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HomeMy WebLinkAbout1635 SOUTH COUNTY ROAD lQ_ Sou-E-h ( o u� - n , •o �I� ' „❑. '. U ,° ., ,. oo .¢n - ❑ w , al p be "�.�P-ypd� flY76 ^ n , ❑^" p p°,�, - o o o r eb U a `:AaQ , 8 n o np ° � I1 0 >„ ❑ I1 � qo o � - „❑ ,. ,. ^ n , ,o �a ., . �� � �" p ° .� ❑ nil „ �d q ^ o p � �.,, .. n .o ,. ❑ :. �,^ � �n ��y 11 � �"❑ ..�� � {�"� q��,: u o , a n ^ ' D , o n : V w n o un s M.*.tl �1.tea" � s--v.-a ,h r...+!"�* - .-�..Jl .e--.y...�,- _w.r..-_ - t'7 C•,- —r.+.I� - 'r+^T-^eR _ _ _ _ '��n -- 4 E ��rrd i t t t t { f c I t o � t oFr Town of Barnstable Building STASM ; Post This Card So That it is Visible From the Street=Approved Plans Must be Retained on Job and this Card Must be Kept- RARN MAS& Posted Until Final Inspection Has Been Made.s639. Permit �0 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. _i Permit No. B-20-377 Applicant Name: PAUL A GEMME Approvals Date Issued: 08/18/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 02/18/2021 Foundation: Location: 1635 SOUTH COUNTY ROAD, MARSTONS MILLS Map/Lot: 097-022-001 Zoning District: RF Sheathing: Owner on Record: BURNES,GORDON M ET AL TRS Contractor Name: PAUL A GEMME Framing: 1 Address: ATTN: HUGH WARREN Contractor License: CS-042446 2 BOSTON, MA 02110-2409 Est. Project Cost: $ 150,000.00 Chimney: Description: INCREASE SIZE OF BREAKFAST AREA/KITCHEN AS PER PLANS Permit Fee: $815.00 Insulation: SUBMITTED Fee Paid: $815.00 Project Review Req: plans and additional information received by email and Date: 8/18/2020 Final: attached Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: 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. Rough 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 Final Gas: work until the completion of the same. Electrical 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:' Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Perso tracting 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 • C� "­7 O Application Number......� ............................. . j MAea Permit Fee.......... ............................Other Fee:....................... z639. TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by.................................On........................... BUILDING PER 41T Map.......00�.....................Parcel........VD.D........ `-!",... APPLICATION Section 1 — Owner's Information and Project Location Project Address 14,3s" 5, L^o 4v7-,* t� . Village AILS �y� �!I Owners Name so 1341"Es, 6r-Aft4, •+ e7WA.v -T *&- 'rRs oAiti4 wonGcrr f cwei /0�F Owners Legal Address ®? .3 o �`'0 A1'C���S ,Y'7 City `'3 his i PtJ State M A Zip 3 yecc Owners Cell # 6 7•-7-T —9a/0 E-mail 1-ZA�9 8 &O-Rj✓.Co M Section 2 —Use of Structure BUILDING DEFT Use Group ❑ Commercial Structure over 35,000 cubic feet FED 0 7 2020 ❑ Commercial Structure under 35,000 cubic feet TOYVIv vt- 6'-h�6 I MF3LE Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description iNL/L�s� .�;�.� ®�= �dL �'`�1'.3r` A-4L��.FiT�.f!�.c,� �•S �� ���.+� T.sict iinrlated- 1111 Snni A Application Number.................................................... Section 5—Detail i Cost of Proposed Construction"$/SC,e 610.�'—J Square Footage of Project %Oa-t 5o4;` Age of Structure .3 C;, w,25 Dig Safe Number IV IA # Of Bedrooms Existing (10 Total# Of Bedrooms (proposed) A./ /0� 110 MPH Wind Zone Compliance Method MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression El Heating System ❑ Masonry y Chimne ❑ Add/relocate bedroom e Water Supply ® Public ❑ Private Sewage Disposal ❑ Municipal ® On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes 9 No Section 7—Flood Zone Flood Zone Designation J Within or adjacent to a wetland, coastal bank? Yes No ❑ Section 8—Zoning Information j i Zoning District t" Proposed Use Lot Area Sq. Ft. yC>P Total Frontage . Percentage of Lot Coverage %0 #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed j Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No i Last updated: 11/15/2018 o Application Number........................................... Section 9- Construction Supervisor Name ?49(- Q c lklm(E Telephone Number 014047, fr Address PO r�ea)C /o US" City Cl b eI'A%d State 114 Zip ad y/ License Number 0 cK;-yyG+ License Type Uiy AES.. -.Expiration Date Contractors Email &0( 01YE I4,(V 6)U,M(04S . Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentatio quired by 780 d the Town of Barnstable.Attach a copy of your license. Signature 0/, . � Section 10—Home Improvement Contractor Name i`�A-0,L C,JV-10 Telephone Number 5-0 E-F4 y E/ i `!o I ftr�-&'#+ Address_F0 g a X /BJ..S- City 6= 1b&wW/-S /` State� a e,Zip Q Registration Number lea 66� Expiration Date �/a P al I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re y 8 C d the Town of Barnstable.Attach a copy of your H.I.C... Signature ate Ild Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date :3 Print Name 14��A,17V A) A �0E7E7XS Telephone Number E-mail permit to: Last updated: 11/15/2018 Section 12—Department Sign-Offs Health Department Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ , I Fire Department ❑ Conservation _ • , , -�o ��3 3 For commercial work,please take your plans directly td the fire department for approval Section 13— Owner's Authorization ` I I, 91cK R ZA4V cFS , as Owner of the subject property hereby authorize y�.�ri��� / OZlOeXS , lam' to act on my behalf, in all matters relative to work authorized by this building permit application for: /6 3 s; S o a T if (Address of job) Signature of Owner date Print Name Last updated: 11/15/2018 @a �also m tgfi� L=tiW 0 PMPb x D d1 I ji LaceJm al EdeUnp yy sse m T E 8�8e Bumes $ Residence laLs swm cmm ne. Menton wu.nu�zsu • omibn al Plggaee Well _0 arabn al ExbOrp Y2o pvr wn�ue�m�rmom �N.cva01w�PPsl.,,u°'ce� w.wmb b Wnl�iue-o Ei PReem9. wlpam.r `• bbM .Y�ev.rY - w J)Nnw puNbu i �mmlrweN��metJUWJ 000 O mmlmnB'• ow O O ; 110 ❑❑ hime"Miee Nt uru Md. JI Fer euemr•evNan Kitchen Plan 1 1/4'=V-O �ehs �CrF�A � [ 0 6 TOM Al Al j 5 215/20 6:28:11 PM e0 1634SCR A1.Otj.— � 1 '' . Y` `�" yyam _ - - ,•� �'� " 1 � XN to dew � ` �� + ' �-' — •JET -- ; `•' ... 1 ; . 