Numb j SbP-732-y?/1 laCi�C er Home Improvement Contractor License#(if applicable) A6 �7� Email: Pyl Droj( / D Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance • SS PE RIWor Check one: ❑ I am a sole proprietor AUG 03 2015 ❑ 1 am the Homeowner 211 have Worker's Compensation Insurance OWN OF BARNSTAg n / LE Insurance Company Name S u l Workman's Comp.Policy# UtC_.- Sa b- ,,S6/3�&9 J 1Zkr # Copy of Insurance Compliance Certificate must accoinpany each permit. Permit Request(check box)Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 2b1l l Cc ✓(�-C S ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\AppDataTocalWicrosoft\Windows\Temp )Internet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc Revised 040215 14 q I 1 1 1 r er J oF� a s • BARN3TABLE. • � '"A Town of Barnstable sesy. �0$ '°rEo Mp'I A Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder AeAK9JO 5, as Owner of the subject property �l�hereby authorize � � � to act on my behalf, in all matters relative to work authorized by this building permit application for: �[POA�.,5�e U%3 ,e 0 (Address of Job) Wature wner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\2PIOlDHR\EXPRESS.doc Revised 040215 f i ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): S DGIa e 1 S Address: l/ eo u,4 Cove- (k/I City/State/Zip: P,04114, /4 Phone#: C12b Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with _ 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. 1 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' insurance.# 9. Building addition comp.[No workers' comp. insurance P• required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. �oof repairs insurance required.] t c. 152, §1(4),and we have no 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. 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 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: lsoclrJq, Policy#or Self-ins. Lic.#: D -5�l �b -�a1� Expiration Date: Aa Job Site Address: c- City/State/Zip: C)M 6 o�- 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 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 coverage verification. I do hereby certify under the pains and ena ies of perjury that the information provided a ov is true and correct. Si nature: i&l� Date: 0Phone#: (19 69y 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#: r WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800)876-2765 NCCI NO 40959 POLICY NO. WCC-500-5013469-2015A PRIOR NO. WCC-500-5013469-2014A ITEM 1. The Insured: Dennis O'Reilly DBA: Mailing address: 11 Cotuit Cove Rd FEIN:"-"'2038 Cotuit,MA 02635 Legal Entity Type: Sole Proprietor Other workplaces not shown above: 2. The policy period is from 06/08/2015 to 06/08/2016 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers'Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. .Classifications Premium Basis Rates Code Estimated Per$100 Estimated No. Total Annual Of Annual Remuneration Remuneration Premium INTRA 0972030 INTER SEE CLASS CODE SCHEDULE Minimum Premium $500 Total Estimated Annual Premium $2,818 GOV GOV Deposit Premium $741 STATE CLASS MA 5645 State Assessments/Surcharges $2,471.00 x 5.8000% $143 This policy,including all endorsements,is hereby countersigned b 9 Y 04/24/2015 Authorized Signature Date Service Office: Rogers&Gray Insurance Agency Inc 54 Third Avenue 434 Route 134 Burlington MA 01803 South Dennis,MA 02660 WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, used with Its permission. URe rpanrnrearrureu.�(,�n��fzaecrc�ccae(,/d ` Office of Consumer Affairs&Business Regulation License or registration valid for individul use only U'V"XOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: .166842 Type: Office of Consumer Affairs and Business Regulation piration: ;_;8/1-61201,6.; DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 O'REILLY&ASSOCIATES_'BUILDERS/DEVELOPERS DENNIS O'REILLY 11 COTUIT COVE RD COTUIT, MA 02635 Undersecretary Not valid without signatu Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor j License: CS-104375 DENNIS T.ORE"Y 11 Cotuit Cove RIRV dr s Cotuit MA 02639 Expiration Commissioner 05/15/2016 Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: • - — __ _egistration: .106842 Type: Office of Consumer Affairs and Business Regulation xpi ratio n: -8/.16/20]6:_ DBA 10 Park Plaza-Suite 5170 r 5 Boston,MA 02116 ORE ILLYSASSOCIATES BUILDERS/DEVELOPERS DENNIS O'REILLY 11COTUIT COVE RD`=: COTUIT, MA 02635 Undersecretary Not valid without signatu U Massachusetts -Department of Public.Safety . Board of Building Regulations and Standards Construction Supervisor License: CS-104375 ' DENNIS T.OREIIY 11 Cotuit Cove Rcr- Cotuit MA 02635- Expiration Commissioner ' 0 511 5/2 0 1 6 I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I Application Health Division Date Issued ILi Conservation Division Application Fee Planning Dept. Permit Fee v Z. Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Village 6 Owner e6�-_M H i� 1) ') t) ° & Address Telephone 5_7 5V y . 3 �5 6, Per it Request C`n c- S -7-y c T i I `- � �[-c . � � �C & cl ' 'P" 6: Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation , U Construction Type P o c"V_d r[ r_ Q Lot Size Grandfathered: ❑Yes ❑ No If yes, attach- upportingrdocuMentation. o Dwelling Type: Single Family ❑ Two Family 0 Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway,: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq!ft) o °r' 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 Heat Type and Fuel: ❑ Gas 0 Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size_ Attached garage: 0 existing ❑ new size _Shed: ❑ existing 0 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 Telephone Number !;:-6 X ?-7 Address 3 S3 C_Rk_ s )A-C, !S')-LW License# [—S (7 to rz a'hL)T�`1 ,4 Home Improvement Contractor# Worker's Compensation # �5 � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ) t D 31 S'Z-- 66 Uyt- SIGNATURE - DATE r � r , FOR OFFICIAL USE ONLY APPLICATION# r "DATE ISSUED MAP'7 PARCEL NO. i ` ADDRESS VILLAGE OWNER f . DATE OF INSPECTION: FOUNDATION " FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH f FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN-NO i ' The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations I' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibl Name (Business/Organization/Individual): V r){-BJ ±Intes- Address: 1-7 Go C ,LA-PA_S J L G City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction ram a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling p and have no employees These sub-contractors have g, ❑ Demolition rking for me in any capacity. employees and have workers' 9. ❑ Building addition o workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions 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' 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. $Contractors 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. I 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.