7d1 S�' DATE(MMIDD/YYYY) A6ORo® CERTIFICATE OF LIABILITY INSURANCE 02/05/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: AP INTEGO INSURANCE GROUP PHONE FAX AIC No Ext: (AIC No): 375 Woodcliff Drive E-MAIL Suite 103 ADDRESS: Fairport, NY 14450 INSURERS AFFORDING COVERAGE NAICS INSURER A: NorGUARD Insurance Company 31470 INSURED INSURER B: Fenton Builders, Inc. INSURER C: PO Box 441 INSURERD: Marstons Mills, MA 02648-0441 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDLSUBR POLICYNUMBER MMILDIDmFF MMIDCDm P LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ O CLAIMS-MADE OCCUR PREMISES DAMAGE TO PREMISES Ea occurrence $ O MED EXP(Any one person) $ 0 PERSONAL&ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 0 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ 0 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acddent UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION I SPER OTH- AND EMPLOYERS'LIABILITY TAT Y/N LITE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $50O 000 A OFFICER/MEMBEREXCLUDED? N❑ NIA FEWC011544 09/15/2019 09/15/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $50O 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $50O OOO DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Employees: Full Time: 4; Part Time: 0 Governing Class Description: CARPENTRY-CONSTRUCTION OF RESIDENTI CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town Of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 367 Main St Marstons Mills, MA 02648 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Town Of Barnstable 367 Main St Marstons Mills, MA 02648 $ Urvision of Professional Licensure l Board of Building Requlations and Standards Co. �Spet�isir Expires: 05/12/2020 PAUL A GEMME P.O.BOX 1006;, ; . EAST DENNIS MA•026.41'_. Commissioner .Te �irrririau��c`<�c�✓/i�ai-1Ci�'�Jc/l-J iOffice of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPEs..lndividual Re91ski6gn, Exalration t:62662= 06/29/2021 PAUL A. PAUL GEMME III 1661 RTE 6A ! . I EAST DENNIS;MA 02641 Undersecretary i ' i Town of Barnstable Building Department Services Brian Florence,CBO nsass. g Buildin Commissioner �FD�A 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 I, Richard M Burnes , as Owner of the subject property hereby authorize Fenton Builders Inc, to act on my behalf, in all matters relative to work authorized by this building permit application for: 1635 So County Rd Osterville Ma 02655 (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Richard M Burnes Jr' �,,��,,. Print Name Print Name January 31,.2020 Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:08/16/17 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Invatigations 600 Washington Street Boston,MA 02111 www mass goM a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): `*eV-11-zW 4 a11_4 e7C 1.1ve- Address: !P �&Sf Lr✓, City/State/Zip: 3 aVS M/(,t-S OP4-07 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.911 am a employer with—_ 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity.acitY• employees and have workers' = 9. ®Building addition [No 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.❑Plumbing repairs or additions myself.[N o workers'comp. right of exemption per MGL y p 12.❑Roof repairs insurance required.]t C. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#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 am employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: �„ �QO S�r�n C 6-r o Ld Policy#or Self-ins.Lie.#: F 'GJ lcd //5"5/a Expiration Date: i!s—/Za ZO Job Site Address:&r S� y.f Y jam,( City/State/Zip: crS f o� Iy'//,S 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 certi under thepains andpenalties ofperjury that the information provided above is true and correct. Si aiure: Date: Z ZG?O Phone#' u6Ir" 7 Z / 0 Of, 7cW use only. Do not write in this area,to be completed by city or town qjjciai 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#: 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 not 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 such dwelling house or on the grrnmds 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 constrict 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(LLQ 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 j 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 Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia 1 Q_—PnAjZ4, �i oFTME Town of Barnstable *PermitFjpm !Fdate Building Department Servileesi' 6Tnmwoft°""r snaxsr , : Brian Florence,CBS Building Commissioner . 200 Main Street,Hyannis,MA 02601 a A �' q www.town.barnstable.ma.us Nov A/ / Office: 508-862-4038 r®IA�n 20�� Fax: 508-790-6230 8A EXPRESS PERMIT APPLICATION - RESIDENT Not Valid without Red X-Press Imprint Map/parcel Number O 22-601 Property Address 3 o U✓ l r dZ ag, r ❑Residential Value of Work$ C/7 000 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address F-i c-4- ,J-o-r% 'f Contractor's Name t� //�/�i- Telephone Number 1S--j9 ,? 7 7 6 y6 Y9' Home Improvement Contractor License#(if applicable) [Z p !j,0 p Email: Construction Supervisor's License#(if applicable)- C S 07 R 7 -2 Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ am the Homeowner have Worker's Compensation Insurance Insurance Company Name 6r Crvaek 14 ✓L GC o.n a Workman's Comp.Policy# S�Z ! Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ e-side Replacement Windows/doors/sliders.U-Value 2°� (maximum.32)#of windows #of doors: *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: Q:\WPFU_ES\F0RMS\building permit fonnsEXPRESS.doc 08/16/17 77M Commomvealth of Afassadliusetts Depar&aent of Iudiulrial Accidents fQ}�ce OfbrVestigadem ' 600 Washington Street Boston,AIA 02HI mmumassgovfdia Workers' Caimpensation Insurance Affidavit:Builders/Contractur&Me ians/Plu3mbers ApUlicant Information Please Print;feebly Nanw aaaFe-w-__E ►3 vx '141 Poe— 1491A mom ZZ 17ie&3 Arreyqyou an employer?Check the appropriate barn: ' Type of project(required}: 1.02 I am a employer-with 4. ❑I am a general contractor and I employees(full azxdfor par time). * have hired the sub�cont at�fors 6. [:]New eoustniction 2.❑ I am a sole proprietor orpartaw- listed onthe attached sheet 7. ❑Remodeling ship and have no.employees . These sub-contractors have g..❑Demolition waridng for me in any capacity. employees and bane worlbers' [No worloers'comp.i4ac�tra.,rg comp-msuran�l 9. [:]Building addition, required] 5. ❑ re We a a corporation and its 10.El Electrical repairs or ad&tions officers have exercised their 3.❑ I am a homeowner doing all wa�rk 1 L❑Plumbing repairs or additions• o woks• right of exemption per MGL ❑ reps �€ � gyp- 12. Roof insurance required_]T c.152.§1(4�and we have no 13_❑Other employees.[No workers' COmp-insurance ) fr' ay app�6at chedsbox 1%l—st also fia out the section belowsrarsag tlieirwoxkere comp—sad+++pore y infurmadon_ t Homeowners who submit this affidavit inffrz=g they are damg all wal aad then hhe outside can- tus—st submit a new affidaeSt iodic n-such. ZCanaactots Stet checlr this box must attadted as addWanat shut sbowarg the name of&a sdb-cootwmz&and state whether or not those emities have emphryees.Iftbesvb-cmbzctmbavemployee%dLey=nTpsvuided=tirarkas'ramp.policy number. lam an employer tliat is prm idit ivarkers'conrperzsafiaii insurance for my enzpla3wes BeIonv is the ptrtfcy mzd job sits informadom Insurance Company Name: of-6-a '.j ,.r c!/-C4elC4L Policy,or Se1Uns.Lic-* (� '�. 5 �.� Expiration Date: Job Eta A,ddcess-- f{� ,�[r/�;�C► InL� /� City/Stafelzip: 036e--00- )z4ir Aftach a copy of the workers'coznpensationpolicy-dectaration page(showing the policy number and expiration date). Failure to secure coverage as nequireduuder Section 25A of MGI c.152 can lead to the imposition of criminal penalties of a fine up to$1,50Q00 and/or one-year imprisonment as well as civil penalties,in the form of a STOP WORK:ORDERand a fine of up to$250.Q0 a day against the violator. Be advised that a copy of this statement maybe ftxwarded to the Office of Iavesfigations of'1he DIA for insuatum coverage verification- I do hffeby cerh)5,ruder the pains and penaHies ofpatiury fhatflte info rrzzatian provi&d above i;true arzd carrect 8imrature: Date- 1 16 f Phone ik 7 7 .6 7 9 O,frciat use only. Do not write in this area,to be campTeted by tdip artorvn official City or Town- Pertmt/License# Issuinzg Authority(circle one): L Board of Health 2.Building Department 3.Ct y)Town Clerk 4.Electrical hupector 5.Plumbing Inspector 6.Other Contact Person: Phone& laformation and Instructions Massachusetts C=-=ml Laws chaps 152 reqrure s all employers to provide workers'compensation for their employees. Pm uant-to this statnte,an eupIoyee is defined as."_.eveay person in the service of der under any contract of lifer express or implied,oral or wriftrn." An e2"p&yer is defined as"an mc�idnA partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged is a joint enter-Prism,and including the legal represenafivm of a deceased employer,or the receives or trustee of an mdividnaI,pmtuersbrp,association or other Iegal entity,employingemployees- However the owner of a dwclling house having not more than three apartments and who resides therein,or the occupant ofthe - dwell house of another who employs pmsons to do maw,construction or repair wol on such dwelling house or c a the grounds or building dng appurt 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 baseness or to construct bwIdings in the commonwealth for any applicantwho has not produced acceptable evidence of compL-mce with the insurance.coverage required-" Additionally,MCrL chapter 152,§25C )sates-Nehb=the nor my ofits political subdivisions shall enter into any contact for the perforo:aace ofpublic work umtl acceptable evidence of compliance with the ins mace.. requj e euts of this chapter.have been presented in the contracting anthoi*." Applicants Please EII out the workers'compensation affidavit completely,by checking the boxes 1hat apply to your situation and,if necessary,supply sob-conttacbor(s)name(s), address(es)and phone mmmb=(s)along with their certrficafe(s)of msurance. Limited Liability Companies(LLC)or Linuted Liability Pariaq:shrps(LLP)with no employees other than the members or partners,are not rbgtmed to cant'wmicers' compensation insmance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidayrt maybe sohmiffj--d to the Department of Industrial Accidents for confirmation of insorance coverage, Also be sure to sign and date the afadavit The affidavit should bez8t omed to the city or town that the application for the permit or license is being req ws en not the Department of . Tnrincfirial Accidents. Shouldyou have any questions rega ding the law or ifyou are required in obtain a workers' compensation policy,please call the De pm nneot at the number listed below. Self-insured companies should enter their s elf-ins-mance license number on the appropriate line. City or Town Officials Please be sore that the affidavit is complete and pried legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigati ons has to contact you regarding the applicant Pleas a be sure to fill in.the peumh' tense number which will be used as a reference,number. In addition,an applicant that must submit multiple pemiitt(license applitmfions in any given,year,need only submit one affidavit indicating^'"Tent policy information(if necessary)and undra'Iob Site Address"the applicant should write"all locations in (City or tnwn)."A copy of the-affidavit that has been officially stamped or madced by the city or town maybe provided to the applicant as proof that a valid affidavit is on fuze for fat$e'permits or licenses_ A new affidavit must be fMed oft each year.Where a home owner or citizen is obtaiamg a license or pezmit not related to any business or commercial venhIIe (i_e_ a dog license or pemmit to bum leaves etc.)said person is NOT r cquired to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any gnestions, please do not hesitate to give us a call- The Department's address,telephone and fax mmnber: th of I chusetls mt of Ii6� AoDidenta office of D.vestikaCLO= ��as�ing�n Sfz�et BQstw2 MA 0�111 Tc,-L#617' -4900 cxt 406 or I-.977 1v1A SAS Fax#617 727 7M Kevised424-D7 r i I Town of Barnstable Building Department Services eA xis A Brian Florence,CBO M i4S9' Building Commissioner 200 Main Street,Hyscn*MA 02601 www.town.barnstablama.tw Office: 50M62-4038 Fax: 508-79( �Y ProP a Owner Must Complete and Sigh This Section If Using A Builder as Owner of the subject property authorize �z� '��1 �2r S ��• to act oa my behalf hereby is all matters relative to work authorized by this budding permit application for. 1,431'- Save (Address of Job) **Pool fences and alarm are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final iaspections are performed and accepted. Signature of er Signature of plimnt Print Name Print Name 1� ACo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 1111% � 11/06/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME AP INTEGO INSURANCE GROUP �N EM): kX (A/C No: 375 Woodcliff Drive EMAIL Suite 103 ADDRESS: Fairport, NY 14450 INSURERS AFFORDING COVERAGE NAIC# INSURER A: INSURED INSURER e: NorGUARD Insurance Company 31470 Fenton Builders, Inc. INSURER C: PO BOX 441 INSURERD: Marstons Mills, MA 02648-0441 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE.INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YY MMIDD/YY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 0 CLAIMS-MADE F—IOCCUR DAMAGE TO RENTED 0 PREMISES Ea occurrence $ MED EXP(Any one person) $ 0 PERSONAL&ADV INJURY $ 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ O POLICY❑JECT LOC PRODUCTS-COMP/OP AGG $ 0 OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ea a.,dent ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS ONLY AUTOS ( ) HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per a.dent $ UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ ,500 000 B OFFICER/MEMBEREXCLUDED? IV NIA FEWC857829 09/15/2017 09/15/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If ESC yes un der nder D RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE I 4LI I 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD naa)uoea,N6 olbAcuoac/ueef , ►tfairs&Business Regulation License or registration valid for individul use only before the expiration date. If found return to: E-NT CONTRACTOR 1900 Type: i Office of Consumer Affairs and Business Regulation p�g: DBA 10 Park Plaza-Suite 5170 __- Boston,MA 02116 foff RVICES °! Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-078724 Construction Supervisor ROY H TOLLIVER ►%•. P.O BOX#396 MARSTONS MILLS MA 102648 Expiration: Commissioner 05/06/2018 i °F„E Town of Barnstable *Permit# 1 ti Expires 6 nron hsjr it is to Regulatory Services Fee BARNSrABI E, r� 6 9 ,�� Thomas F. Geiler,Director DIED MA'1 A `li , 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 Not Valid without Red X-Press Imprint ' Map/parcel Number y OO Property Address 4eD o v „ 'Residential Value of Work' �r `L7), Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address C 411ty L 1 ll rl l n- Contractor's Nameo Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Y ❑Workman's ompensationInsurance ` PRESS PER Ch k one: I am a sole proprietor FEB 1 9.2010 ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BP►RNe TAB Insurance Company Name CT / Workman's Comp.Policy# y Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ,zr ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows, *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 py of the Home Improvement ontractors License & Construction Supervisors License is eq ired.. SIGNATURE: QAWPFILESTDRIATbuilding pemutt forms\EXPRESS.doc Lit ! ti The Commonwealth ofNlassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www;mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/.Electricians/Plumbers Applicant.Information Please Print Le ibl Name (Business/Organization/indiwidual)` j „//� TIC_ / ,��'r"�t l Address: City/State/Zip: L'/ hone #: so P6-2, i<I P Z Are you.an employer? Check the approp iate box: Type of project(required): 1.❑ l am a employer with 4. ❑ I am a general contractor and 1 6. ❑ New.construction mployees (full and/or part-time).* have hired the sub-contractors actors 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 mein any capacity. employees and have workers' 9. ❑ Building addition [No workers comp. insurance comp. insurance.t 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 I LE] 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' 13.❑ Other comp.insurance required.] "Any applicant that checks box tll 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. tContradtors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers',compensation insurance for my employees. Below is the policy and job site information. 'Insurance Company Name: r Policy# or Self-ins. Lic.M Expiration Date: .lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the impositiolh 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 it der the pains a naltie f erjury that the information provider!above is i ue and correct. Signature: — — Date: Phone# /�o? 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 ofllealth 2.Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other. • r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an emplo),ee 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 enteuprise, 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 not more than three apartments and who resides therein, or the occupant of the, dwelling house of another who employs persons to do maintenance, constniction or repair work on such 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 con-unonwealth 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 fiiture permits or licenses. A new affidavit must be filled out each year, 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 I. 02/19/2010 15:15 FAX CHARLES RIVER VENTURES R 002 ReguIato>ry Ser'vices aesa Thomas P,Ceflar,blrecfar . . Blinding W ision V TOM Perry, 1311llding C0=4821ener 20D Main Street RYW- -MA 02601 17"w.tafVa:barnstable.Ma.us Office: 508-862-403 8 Fax: $08-7M.6230 Propelty Owner Must Complete and Siga.This-Section If Us g A.Bugdeez ri $ er of'the subject pIDP elt jr hereby authorize rr to act on mY behalf, is ali matters ze"ative to work aut oriz,d bp this 1�iu7d;a - g Pew'application for; ,• _ (Address oil 45 Sim of Owner dZ IO , CJ print Name Q�OP.tvlS:oro�'I�ERPFsRM15SI4N Massachusetts- Department of Public Safet} Board of Buildinl- Re!-ulations and Standards Construction Supervisor License License: CS 17232 Restricted-to: 00 .,-LAWRENCE A PERRAULT 10 DEACON PATH ,SANDWICH, MA 02563 Expiration: 9/3/2011 Cununissiuner. Tr#: 2791 Boar o u�ge Iao o ns an an ar s One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 137897 Type: Individual Expiration: 1/23/2011 Tray 27W7 LAWRENCE A. PERRAULT LAWRENCE PERRAULT 10 DEACONS PATH SANDWICH, MA 02563 Upd Address and return card.Mark reason for change. Address Renewal iJ Employment ,, Lost Card )PS-CAI 0 5OM-07/07-PC8490 : Town of Barnstgble. o� Regulatory ServIces y Thomas F.0e11cr,Director � h a $TIdjbg Dbrision ' U Toth perry, 3gt1 ftg CoMmissioner 200 Main Stxcot; Hymn®,MA.02601 www towu.barns#able;ma.us Office: 508-862-403 8 Fax: 508-790-62-30 P113pexty Owner Must Complete and Sign This Section If Using .A.Builder 3 �j 'er c)f the subject property G�e✓r�C`n L herebq auch0= to act on.2Y behalf, . ' in alb=tters zelalive to work aut}�osized bythis biuldzng perms application for , (Address off �(¢ i 5 Sigaa of Owner D to `~ iPlCiM -emu vn�, Print Name QFOP.MS:OWI•TEFtPERMI5SI0N . ' TOWN CLERK • WNs-riGLE, MASS. Town of Barnstable Zoning Board of Appeals .21001 FED -7 Pill 2: 41 Notice-Withdrawn Without Prejudice Appeal 2001-12 . - Burnes 2001 - 12 -Appeal of the Building Commissioner Summary: Withdrawn Without Prejudice Petitioner: Richard M.Burnes Jr. and Nonnie S.Burnes Property Address: 1635 South County Rd.,Marstons Mills,MA Assessor's Map/Parcel: Map 097,Parcels 022.001,022.002,017,020,021 and 025 Zoning: Residential F,Resource Protection Overlay&Groundwater Protection Overlay Districts Relief Requested,&Background: The applicants are appealing the decision of the Building Commissioner in refusing to.issue a building permit for.an,additiomto the home that includes a second kitchen:. : The.,progerty;consists`:of six;lots totaling 21 acres. The existing dwelliiig:is located on Parce1.022.001. That lot is 12 62 acres m area aiid is developed with a 1 &1/2 story,6 bedroom 4;537 sq.ft. single-family dwelling. "..accessiory structure-a barn-of 900 sq.ft. is also located oriAe:property.The dwelling was originally linilt.in 1984 and added to in 1997. Today,the applicant;seeks to add'another addition of 2,040 • sq.ft. (1,320.4irs[floor,720 second floor). The addition is to contain-2 bedrooms,..2..baths,.a family room _ and a second-kitchen. Procedural&Hearing Summary: This appeal was filed at the Town Clerk's Office and at.the.Office of the Zoning Board of Appeals on November 28, 2000. An extension of time for holding the hearing and for filing of the decision was. executed.between the applicants and the Board. A public hearing before the Zoning Board of Appeals . was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened January 