#: Expiration Date: Job Site Address: l , C�( -f k/�C— C-6 a u- City/State%/ Zip: (i©-rU fT P/ 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 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 coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correc4 Signature: Date: Phone#: ��S 7 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 S. Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having no.t more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on suoh dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." . Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance 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 apply to your situation and, if necessary, supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of 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' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit.. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their 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 affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must 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. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. 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. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia r Town of Barn-stable Regulatory Services Thomas F.Geiler,Director Ruilding Division Tom ferry,Building Commissioner 21DO Mein Street Hyeanis,MA 02601 www-town-barer tab 1 e.ma.us Office: 509-962-4038 Fax: 508--7904230 Property Owiier Must Complete and Sign This Section If Using A Builder Owmr of the nJ*ct.property.. hem6y autborizc Vjr4 L- to act on my 1eb4, in A matters relative to work authorized by this binding permit application for (Addmss of Job) Gem I r 14 A Stgnatwe of Qwaer Date prpvt Nave If Propc;U Owner is applying forpennit please complete the Homeowners License Exemption Form on the reverse side. 4 J Office of Consumer Affairs'&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation = Registration`:,,.,`1.30009 10 Park Plaza-Suite 5170 Expiration;--12/1:3/2011 TrfA 291920 ��.-:.;_:;.:..n Boston,MA 02116 Type;: =liai3iluF ;'.:-'.•; John Hanson John Hanson ,r 353 CarriageshopiRd:= ?r= East Falmouth,MA 025:%,;''r Undersecretary Not ithout signature £LL£L W1 �nunsmmu�,� L LOZ/OZ2l :uoiiendx;; r 9C96�vw:AbIdWWJJ 3 'NOSNVH`'V NHOP' : . ML9 So :9su031 asua:Wj JOSlAJadnS'uo j?nj;suo spir.purl� pur. sumlrin~aj Yutpl'mg�o parn8 .ili.Ir.0•i!ltlnd jo luamlar(l:)n -srl:nny�rssrlN y • Lisa Ramos Department of Environmental Protection Waterways Regulation Program 20 Riverside.Drive Lakeville, MA 02347 RE: Waterways Application No: W09-2736, License No. 12567,Transmittal 4X228342 Shoestring Bay, Barnstable (Cotuit),Barnstable'County Dear Ms: Ramos: .This is to notify you that the above referenced Waterways license was recorded with the appropriate Registry of Deeds/-Land Court for this project location and to provide your office with the following, recordation information. 11 Date of Recordation: �� v ' OF DEE �4-rJ���1� CountyRe is of Deeds: ARNSTAKE REGISTRY ft Book number -� 93 and page numbers 7' 7 (��6 7 71 Pg ( ) , Bk 24371 Ps7 8142 02-16-2010 Q 03257P Land Court: Land Court Lot# Plan# Certificate Document Number We will notify your office in writing of the date the authorized work or change in use is completed. Sincerely, apter 91 Waterways Licensee LICENSE VOID IF NOT RECORDED. WITHIN 60 DAYS OF ISSUANCE i r Bk 24371 Po 7 -H 142 02-16-2010 ad 032575, D al of filassuc uafto C �IIriYrii 1tlU No. 12567 Q1y V'� � FrE�iB, Peter Menounos of--Barnstable-- in the County of--Barnstable-- and Commonwealth aforesaid,has applied to the Department of Environmental Protection for license to -- construct and maintain a pier, ramp and �— float-- and has submitted plans of the same; and whereas due notice of said application, , has been given, as required by law, to the -- Town Council -- of the Town of--Barnstable. -- NOW, said Department, having heard all parties desiring to be heard, and having fully considered said application,hereby, subject to the approval of the.Governor,authorizes and licenses the said r -- Peter Menounos --, subject to the provisions of the ninety-first chapter of the General Laws, and �-' of all laws which are or may be in force applicable thereto, to -- construct and maintain a pier,ramp and float-- in and over the waters of-- Shoestring Bay -- at-- 176 Clamshell Cove Road--in the--Town of Barnstable (Cotuit) -- and in accordance with the locations shown and details indicated on the accompanying DEP License Plan No. 12567 (3 sheets). I PRINTED ON RECYCLED PAPER v _ License No. 12567 Page 2 The structures hereby authorized shall be limited to the following use(s): noncommercial docking and boating access to navigable waters. This license will expire thirty (30) years from the date of license issuance. By written request of the licensee for an amendment, the Department may grant a renewal for the term of years not to exceed that authorized in the original license. This license supersedes License No. 6171 (Renewal), issued on February 26, 2007 to Gerald Antis. In accordance with License Plan No. 12567, the Licensee shall remove the previously authorized structures under License No. 6171. Said structures shall be removed in their entirety and properly disposed of in conformance with all local, state and federal laws. Special Waterways Conditions: In accordance with any license condition, easement, or other public right of lateral passage that exists in the area of the subject property lying between the high and low water marks,the Licensee shall allow the public in the exercise of such rights to pass freely over or under all structures within such intertidal area. Accordingly, the Licensee shall place and maintain, in good repair, a public access sign on both the northerly and southerly sides of the pier authorized herein, adjacent to the mean high water shoreline. Said signs, provided by the Department, shall be posted immediately upon receipt. Nothing in this condition shall be construed as preventing the Licensee from excluding the public from portions of said structure(s)or property not intended for lateral passage. In partial compensation for private use of structures on tidelands of the Commonwealth, which interferes with the rights of the public to use such