24, 2001, at which time the applicants through their representative requested and the Board granted to allow the appeal to be withdrawn without prejudice. Board Members hearing this appeal were; Dan Creedon, Gail Nightingale, Ralph Copeland,Raldoph Childs and Chairman Ron S.Jansson. Attorney John Alger represented the applicants. At the opening of the hearing,Mr.Alger stated that he had received a building permit for the requested kitchen upon the commissioners review, and based on the fact that the kitchen would not be isolated within the dwelling and could not be closed off from the remainder of the home. Motion: At the January 24, 2001, hearing, a motion was duly made and seconded to grant the applicants request to withdraw the appeal without prejudice. The vote was as follows: AYE: Dan Creedon, Gail Nightingale, Ralph Copeland,Raldoph Childs and Chairman'Ron S.Jansson • NAY: None i I i Ordered: Appeal 2001-12 has been withdrawn without prejudice. Appeals of this decision,if any,shall be made pursuant to MGL Chapter 40A,Section 17, within twenty(20) days after the date of the filing of this decision in the office of the Town Clerk. S� • 2 0 Ron S.Jans airman Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable County,Massachusetts,.hereby certify that twenty.(20) days have elapsed since the Zoning Board of Appeals filed this decision and that i no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day pf` . "��`�� under the pai* s.•anel penalties of perjury: Linda Hutchenrider,Town Clerk I :i y i ,I i 2 I. I L %4sr's map'and lot number �..... z..�....... /V. Sewage Permit number .... .. . ..... ......... 0 0 �►rt:i"� �,r Z BARNSTABLE. House number ._�. �� � �.. .... ..... ... .. . ....... .� rt�l:�fi�..�. Mb /� p T A e�p r .o� / �710� ti`���lC�`L �0.j �� 5 1 9O�'FpYAVA,- m VA ►Tt.E ODE ANC OWN OF4_ BAUAo U 1RECi1� SOW BUILDING INSPECTOR APPLICATION -FOR PERMIT TO .. X\a......! ,:?.Caa4`\1)[. ....................................................................... f TYPE OF CONSTRUCTION ......"fnl&.............................................................................................................. ................ a3.........19........ TO THE INSPECTOR OF BUILDINGS: r `+ The undersigned hereby applies for a permit according to the following information: 9 � n 1 Location .� T'/.....-.��(.A.C ...�c�Cs►�c� .... tl.....................: �Qith3... .��1�S......:.:.:.... .............. ProposedUse ... e ....................................................................................... '...............................:.................:., .......... Zoning District ...� ...........................Fire District I".. () Name of Owner '.............Address ...Loj x\(a I11i... Cl.... .�.�.�,f '1 Name of Builder .....�!�.Q,......Address .. -.4-7 0........ CUI.� ........................ Name of Architect ........Address ............................ Numberof Rooms ......3......................................................Foundation :.00.h C-............................................................ Exterior .....LRjZ.C--,k .............................................................Roofing .....O.qq#Q .............................................................. Floors ...... Q.t- ..........................................................Interior ... ... 1G,�1.................................................... Heating ... ....)�I......................................:.Plumbing aq�... ................................................... Fireplace ......:/.........................................................................Approximate Cost .......)0..Qj..0.Qo ............................. Definitive Plan Approved by Planning Board ---_------_------_-----------19 . Area ...16aQ........... Diagram of Lot and Building with Dimensions Fee o SUBJECT TO APPROVAL OF BOARD OF HEALTH \\ mgss N '00 0 0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ... . ... c,--.. ........%....................... ©/� / 7.7 BURNES, RICHARD JR. -A 25265 12 Story -sM6 ................. Permit for .................................... Single Family Dwelling ...................�e.ge................................................ South. County Road ok Location ................................................................. ............_Ma.r.s.t.ons...Mills' ....................... ......... .. . .. ....... ..... .. . .. Owner ...Richard Burnes Jr. .I............................................................. 'Ole Type of Construction Frame .......................................... ........................................................................... jpllot ';­�'....................... Lot ................................ 3 0 83 Permit Granted............June................ .19 Date of Ins p`ectjon Pg...................Z .19 Date Completed ......IZ-9��;R3...ig ;41A�A-3 PERMIT F till REFUSED ................................................................ 19 t) � H, ............................................I....................... ........... 0 . . ................................................................................. Y ....................................................................... ........................................................................... Approved ................................................ 19 . ................................................ .............................. ............ ............/............... ...................... Assessor's map.and lot number ..................... OF THE t0 Sewage Permit number ...... .. :'... A :..........:................... d R BARNSTADLE, i d House number ......:...a NAB& �......................::..... ..........,,................ i639 ♦� 'E0 YPY a` TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......::.::..:..... ........:..: .......... y:...: ....................................................................... A TYPE OF CONSTRUCTION ......::. : ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......................................................� ...... ....: ' .a ........ ProposedUse .... ..:.................................................................................................................................................................... Zoning District ...:.:.......:..........................................................Fire District Name of Owner .................................. Address ........ ... .:.:. . Name of Builder �„ ":. ...*t.:.:.....:. Address ....:....e Nameof Architect ..................................................................Address .........................................................:.......................... Number of Rooms ......:,..:'.......................................................Foundation ........................................................................... Exierior Roofing Floors Interior 4,. .:R............:........................................................ Heating ..........................:.......................................................Plumbing .......................... Fireplace ..................................................................................Approximate Cost ........:...: ........................... Definitive Plan Approved by Planning Board ________________________________19________. Area :............................ .Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ....... g: :;-.. ....... :.......:....:.:..-......................... BURNES, RICHARD JR. '"-/ 25265 �2- No ................. Permit for .....1......Story.................. .....Single...Family. Dwelling ................ .. .. .... .. .. ....... ... .... .. .... ..... Location ...1791 South Coun ........................................t.Y..RQAd... Marstons Mills ............................................................................... Owner .........Richard...........Burnes...J.r.,............... Type of Construction ....ZKAIRe......................... ................................................................................ Plot ............................. Lot ................................ Permit Granted June 30. .........19 83 ....... .. . Date of Inspection ....................................19 Date Completed ...:..................................19 PERMIT REFUSED AA .......LVA... Z-0.......0 19 r ........... ....................... ................... L NO............... . .............................. ........... ................................. ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... F Assessor's mar'and lot number ....97. ....... Q . Sewage r • Permit' number � ' `b 3S / i BAWSTABLE, i Housenumber .........................:.........:........:........................... v "6 a Q�� 1 �O 39• �0 OYPYa TOWN OF BARNSTABLE • r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ ..�N:,, rJsT..... I! N................v....1 k............t.................... TYPEOF CONSTRUCTION ............... ....................................................--........................ ..................... ..Q......... 19e / TO THE INSPECTOR OF BUILDINGS: D The undersigned here/by applies for a permit according to the ffollowiinnjgJ information: Location ............... .... .... ......................................... ........... ............. .... ........................ / n� /.eio ! ..Us.. .................................................. Proposed Use .......74 ! 5/f?P..........( .e�........... .. ��, ZoningDistrict ..............l..l.�...............................................Fire District ...............�� .................................................. ay Name of Owner ../1.t R� .....( tJ�1�! 5....V. .♦................Address .....�(o..►��.�........�.✓....!...`... ..... ....... ....... . / Name of Builder ..... Q.. C.1,$......t..M f.I/...-�...Address Rod 3/a.......�� )1.......'tv..... ..................... Nameof Architect .............. :.V �..................................Address .................................................................................... Number of Rooms ............�............................................. .Foundation ........,,,`?l/?.p...................................................... Exterior ...........C.! ...............................Roofing ........ . .....5�.,/e,0;7/................................ c r / , N�� c�J . 7 .Interior .........f� ' N/S�+r� ..................... Floors .......... .......... . .......... :. . / /O� Na �Heating ................ ................................................... umng ..................... .................................................... Fireplaces ..................................................Approximate. Cost O ............. ............ ..6....p...................................... Definitive Plan Approved by Planning Board ---------------____-----------19_______ . Area ......k-7—.7. Diagram of Lot and Building with Dimensions Fee ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH a penes -y n J OCCUPANCY PERMITS REQUIRED FOR NE LINGS I hereby agree to conform to all the Rules and Regula ' ns of the Town f Barnstable regar the above construction. Name ................ Construction Supervisor's License ...// /y /7 BUFNES, RICHARD JR. 26869 Build Barn .................. Permit for .................................... Accessory to Dwelling ............................................................................... Location ..�635 South County Road ........................................................... Marston Mills .......................................................... ............ Richard Burnes Jr. Owner ................................................................... Type of Construction .............Frame.................. .......... ................................................................................ Plot ....*........................ Lot ................................ Permit Granted ....August 21, 19 84 .......................... Date of Ihspection .....................................19 Date "Completed ................ 19 97,� .. Asses"sor's map, and lot riumber.•............'.. ......."�... .. ,� '• , y0i THE Tp� J r r �(! 4rQ Sewage Permit- number ....a.... t'rr.�4,...... �.... ..!�� r BABBSTABLE, i g Z House number �b J� t 9' ""Sa......................... .........................................i... �O i639. t TO=W:N OF BARNSTABLE- =1� BUILDING : INSPECTOR APPLICATIONFOR PERMIT TO ....:...:..............................................................................x............,.................... TYPE` OF CONSTRUCTION .......... GUU/� ....liIMP....................................... 1......., ..........1 • ..........�j . e..,! .•.19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a peJJrmit according to the following minfformation/:: / Location .......... 5 ..... ��.v.7`?....lUv.✓ y �4... %�;`. �!b/:.`�...............................!! ' .............. . ..... Proposed Use 7,_:q / ?),mn? � � Zoning District A t �..............................................:Fire District ...............1074 0 ! / Nameof Owner ............................................� ..p................Address ........ ......................................................... PAP ✓ O /D iiName of Builder ..... 4r?!7. ,,,, „/.! '/G� y,,,,,, J .... ...... -�.. ...Address ...�..k.....�........................�........�.`..-.................... Name of Architect .............�Q/V'-.'..................................Address ...................... .....................t Number of Rooms ............ ...............................................Foundation ......... h-............/.....................:............... Exierior r" �....:� �!�'!.. � Roofing !