lands, the Licensee shall allow the public to pass on foot, for any purpose and from dawn to dusk, within the area of the subject property lying seaward of the high water mark. This condition shall not be construed to prevent the Licensee from taking reasonable measures to discourage unlawful activities by users of the area(s) intended for public passage, including but not limited to trespassing on the adjacent private areas and deposit of refuse of any kind or nature in the water or on the shore. Further, the exercise by the public of free on-foot passage in accordance with this condition shall be considered a permitted use to which the limited liability provisions of M.G.L.c.21,s.17c apply. No dredging(including,but not limited to the effects of prop wash)is permitted herein. The float shall be constructed with float-stops as shown on License Plan No. 12567, in order to maintain at least 12 inches of clearance off the bottom at extreme low tide. All work authorized herein shall be completed within five (5) years of the date of license issuance. Said construction period may be extended by the Department for one or more one year periods without public notice, provided that the Applicant submits to the Department, thirty (30) days prior to the expiration of said construction period, a written request to extend the period and provides an adequate justification for said extension. Within sixty (60) days of completion of the Iicensed project, the Licensee shall request, in writing, that the Department issue a Certificate of Compliance in accordance with 310 CMR 9.19. That request shall be accompanied by a certification by registered professional engineer licensed in the Commonwealth that the project was completed in accordance with the License. Please see page 3 for additional conditions to this license. Duplicate of said plan,number 12567 is on file in the office of said Department, and original of said plan accompanies this License,and is to be referred to as a part hereof. License No. 12567 Page 3 STANDARD WATERWAYS LICENSE CONDITIONS • 1. Acceptance of this Waterways License shall constitute an agreement by the Licensee to conform with all terms and conditions stated herein. 2. This License is granted upon the express condition that any and all other applicable authorizations necessitated due to the provisions hereof shall be secured by the Licensee prior to the commencement of any activity or use authorized pursuant to this License. 3. Any change in use or any substantial structural alteration of any structure or fill authorized herein shall require the issuance by.the Department of a new Waterways License in accordance with the provisions and procedures established in Chapter 91 of the Massachusetts General Laws. Any unauthorized substantial change in use or unauthorized substantial structural alteration of any structure or fill authorized herein shall render this Waterways License void. 4. This Waterways License shall be revocable by the Department for noncompliance with the terms and conditions set forth herein. This license may be revoked after the Department has given written notice of the alleged noncompliance to the Licensee and those persons who have filed a written request for such notice with the Department and afforded them a reasonable opportunity to correct said noncompliance. Failure to convect said noncompliance after the issuance of a written notice by the Department shall render this Waterways License void and the Commonwealth may proceed to remove or cause removal of any structure or fill authorized herein at the expense of the Licensee, its successors and assigns as an unauthorized and unlawful structure and/or fill. 5. The structures and/or fill authorized herein shall be maintained in good repair and in accordance with the terms and conditions stated herein and the details indicated on the accompanying license plans. 6. Nothing in this Waterways License shall be construed as authorizing encroachment in,on or over property not owned or controlled by the Licensee,except with the written consent of the owner or owners thereof. 7. This Waterways License is granted subject to all applicable Federal, State, County, and Municipal laws, ordinances and regulations including but not limited to a valid final Order of Conditions issued pursuant to the Wetlands Protection Act,G.L.Chapter 131,s.40. 8. This Waterways License is granted upon the express condition that the use of the structures and/or fill authorized hereby shall be in strict conformance with all applicable requirements and authorizations of the DEP, Division of Water Pollution Control. 9. This License authorizes structure(s)and/or fill on: x Private Tidelands. In accordance with the public easement that exists by law on private tidelands,the licensee shall allow the public to use and to pass freely upon the area of the subject property lying between the high and low water marks,for the purposes of fishing,fowling,navigation,and the natural derivatives thereof. x Commonwealth Tidelands. The Licensee shall not restrict the public's right to use and to pass freely, for any lawful purpose, upon lands lying seaward of the low water mark. Said lands are held in trust by the Commonwealth for the benefit of the public. _a Great Pond of the Commonwealth. The Licensee shall not restrict the public's right to use and to pass freely upon lands lying seaward of the high water mark for any lawful purpose. —Navigable River and Streams. The Licensee shall not restrict the public's right to use and to pass freely, for any lawful purpose,in the waterway. No restriction on the exercise of these public rights shall be imposed unless otherwise expressly provided in this license. 