/�6'i ! "�<� . .................................... g ..................... .............. ..................................... ..... .W/ Floors ............. .t2,P ......... ...........................Interior .........:1 ... f Heating Plumbing ..........� / ...................... ................................................................ ............ _ + 4 Fireplace ................. ..................................................Approximate. Cost ...............�a..�............................................. Definitive Plan Approved by Planning Board -------------------_-----------19--------, Area ............t,........... ............ Diagram of Lot and Building with Dimensions Fee�.............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 0y 1 a oq.C/ce S - ` w r OCCUPANCY PERMITS REQUIRED FOR NEW DWE LINGS r• I hereby agree to conform to all `the Rules and Regulations of the Town f Barnstable regarjing the above construction. �+ Name .. ..... .................... .. .. ...... .... "................. Construction Supervisor's �I.;-ense ......�............................. A=97-22-1 BLS tP--X-9 No .... Permit for Build Barn................ . .... ......... Accessory to Dwelling .......................................................... 1635 South CountRoad Location .....................................y ............. Marston Mills ............................................................................... Owner ..Richard Burnes Jr. ........................................................... Type of Construction ..Frame ............................... ......... ............................................................. ................... Plot ............................ Lot ..............I................... Permit Granted ...Augus.t..21.,...............19 84 ........... .. Date of Inspection ....................................19 Date Completed ......................................19 2 ,Z5 kt.-.Q, J_r,�- Zo • l�. �. l3, IVY- �.�: •. J. �._.._ j�k OF fAgssgc+ --- WILLI,AM yGw C, v N Y E y CEQTIFIED pl.bT' Pt-•I�IJ ,p No. 19334 . vinr"Ek40 LoC.AT10�4 �,/1��.�7Tc*z t IL.L's ba suK GAL 1 �►1 p AT l= (�.Z7- ' pLAl�1 R�FE�E�.1GE I G wZ T l F*( T"AT T H E if"C-- f ZE .5"aw U t-1EQEDN CQrV\PL�(S W1TN TPG: 51VE.LP-I1` Al E> Sr re- AClG RE4vIRENIcIJZ'S OP THE 7o W U o1r V6�ZuSTA(3LAE AUD IS U OT (... IC>�- LoGATvs D. ...-W I TIA I FLooD miI 00 i aAT� 'Z "� RE G l S�1z-1ZLD L.A 1.t'D 5U eV cYo IDS o 5 T e V-V% -LG o TH IS D L.A1-I Is ..t,. OT' BA-iEV v�:1 N �r UJy'T�tJA�ENT SUQVc�{ T4�� vFs=51FrS SIloevLa APPt_1r- 7' IL1CIon �. 1�JGT 0C u5r-.Q To. varc—v- c LOT- Lti.l�S �( �� _�•. /� ICJ 2 �' I d TOWN OF BARNSTABLE --- � Permit No. -•-----------�•--_-- �n Building Inspector Cash an 163 we 2 Bond ---k - OCCUPANCY PERMIT --- -- �0 Issued to Richard Tiurrie:s, 3r. Address 5 J Tirr„tl, rnomiy ^hngrl ''arr-r nct Mills; Winn Inspector �( Inspection date ' g %r 1 f/.vt i..._ Plumbing Inspector Inspection date Gas Inspector J / Inspection date Engineering Department / �� Inspection date Board of Health _ _` '�' / 3 2 Inspection date f THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION,119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. -- -- Buildi g Inspector r- :; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .r.. 7 Map 6V 6'44 01 Parcel Loi-,aa t-aa Permit# Health Division Date Issued O �� Conservation Division Ace/ pit—_ Fee dAvc Tax Collector SEPTIC SYSTEM MUST 1'Z:' Treasurer 4 e INSTALLED IN COMpLIANC„ Planning Dept. WITH TITLE bENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 16 3 Soak Gov ( • /?b Village 7' C, Owner !ZC_A4 -/ Ryoe lid' Address /615 5141 i (OLWIX Rb Telephone ` Permit Request !'A 6KW P S O KX 6 w /� e�., y ;4 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new ow Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ 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) 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 ( 9 ) 9 Heat Type and Fuel: ❑Gas ❑Oil Cl Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:0 existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use T BUILDER INFORMATION U Name -�Py Telephone Number 7 7- Address /6' IUY1?7,4A/ R/� License# %I CR 6fead ! f JA . al FQI Home Improvement Contractor# f'6 S'Q Worker's Compensation# WC t 717 J(4(4(13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S SIGNATURE DATE FOR OFFICIAL USE ONLY PARMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS- -­ VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH,, FINAL y GAS: ROUGH'" _ «° FINAL FINAL BUILDING ... : Tn t G r DATE CLOSED O®UT� � ASSOCIATION PLAN,-NO. f The Commonwealth of Massachusetts -_- Department of Industrial Accidents — 600 Washington Street Boston,Mass. 02111 --- Workers' Com ensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one working in any capacity ME FEW ❑ I am an employer providing workers' compensation for my employees working on this job. company name 0 5 .. A14LITY , address ` d r /b.0 E Qjd hone#: I 41` c� 'Q insurance co. k�s fle III olicv i ❑ I am a sole proprietor general contractor or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: :::;::::::: �m any name X. lTYv�I f address {� hone# . 9V 6 <x cV �,.. an name: ;... address.' here# . ai entrance co::: _ gafltae to scene coverage as required under Section 25A of MGL 152 can lead to the imposition of crisninal penalties of a fine up to$1,500.00 and/or ama yeah'fatprhomnent as wen as rird penaltia in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a co of thb atatemeat may be forwarded to the OtIlce otInvestigations of the DIA for coverage verification. p7 I do hereby e p nald of pmury that the injor matwn provided above is trw.and coned Signature Date Print name A'096e7t 4 CAI% Phone# 97Jo—463- pond (c:on:tact only do not write in this am to be completed by city or town official : permit/license# ❑Bunftg Departmnent ❑Licensing Board immedlate response is required ❑Selechnen's Office ❑Health Department son: phone#; ❑Other Um d 9195 PJA Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 not 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 such 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a ceitificate of insurance as all affidavits 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. City or Towns 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. The affidavits may be redmzed to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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, Me of luvestlgatlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 , phone#: (617) 727-4900 ext. 406, 409 or 375 of THE A ti The Town of Barnstable 9� MAM �0g Regulatory Services ''rEo rra+► Thomas F. Geiler, Director• Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. �v G o y D S IPA Estimated Cost 400a Type of Work: Address of Work: Owner's Name: ?,C_44rd Date of