10. Unless otherwise expressly provided by this license,the licensee shall not limit the hours of availability of any areas of the subject property designated for public passage, nor place any gates, fences, or other structures on such areas in a manner that would impede or discourage the free flow of pedestrian movement thereon. F . License No. 12567 Page 4 . The amount of tide-water displaced by the work hereby authorized has been ascertained by said Department, and compensation thereof has been made by the said-- Peter Menounos --by paying into the Treasury of the Commonwealth -- two dollars and zero cents ($2.00) -- for each cubic yard so displaced,being the amount hereby assessed by said Department. (1 cy=$2.00) Nothing in this License shall be so construed as to impair the legal rights of any person. This License shall be void unless the same and the accompanying plan are recorded within 60 days from the date hereof,in the Registry of Deeds for the County of Barnstable. IN WITNESS WHEREAS, said Department of Environmental Protection have hereunto set their hands this 9 t h day of February in the year two thousand ten. Program Chief Department of Environmental Protection Commissioner THE COMMONWEALTH OF MASSACHUSETTS This license is approved in consideration of the payment into the treasury of the Commonwealth by the said--Peter Menounos -- of the further sum of--nine hundred dollars and zero cents ($900.00) -- the amount determined by the Governor as a just and equitable charge for rights and privileges hereby granted in the land of the Commonwealth. BOSTO Approved by the Governor. Governor C C SAN TUI T Q 13 F �O ROAD 000 MENOUNOS, PETER // SI TE o Z o 176 CLAMSHELL COVE ROAD Q COTUIT, MA. 02635 v A.M. 005-031 / .58. ACRES o,I'p W Y C P�7P. BAY QQ — mQ N = � �Z LOCUS 'MAP m Cl) m NOT TO SCALE Z � � � J ti Q o PROPOSED o m Qo �c,=o hN 4 BEDROOM N LA- z o DWELLING o Duo SEE SE3 - 4687) 3 0 OP CEP \ WpRK--- _ __ ~ � � D�4S 44, - - 41M/T BANK N o 20= _ _3 p �<v g "�3--3' 3 `� ZONE �W) LOOD _ SALT__ ----M'y - • — - • � `�Q ems: :�o P � Q MARSH -_ '•�-- _ --. ,_� ' �� zs Q F • . . Lo is 00 ol Q��RO �V W EXISTING PIER, ® . • °' . 1�'9��T RAMP AND FL OA T o Y N�K TO BE REMOVED s �� SHOESTRING CL BAY ao 0 20 ao Q CIO C. o GRAPHIC SCALE ( IN FEET ) a I inch = 40 ft. PLANS ACCOMPANYING PETITION OF ELEVATIONS ARE BASED ON MLW=0.0 PETER MENOUNOS ' LICENSE PLAN NO 5 L7 TO CONSTRUCT AND MAINTAIN A 12 PIER, RAMP & FLOAT Approved by n—`irtment of Environmental Protection (t ON SHOESTRING BAY of l�assar COTUIT, MA. w )ATE: OCT. 9, 2008 SHEET 1 OF 3 �.M. WILSON ASSOC., INC. JOB NO. 2.1486.01 m ----.,-A.M. 005-0JI _ 58 A > ,� - _ q� Fn RES m ~TOE-sue •�\•� ' -� m- ,�- ;Y/�`=- __ z 06 --� C �A•TER $ pF S M.y'�y-��ESS SrA�RS '0.\ �F �.zo PROPOSED 5' x 8'a N KAYAK RACKS " E4 o 48'f Q 0. o EX/STING PIER, RAMP AND FLOAT + TO BE. REMOVED PROPOSED 10' x 18' FLOA T SHOESTRING (TIDAL) + BAY + 0 NOTES: 1. NO CCA PILES + 2. MINIMUM 3/4" SPACE BETWEEN DECK SPACE 3. 5' MIN. CLEARANCE UNDER DECK AT MLW 4. REPLANT AREAS OF BANK DISTURBED BY CONSTRUCTION WITH BAYBERRY, LOWBUSH BLUEBERRY, FESCUE OR SIMILAR IN CONSULTATION WITH CONSERVATION AGENT 20 0 10 20 GRAPHIC SCALE ( IN FEET ) �XENSE PLAN NO. I P-5('7 0 Approved by Department of Environmental won 1 inch = 20 ft. Date: )ATE: OCT. 9, 2008 SHEET 2 OF 3 %.M. WILSON ASSOC., INC. JOB NO. 2.1486.01 in D . 20' 64' FIXED WALKWAY qc PIER - rn 0 o EL.=9.5' MLW EL.=10.25' MLW _ • co vDi PROPOSED �— 0 0 '10' X 18' FLOAT RAMP _ �j CO E2: _ M.H.W. EL.=2.6' o M.L.W. EL.=0.0' .........., ----------------- ------------------- .�.,.. O m • m N EXTENDED PILE U' io o s iorT 4.0'± ABOVE DEC 9 2" X 6" DECKING w WITH 3/4" SPAC'ING(TYP.) ( GRAPHIC SCALE IN FEET ) 4•0'— �, 1 inch = 10 ft. 2" X 12" STRINGERS\ b PROPOSED 16" O.C.(Tl P.) rm- 10' X 18' FLOAT 3/4" DIA. GA-V. IL m PILE GALV. BOLTS(--YP.) \ �� .g 0 5' 2" X 12" CROSS-BEAMS ;p- z EACH SIDE OF P:LE(TYP.) 9 U) 2t 0- 0 > PIER 3� 2" X 8" BRACING m AT ALL PILE BENTS(TYP.) to > � 0� 12" DIA. TIMBER FLOAT BRACKETS PILES 10' O.C. (TYF) SET AT EL.=1.0 MLW J oz 15' MIN. OR REFUSAL PILE EMBEDMENT DETAIL FLOAT I I � IJ (NOT TO SCALE) TYPICAL KAYAK RACK o MOUNTING DETAIL TYPICAL FIRE o (NOT TO SCALE) PIER SECTIOP (NOT TO SCALE. I) Bk 23114 Ps 155 -44419 c 03-21-2008 a 03 ® 12x� Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code A. General Information Important: Barnstable When filling 1.From: Conservation Commission out forms on the computer; 2. This issuance is for(check one): a. ® Order of Conditions b. ❑ Amended Order of Conditions use only the tab key to 3. To: Applicant: move your cursor-do not Peter Menounos use the return a.First Name b.Last Name key. c.Organization 176 Clamshell Cove Road d.Mailing Address Cotuit MA 02635 e.Cityrrown f.State g.Zip Code 4. Property Owner(if different from applicant): a.First Name b.Last Name �1""WEE►ow c.Organization 0 BanrrsrABLF- ; d.Mailing Address Mass 39. e.City/Town f.State g.Zip Code 5. Project Location: / 176 Clamshell Cove :.Cotuit a.Street Address b.Village 005 031 c.Assessors Map Number d.Assessors Parcel Number Latitude and Longitude, if known: e.Latitude f.Longitude 6. Property recorded at the Registry of Deeds for(attach additional information if more than one parcel): Barnstable a.County b.Certificate Number(if registered land)/Plan/Lot# 21996 276 c.Book d.Page AUG 2 O 200� 7. Dates: June 30, 2008 August 5,2008 a.Date Notice of Intent Filed b.Date Public Hearing Closed c.Date of Issuance 8. Final Approved Plans and Other Documents (attach additional plan or document references as needed): Revised Site Plan a.Plan Title A.M. Wilson Associates, Inc. Robert A. Drake, P.E. b.Prepared By c.Signed and Stamped by August 11, 2008 1" =20' d.Final Revision Date e.Scale f.Additional Plan or Document Title g.Date wpaform5.doc• rev.2/27/08 Bamsb3ble revised 4/11/2008 Page 1 of 10 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code B. Findings ILI 1. Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing,this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: a. ❑ Public Water Supply b. ® Land Containing Shellfish c. ® Prevention of Pollution d. ❑ Private Water Supply e. ® Fisheries f. ® Protection of Wildlife Habitat g. ❑ Groundwater Supply h. ® Storm Damage Prevention i. ® Flood Control 2. This Commission hereby finds the project,as proposed, is: (check one of the following boxes) Approved subject to: I a. ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above,the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. Therefore,work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. A description of the performance standards which the proposed work cannot meet is attached to this Order. c. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act. Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). I Inland Resource Area Impacts: Check all that apply below. (For Approvals Only) 3. ❑ Buffer Zone Impacts: Shortest distance between limit of project disturbance and wetland boundary(if available) a.linear feet Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a.linear feet b.linear feet c.linear feet d.linear feet 5. ❑ Bordering Vegetated Wetland a.square feet b.square feet c.square feet d.square feet 6. ❑ Land Under Waterbodies a.square feet b.square feet c.square feet d.square feet and Waterways e.c/y dredged f.c/y dredged wpaform5.doc• rev.2127/08 Bamstable revised 4/11/2008 Page 2 of 10 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code B. Findings (cont.) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 7. ❑ Bordering Land Subject to Flooding a.square feet b.square feet c.square feet d.square feet Cubic Feet Flood Storage e.cubic feet f.cubic feet g.cubic feet h.cubic feet 8. ❑ Isolated Land Subject to Flooding a.square feet b.square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9. ❑ Riverfront area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet Sq ft between 100-200 ft square feet h.square feet i.square feet 9• q q q J.square feet Coastal Resource Area Impacts: Check all that apply below. (For Approvals Only) 1o. ❑ Designated Port Areas Indicate size under Land Under the Ocean, below 11. ® Land Under the Ocean --330 shaded; —6.3 displ. b.square feet c.c/y dredged d.c/y dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ® Coastal Beaches —100 shaded; —3.14 displ. b.square feet c.c/y nourishmt. d.c/y nourishmt. 14. ❑ Coastal Dunes a.square feet b.square feet c.c/y nourishmt. d.c/y nourishmt. 15. ® Coastal Banks 8 (--104 shaded) b.linear feet 16. ❑ Rocky Intertidal Shores a.square feet. b.square feet 17. ® Salt Marshes —168 shaded; -39 —4 displ. b.square feet c.square feet d.square feet 18. ❑ Land Under Salt Ponds a.square feet b.square feet c.c/y dredged d.c/y dredged 19. ® Land Containing -0- Shellfish a.square feet b.square feet c.square feet d.square feet 20. ® Fish Runs Indicate size under Coastal Banks, inland Bank, Land Under the Ocean, and/or inland Land Under Waterbodies and Waterways, above -0- a.c/y dredged b.c/y dredged 21. ® Land Subject to Coastal ' —702 Storm Flowage a.square feet b.square feet wpaformUoc• rev.2127/08 Barnstable revised 4/11/2008 Page 3 of 10 LIMassachusetts Department of Environmental Protection MassDEP File Number: Bureau of Resource Protection - Wetlands WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill.Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, WassDEP] "File Number SE3-4749 " wpaform5.doc• rev.2/27/08 Bamstable revised 4/11/2008 Page 4 of 10 LlMassachusetts Department of Environmental Protection MassDEP File Number: Bureau of Resource Protection - Wetlands I WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before MassDEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A)to the Conservation Commission. I 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place,the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission,which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. 18. The work associated with this Order is (i)❑ is not(2)❑ subject to the Massachusetts Stormwater Policy Standards. If the work is subject to the Stormwater Policy, the following conditions apply to this work and are incorporated into this Order: a) No work, including site preparation, land disturbance, construction and redevelopment, shall commence unless and until the construction period pollution prevention and erosion and sedimentation control plan required by Stormwater Standard 8 is approved in writing by the issuing authority. Until the site is fully stabilized, construction period erosion, sedimentation and pollution control measures and best management practices (BMPs)shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan, and if applicable, the Stormwater Pollution Plan required by the National Discharge Elimination System Construction General Permit. wpaform5.doc• rev.2127/08 Bamstable revised 4/11/2008 Page 5 of 10 I Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) b) No stormwater runoff may be discharged to the post-construction stormwater BMPs until written approval is received from the issuing authority. To request written approval, the following must be submitted: illicit discharge compliance statement required by Stormwater Standard 10 and as-built plans signed and stamped by a registered professional engineer certifying the site is fully stabilized; all construction period stormwater BMPs and any illicit discharges to the stormwater management system have been removed; and all post-construction stormwater BMPs were installed in accordance with the plans (including all planting plans)approved by the issuing authority, and have been inspected to ensure they are not damaged and will function properly. c) Prior to requesting a Certificate of Compliance, the responsible party(defined in General Condition 18(e))shall submit to the issuing authority an Operation and Maintenance (O & M) Compliance Statement for the Stormwater BMPs. This Statement shall identify the responsible party for implementing the Operation and Maintenance Plan and also state that: 1. "Future responsible parties shall be notified in writing of their continuing legal responsibility to operate and maintain the stormwater management BMPs and implement the Pollution Prevention Plan; and 2. The Operation and Maintenance Plan for the stormwater BMPs is complete and will be implemented upon receipt of the Certificate." d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and, if applicable, the Stormwater Pollution Prevention Plan required by the National Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the issuing authority shall presume that the responsible party for maintaining each BMP is the landowner of the property on which the BMP is located. To overcome this presumption,the landowner of the property must submit to the issuing authority a legally binding agreement acceptable to the issuing authority evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of Conditions 18(f)through 18(k)with respect to that BMP. Any failure of the proposed responsible party to implement the requirements of Conditions 18(f)through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one lot, the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans,the Operation and Maintenance Plan section of the approved Stormwater Report, and the Massachusetts Stormwater Handbook. g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three years including inspections, repairs, replacement and disposal (for disposal the log shall indicate the type of material and the disposal location); 2. Make this log available to MassDEP and the Conservation Commission upon request; and 3. Allow members and agents of the MassDEP and the Conservation Commission to enter and inspect the premises to evaluate and ensure that the responsible party complies with the Operation and Maintenance requirements for each BMP set forth in the Operations and Maintenance Plan approved by the issuing authority. h) All sediments or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 are prohibited. wpaform5.doc- rev.2/27/08 Bamstable revised 4/11/2008 Page 6 of 10 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code C. General Conditions Under Massachusetts Wetlands Protection Act (cont.) j) The stormwater management system approved in the Final Order of Conditions shall not be changed without the prior written approval of the issuing authority. Areas designated as qualifying pervious areas for purpose of the Low Impact Site Design Credit shall not be altered without the prior written approval of the issuing authority. k) Access for maintenance of stormwater BMPs shall not be obstructed or blocked. Any fencing constructed around stormwater BMPs shall include access gates. Fence(s) shall be at least six inches above grade to allow for wildlife passage. ' Special Conditions (if you need more space for additional conditions, please attach a text document): D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The Barnstable hereby finds (check one that applies): Conservation Commission a. ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: §237-1 to §237-14 Town of Barnstable Code 1.Municipal Ordinance or Bylaw 2.Citation Therefore,work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. b. ® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: §237-1 to §237-14 Town of Barnstable Code 1.Municipal Ordinance or Bylaw 2.Citation 3. The Commission orders that all work shall be performed in accordance with the following conditions and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans,specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. The special conditions relating to municipal ordinance or bylaw are as follows (if you need more space for additional conditions, attach a text document): See pp. 7.1, 7.2, and 7.3 wpaform5.doc• rev.2127/08 Bamstable revised 4/1 1/2008 Page 7 of 10 SE3-4749 Name: Menounos Approved Plan= August 11,2008 Revised Site Plan by Robert Drake,P.E. Finding: 1. A waiver from regulations is herein approved. The proposed pier will replace a previously approved pier which was found to be more detrimental to wetlands interests. Special Conditions of Approval I. Preface Caution:Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 4 and continue on pages 5 through 7. The Special Conditions are contained on pages 7.1,7.2 and 7.3 if necessary.All conditions require your compliance. H. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8(recording requirement)on page 4 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the.start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work. 3. General Condition 9 on page 4(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. 5. The Natural Resources Department shall be notified at least twenty-one(21)working days prior to the start of work at the site,to inspect the areas for shellfish. If deemed necessary by the Shellfish Constable, shellfish shall be removed from the work area to a suitable site and/or replanted at the locus following construction. The foregoing measures for shellfish protection shall ensue at the expense of the applicant. Page 7.1 6. The applicant shall obtain a building permit for the proposed pier from the Town Building Commissioner. M. The following additional conditions shall govern the project once work begins: 7. General conditions No. 12 and No. 13 (changes in plan)on page 5 shall be complied with. 8. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 9. This permit is valid for three(3)years from the date of issuance of the original Order of Conditions, unless extended by the Commission at the request of the applicant. Caution: a future Amended Order does not change the expiration date. 10. Salt marsh shall not be disturbed. JI 11. CCA-treated piling and structural timber(greater than 3 inches thick)are allowed. Otherwise,no CCA- / treated or creosote-treated materials shall be used. { 12. Lateral access stairs shall be provided at the pier. 13. The proposed stairs shall be constructed a minimum of one foot above grade without solid risers. J114. Deck plank spacing shall be at least three-quarters(3/4)of an inch. 15. Work shall occur during the off-season only: October 15 through May 1. 16. No dredging(including but not limited to effects of propeller wash)is permitted herein.Deepening the berth by propeller scouring is strictly prohibited under this Order. 17. The seasonal storage of floats shall be at a suitable upland site. Floats shall not be stored on banks, s or dunes. -1Wemianent the approved plan shall be implemented. 1 1 be installed to keep the float a minimum of one(1)foot above the substrate at low tide. g shall be driven into place. Some initial pilot hole jetting is allowed. The following special conditions in italics shall govern boat use at the approved pier. These conditions shall continue over time. Note: For purposes of this Order of Conditions,the term"pier" shall refer not only to the linear pile-supported structure,but also to any of its components or appendages such as the float(s),ell,tee,ramp,outhaul piling,etc. 21. The motor craft using the pier shall not exceed 24 feet LOA.Maximum allowed draft shall be 33 inches with the engine in down drive position; 17 inches with drive up. 22. Boats shall only be berthed at the float, and only in a bow-in configuration. Page 7.2 23. Mid-tide to lower, the drive shall be trimmed when navigating to and from the channel to prevent propeller scour. Drive shall always be trimmed at float. 24. A small sign shall be displayed at the end of the seasonal the pier. It shall read SE3-4749 Limitations: • Motor craft max=24 ft LOA • Motor craft max draft= 17"prop up/33"down • Trimming required at float,to/from channel 25. Any desired pier lighting shall receive prior approval of the Conservation Commission. /26. Lead piling caps shall not be used. 26. Work on the pier shall ensue mid-tide rising to mid-tide falling or as otherwise necessary to provide a minimum 12-inch clearance for the work barge above the substrate. 27. In this Order,a mooring permit for the applicant is neither implied nor anticipated. That is the domain of the Harbormaster. IV. After all work is completed,the following condition shall be promptly met: 28. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect, landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. Page 7.3 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code E. Issuance This Order is valid for three years, unless otherwise specified as a special AUG 2. 0 2008 condition pursuant to General Conditions#4, from the date of issuance. 1.Date of Issuance Please indicate the number of members who will sign this form: This Order must be signed by a majority of the Conservation Commission. 2.Number of signers The Order must be mailed by certified mail (return receipt requested)or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office, if not filing electronically, and the property owner, if different from applicant. Signatures: —U) Notary Acknowledgement Commonwealth of Massachusetts County of Barnstable Jr- On this Day Of Mc th Year Before me, the undersigned Notary Public, personally appeared Name of Document Signer proved Jttom�e(through satisfactory evidence of identification,which was/were Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of Barnstable Conservation Commission Cityrrown Signature of Notary Public fZ Printed Name of Notary Public Place notary seal and/or any stamp above V)-,an My Com ission xpires(Date) This Order is issued to the applicant as follows: ❑ by hand delivery on ® by certified mail, return receipt requested,on AUG 2 0 2008 Date Name Signature Date wpaform5.doc• rev.2127/08 Bamstable revised 4/1 112 0 0 8 Page 8 of 10 ILIMassachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE-3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code F. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate MassDEP Regional Office to issue a Superseding Order of Conditions.The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7)within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. Any appellants seeking to appeal the Department's Superseding Order associated with this appeal will be required to demonstrate prior participation in the review of this project. Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a Superseding Order or Determination, or providing written information to the Department prior to issuance of a Superseding Order or Determination. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act(M.G.L. c. 131, §40), and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. Section G, Recording Information is available on the following page. wpaform5.doc• rev.2/27/08 Bamstable revised 4/11/2008 Page 9 of 10 • Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 l I Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on this page shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 176 Clamshell Cove Road, Cotuit, MA 02635 SE3 4749 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: Barnstable County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: Document Number Signature of Applicant wpaform5.doc• rev.2/27/08 Barnstable revised 4/11/2008 Page 10 of 10 • Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands MassDEP File Number: WPA Form 5 - Order of Conditions SE3- 4749 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 and § 237-1 to § 237-14 Town of Barnstable Code G. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title of the affected property. In the case of recorded land,the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on this page shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: Barnstable Conservation Commission Please be advised that the Order of Conditions for the Project at: 176 Clamshell Cove Road, Cotuit, MA 02635 SE3 4749 Project Location MassDEP File Number Has been recorded at the Registry of Deeds of: B t- 2.31I. 14 F':9 15 5 4 4 419 Barnstable County Book Page for: Property Owner and has been noted in the chain of title of the affected property in: Book Page In accordance with the Order of Conditions issued on: Date If recorded land, the instrument number identifying this transaction is: Instrument Number If registered land, the document number identifying this transaction is: I Document Number Signature of Applicant wpaform5.doc• rev.2/27/08 Bamstable revised 4/11/2008 Page 10 of 10 Assessors map and lot number .................... ....:............ .... �oF THE Tod wage `Permit number �/. ........ e�P ♦�g / Z BAR33TSDLE. i House number ....�7(O /?? .........................._................. o rhea 9 54� U 1639- 0 MAI Ar, TOWN OF BARN-STABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO .. v.... ...... ...:✓L 1.. ............. ................................. TYPE OF CONSTRUCTION ................. ' `� ../...................................................................... ................................................19........ ' f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ./�0 .. ..... �i��.7..s/ / -.�.�..... o! ! ....l�re .......... .......................... ProposedUse ........//..(Jv.,S/..................................................................................................................................................... ZoningDistrict .......:..:......i�TI...................................................Fire District .......(..,,! !. .1.............................................. Nameof Owner ...... .................Address .................................................................................... I - Name of Builder ..... !y.%�:5.............Address .................................................................................... Name of Architect C,y��r�/z.S..../...!.. ..T..�..............Address .................................................................................... Number of Rooms ............................. .Foundation .r�'''! — � ��................... ..................... Exterior ��. ..Ti. + ,....... i, .n j........................Roofing .................... .....: :'..... h ....ot........................... Floors ia� ,^_ �Ocs' - wa7v �/�/�./.......Interior .... = :......� .o:7.... .............................. . Heating i /.../��/�; 2,�'..... ��..=............................Plumbing •'••• �' ':/....�.... / .S:I.L.c.......:?� 1 � //l�dr S/O 2 S Fireplace .................. Approximate Cost .................................................................... Definitive Plan Approved by Planning Board -----------_______-----------19________. Area ...... ................... Diagram of Lot and Building with Dimensions Fee ......h 4.3 v....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of-Barnstable regarding the above construction. l Name �°.. ..::='................................................................ ANTIS, GEBAI,D . ` CA=5 D , 23230 Two Story No ................. Permit for ------------ . - Single Family Dwelling --------------------------. ' . ~ Lot #59 176 ClamabeII Cove Bd ' Location --------------------- ` ' Cotuit - --------------------------� . Gerald Antis Owner ---------------.- ------ ` ' Type'of, I7z�ou�___,______ ` . . - ' � ' ' Plot , ~ . ` Permit G,o ' ^ [ .' . ^ ` Dote Completed ' . ^ ^ ' PERMIT REFUSED � . | -----.----...'�----..----. lV / ............................................. ' ' ^—_—~---------------------. ' ^ '�-� ------ -----_ --- ' ^� ,------\=�.��^ —..^���.�[�—...--- ' Approved ---------------- lA ' ' ' .....................................................--------- ` ' ------,---,�--------.—.—.'--.` � � r CERTIFY THAT THIS PLAN HAS BEEN PREPARED IN CONFORMITY WITH THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS OF THE COMV; 4 " T OF M ASSACH U SETTS. g RALPH v o HARLOW Co y : —.7-1-08 Profe a` Surveyor Date: C' o YQQ Al J F<< Q ?O�F ROAD T Ypco 46 0 o >- MENOUNOS, PETER O // S/TE Z o 176 CLAMSHELL COVE ROAD Q � Q COTUIT, MA. 02635 o J A.M. 005-031 Q� Q .58 ACRES 0 J Z -coP. BA Y WLOCUS MAP M Z QCO m NOT TO SCALE � m oO� p v PROP p m Q 2 POSED �N Z o p WFDR40M N N v� p - 3 �sEE LUNG O � o O CL v, sE3 O o 4687) 3 70p �. -30 -.\, _W - - ' ZONE51 M W) SALT___ Y EXISTING PIER, • ' •. . '�s'9� 1ypT p Y RAMP AND FLOAT O TD BE REMD QED ••, • . SHOESTRING � o � BAY • �° x ap 40 0 20 40 0 CL, aGRAPHIC SCALE ( IN FEET ) 1 inch = 40 ft. PLANS ACCOMPANYING PETITION OF ELEVATIONS ARE BASED ON MLW=0.0 PETER MENOUN°OS TO CONSTRUCT AN.D MAINTAIN A PIER, RAMP & FLOAT ON SHOESTRING BAY COTUIT, MA, DATE: OCT. 9, 2008 SHEET 1 OF 3 A.M. WILSON ASSOC., INC. JOB NO. 2.1486.01 CERTIFY THAT THIS PLAN HAS BEEN PREPARED IN CONFORMITY WITH THE RULES AND REGULATIONS OF THE REGISTERS OF DEEDS OF THE COMMOp OF MASSACHUSETTS. RAL�'H GF � HAI �OV1f `� .2 cn .2 y -3�-016 Profe L; Surveyor Date: j MENOUNDS, PETER 176 CLAMSHELL COVE ROAD . -___- _ o COTUIT MA. 02635 _ !L1q -o TOP 0 EP o A.M. 005-031 C 10 58 A RES Ot m g� 0 Q Q- O ol g SIAIRS Q� : .� �p g � • 0�0 �'QSy�.` � ' �. �� 4 `• e PROPOSED 5' x 8' �. ^o KA YAK RACKS E� o �+- + EXISTING PIER, I 'a RAMP AND FLOAT + k TO BE REMOVED n PROPOSED , 10' x 18' I FLOA T SHOESTRING (TIDAL) + rn � BAY + 0 NOTES: I 1. NO CCA PILES + 2. MINIMUM 3/4" SPACE BETWEEN DECK SPACE 3. 5' MIN. CLEARANCE UNDER DECK AT MLW 4. REPLANT AREAS OF BANK DISTURBED BY CONSTRUCTI.ON WITH BAYBERRY, LO.WBUSH BLUEBERRY, FESCUE OR SIMILAR IN CONSULTATION WITH CONSERVATION AGENT 20 0 10 20 GRAPHIC SCALE ( IN FEET ) I 1 inch = 20 ft. DATE: OCT. 9, 2008 SHEET 2 OF 3 A.M. WILSON ASSOC.., INC. JOB NO. 2.1486,01 20' 64' FIXED WALKWAY & PIER . m O z EL.=9.5' MLW EL.=10.25' MLW cn cDi> V PROPOSED o 0 10' X 18' FLOAT n co ... z ... M.H.W. EL.=2.6' ..�" M.L.W. EL.=0.0' ..........., , , . ....... O rTm • m EXTENDED PILE n — 0 10 0 s 10 4.0'$ ABOVE DECK O fT1 C Z7 n rn m _ . . 2" X 6" DECKING ( M - • C^' WITH 3/4" SPACING(TYP.) (', COf�ly� Q 0) D ( GRAPFUC SCALE IN FEET ) 4.0' 1 inch = 10 fL 2" X ,12" STRINGERS rn 2�� ' ` ;:aZ m PROPOSED 16 O.C.(TYP.) m _ 0 11 -I 10' X 18' FLOAT 3/4" DIA. GALV. . S� Q 2:GALV. rn m PILE ) m n 5' 2" X 12" CROSS-BEAMS o Sll� O m C zO EACH SIDE OF PILE(TYP.) Z c -T1 mp D -T c `D O (/) PIER 2 3� 2" X 8" BRACING l O CD AT ALL PILE BENTS{TYP.) N D Q Z r D } 12" DIA. 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Re ' i�F' !J 4'E�t!7�$' .__ F:•� s ,�.. �►;°' vF/T'E' � MAY /S, /9B/ _... __ ..._,.� �*If�IV' 'Qoyootis K 1 tiq�� 08/11/08: Shorten Pier Added Lateral off, Q� Access + Kayak Rack SANTUIT c^c ROAD EXTEND PILE j , 4.0't ABOVE DECK a a a 2" X 6„ 2"X6" DECKING 2.0 PILE 20'- ------64' AXED WALKWAY c1c PIER WITH 3/4" SPACING(TYP) PROPOSED 1.0'x18' FLOAT EL. 9.5' MLW EL, 10.25' MLW PIER SI TE r 4'-0.1 2 X12 STRINGERS 16"O.C.(TYP) PIER ELEVATION VARIES 1.0' M.H.W. EL.=2.6' M.L.W. EL.=0.0 ._ _. .w. 3/4" DIA. GALV. BOLTS(TYP 16' . �-12" DIA TIMBER ,� 2 X12.1 CROSS-BEAMS PILES 10 O.C. (TYP)EXISTING SLOPEY POPPONESSET EACW 51DE OF PILE(TYP) 12" DIA. PILES 2"X8"BRACING I BAY ...,.. . w,•.. AT ALL PILE BENTS(TYP) TYPICAL 'Krp►�''Jd1,K RA0-K 15' MIN. OR REFUSAL I1Atai.,1N'I"ING DETAIL, , / l PILE EMBEDMENT L OCUS MAP (NOT TO SCALE) Existing Conditions Surveyed By �y NOT TO SCALE TYPICAL FIXED PIER SECTION . ZONE: RF 63 county Road, Box Sol SCALE: NONE North Falmouth, MA 02556 MAP: 5 PARCEL 31 508-563•-7777 I FLOOD ZONE. A 1J (EL 12.8 MLW) I -5.s2 --1.11 ! PIER NOTES ! . Proaact 11tie +-•2.00 ! 1. NO CCA PILES 2. MINIMUM 3/4" SPACE BETWEN DECK SPACE. I 3. 5' MINIMUM CLEARENCE UNDER DECK AT MLW. +--6.1 1 FLOOD ZONE , 176 • 13 10 12. 8 ML W) 0 T � a 4. REPLANT AREAS OF BANK DISTRUBED BY CONSTUCTION WITH ry BAYBERRY, LOWBUSH BLUEBERRY, FESCUE OR SIMILAR IN i I CONSULTATION WITH CONSERVATION AGENT. ,( N 1�1 IV �� 'd she +--2.10 I C5 0 V MRG.M200 EXISTING SALIT -8.00 PIER, RAMP « MARSH � � RAND FLOAT ��•lFLOOD ZONE 0ad. / TOWN OF BARNSTABLE i +•-1.43 ll '� 100 YR MA. DEP TOP OF COASTAL E',ANK 14.2 AMW10 FLOOD TOP COASTAL OLD STONE SURFACE TO BE REPLACED 8 I ,l r LIMIT BANK WITH NA 77VE COMPATIBLE GROUND COVER i °` Yt / I �4 SUB-•-SHRUBS AN01 OR SHRUBS / Rarnstable !--7.07 . ' / I/ � ! " r^ STONE ti I, ._t.4r ' _� r _ . ---WA S 3 LL - -- / �)'' / %% 87 32 5 • A lW cLr 1 1 BRKN. C.B, fnd. BAY /'(P)` l / p�:1 1 / 1 1 1 / / I l STONE ` / / �,V 28.68 DRI VE ` Jt�� Q- MRG.M15a (D-5.86 +�-1.34 Cti ��� W8= l / i ! ! ! ! I ! I I i p SHaWE'R 4 .. _..,,, / PROPOSED 5' x 8' o ; l /l l i l ! 1 Z '� -._., • / Prepared For KA YAK RACKS l / ! ! l cn I c� r STONE DRIVE • j '( ! �0 ! / ` '! !! / / /� .. `_ ."``" `1 TO BE REMOVED / 48' C,18a MW I PA ! ! ! ! l / / ----- l Water -1.39 -i- $` , Td qE M`0A/EQ) / �; ; t 4 x 24# RA �4/P IiodO I I / ! / I o no! , ' �° ! NMA • 1 7L�PS/ I Q W I BRICK 7 0 / PROPOSED : ( ( I ! ! O + WALK A '� " 10' x 18' ']'' �j (] -2.29 -I- EXISTING PIER, +� � � � � 'c ,�' � J LOT l' `� ✓ � 20 Rascally Rabbit Roe FLOAT 50 1 , «I: 1 Marstons Mills, MA RAMP AND FLOAT Y° ( I , I I i I / "�` / 25,550 f s / o I I I p' \`V ( ozs�a TO BE REMO VED ( h q ITAl ti ! ''c- � (V � O ,i• ..yt.ej;,y,'• .:ri.•;tii:r,•:;;:�:•::•.•;:� z• ( l ! l l T 6 a i�/ I v +-1.39 MW4:l `w F,s /�,1r DETAIL FLOAT rl'�� SA '/T I :% l l l / l / DC � � cn m � "'' ':,•t•.•� �:a. ..,;••;,.,:,.<•..:• r :�,+••::`� • / / / / / / FOR PERMIT k ••• / O S^ A, M. fflson Aaaaclatea Inc. / MW3 SEE SE3-4687 / POLE PROPOSED 10 x 18' FL OA T HYD. 508 420 0702 / FAX 420 9795 W 1 i _ Drawing Title 79' 64#1 81?USH 0 • / ,� // / TONE 4 , d.s ! % /ti��' / ' N8 DRIVE / `� TYPICAL FLOATS BRACKETS f" c�' /otititi �ti w 3z 50 � �w 201' SET AT EL. = 1.0' MLW +-1.61 o / f��T +--2.01 1 MA. DEP PLANT TO EXISTING � I i FLOOD ZONE TOP COASTAL NATIVE COMPA TABLE } 7.3 (EL 7 2. 8 ML W) BANK SUB-SHURB OR ` I Pli, PIER, RAMP i SIMILAR WOODY •AD AT nin, � N FLo / FLOOD ZONE C COVER �J ��' 'c « o� ROBERTA. �G DRAKE 4 +-0.77 TOWN OF BARNSTABLE / CIVIL TOP OF COASTAL BANK 9 No.41642 a y +-1.54 !/ ��0 '°9qF�/sz��`� Q / lan LOT 58 AL T rr MARSH $ r It (Q S i +--1.85 Scale:1 20' // / C.B. fA7d. • 0 10 20 30 40 50 FEET iL Date JUNE 21, 2008 O �• / D Drawing No. Design R.D. •//� Check Drawn R.D. Job. No 2.1486.1 _ -- ---�- Last Rev. 8 j11 i