Application: �� f I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNS ER PENAL" ENAL OF PERJURY I hereby apply for a permit as the a en f e o ner: his ' ate Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav:rev-070601 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations '$25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET LIVING SPACE square feet x$96/sq.foot= x .0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost .w ayi°P n � Vo. 1 � U� U ` C �I— P �. ( � G r � 7 C ` .d 92w Tr' 1? Ru n c.l Om h 13 tj 13(:),:3 an M j!:L': 'L 0 5-0 8 4. -/16 Tv P gxe& HOPE MPROVIIIENT CONTRACTOR Registration: 1-1 Expiration: 1/1 Type Private Corporatio a 0 13—,-1. CUSTOh QUALITY POOLS INC. Robert Bent 7f 16 vy2in Road - ADMINISTRATOR Billerica MA 01321 BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 040192 Birthdate: 01/10/1953 Expires:01/10/2003 Tr.no: 5578 Restricted To: 00 ROBERT A BENT 16 WYMAN RD BILLERICA, MA 01821 Administrator ACCORD CERTIFICATE OF LIABILITY INSURANCE DA'tc(0 J200 03/3o/zool � PRO,UCER (603)893-9450 FAX (603)893-9480 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lakeside Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.Ti HS CERTIFICATE DOES NOT AMEND,EXTEND OR 88 Stiles Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Salem, NH 03079 INSURERS AFFORDING COVERAGE INSURED Custom Quality Pools Inc INSURER A: Valley Forge 16 Wyman Rd INSURERB: Transportation Billerica, MA 01821 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECT YVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIY DATE MMIDD/YY LIMITS GENERAL LIABILITY 8005863415 02/01/2001 02/01/2002 EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) S 100,000 CLAIMS MADE ®OCCUR MED EXP(Any one person) S 10,0-1 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY � NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S DEDUCTIBLE $ RETENTION S S WORKERS COMPENSATION AND WC177744413 02/01/2001 02/01/2002 X I TORY LIMITS ER EMPLOYERS'LIABILITY B E.L.EACH ACCIDENT $ 500,000 E.L.DISEASE-EA EMPLOYEE $ _ 500,000 E.L.DISEASE-POLICY LIMIT S 500.000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENOORSEMENT/SPECIAL PROVISIONS Covering Swimming Pool Construction and related operations to be performed by the insured during the policy period. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ADOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO!TAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, R. P. Marzi l l i BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 21A Trotter Drive OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Medway, MA 02052 AUTHORIZED REPRESENTATIVE lJoseph Rossetti/USER31 9 _ ACORD 25-S(7/97) FAX: (508)533-3718 GACORD CORPORATION 1988 ala Engineering Dept.(3rd floor) Map Q1 Parcel 22"' Permit# 5�0- House# I(O Date Issued 9 9 6 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) 9�q �v 3 015 O Conservation Office(4th floor)(8:30- 9:30/ 1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SYS'f E ST BE Definitive Plan Approved by Planning Board 19 INSTALLED ANWIT ENVIRONM` TOWN OF BARNSTABLETOWM" R, Building Permit Application Project Stre dress 1�'35 SOy'tN CA�.1tiJ'T ?_0Ap Village Owner Q,1Cl-IAyzo NOUN►z b.1YLwes Address 1*1 FICV_Wtt !( %T. SOS-10Q Telephone Permit Request Nta> Ttb `)(l S—L l k Crr First Floor 013 square fe Second Floor Z 30 s 1quare feet Construction Type \V OO b FY2AMfL Estimated Project Cost $ 15 5, OOCO Zoning District K F Flood Plain wO Water Protection IM 1100 GE Lot Size 12 .(a'L AG(2 ES Grandfathered Yes ❑No Dwelling Type: Single Family fQ9 Two Family ❑ Multi-Family(#units) Age of Existing Structure 15 YRS Historic House ❑Yes U(No On Old King's Highway ❑Yes JNo Basement Type: 0 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4 Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing Z New to Half: Existing _4 New No. of Bedrooms: Existing '3 New Total Room Count(not including baths): Existing 2 New 2 First Floor Room Count -7 Heat Type and Fuel: (9 Gas ❑Oil ❑Electric ❑Other Central Air a Yes ❑No Fireplaces: Existing ( New ( Existing wood/coal stove ❑Yes 21 No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) 301 V Z O 1 None ❑Shed(size) i ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes fA No If yes, site plan review# Current Use Q CGS 1 0**J'l 1 A L Proposed Use S lA M t 'Builder Information Name ROG�rzs I�on � `Ki C Telephone Number 0(6 Address 20 ?OK 310 License# O(o I q.19 0-anecav lLoc, rM.4 Home Improvement Contractor# 100 13e} Worker's Compensation# %-,.\lC 1022 (c 5(o NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURES DATE BUILDING PERMIT DENIE THE FOLLOWING REASON(S) ._ A 4 ,, �, ;. .�. _ >� �, _o A �' �' _ ` i I, I I r,GaIvnr+y 7 � Jf T7,, n !n•YT T,T;.',^•!y�.,Jl �igN'LiOLYtY4DKia.Yr �.•2N rC��y�S�II'�.� �V7'�1•�.x�"''viT,�I°xw.tl`f.[�'•r�.�iw'�'7cwr:En:t�� star, 7�raa.ai}r'�14'�t'':r��;7...1• r,r�,�►.scc.kiaa�+k 'i1�A"s_k�.� °� � I am a yule proprietor, eneral eontracto or homeowner(cln:le one)and have hired the contractors listed below w'ho have the followin.-workers' compensation polices: sctsnnv n tmr I -\\) 1 D city' .. F-�y AN�.�� . . ... .(�n��itc�N• �•1 � ���c) iDaVrsricecp '�..,1•I'�CQ�'1�( .:I�VfLCt^;.::. . :..: .' ;•. .' •.pQlicy7l.. .u�C', �:"'•��•�' �"V-F2�'Z-'7 " �2� �I�tanY p'imC l `�,l3 �•�"� .'`H'�ON.�`•'� .. : .• : City- CjO Tu 17 vdorir ft- in.yur1nce� policy#' &1.''�i• �,taz�$"2'Ga::i:�i� : �ey ,,. .__ �� ��'�;p,�"+.,�+4_'�bSC�•���'�f',,.�`DJ��'`..�is71>�A��".'Y.34ba'fit I am a sole proprietoY'�r, ,eneral contras o or homeowner(rlrc:le one) and have hired the contractors listed below who have the following workers' compensation polices: �J LgnJtnny c�_1r �1O�A 0 . 1 4 r`�'��b" . ►"��r�l� atlslrf p O Ob SIIY' n wV(�i 1� in�t�raricr co ..1 T�'F-t��',•L-��,.�.J:'.'�•5.::'.c�.�'�:J�. .' .pojicy•I1•• '����"yl:i"G-1�—. ant tan • c5>-4022C-:IIJ.� �•�sD1JST+2uQ"l.t•O►.�• ••. city in9urancr� A�LsGI• I�.S QolicY#'. •'•R. U.�, �, :��•(: I am a sole proprietor:Genera con rac or homeowner(cln:le one) and have hired the contractors listed below who have the following workers' ' � COX polices: rkA nt un r' ✓ 1X f11Y •• �irC1J1��V l'��•.. . . 'Rhbnc.N: �1 S - 3.4�5 . Ip7Ur9riR cp ctA•S1�c,2tJ •� �L��''•: '• :•. .' •ppiicVu• � 'V�/�'�f•oo''1Q'��.9. c �tttj)any nameS4�0►2` 1��A1 toCa 6OL(1J tp •... 51 w, i'�tiS 'Pa�ilil cih �1 tQ2i't1(Lblrll-� pliorir fl -M (044 (6S 03 in.9urancecp ..TYZ Av ��c s policy#:•'• ?C— lJ.�...527�OC1•¢ _4^�1(S �s - 71 :~ax t _ � The Commonwealth ofAfassachus'etts 'Department of IndustrialAccidents 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit lj)Cali nn: • city phrm i7 Cl 1 am.a homeowner performing all work tit}'self. I am a sole proprietor and have no one working in any capacity ® I am an employer providing workers' compensation for.my employees working on this job. �tnyany nAnte I�OV S '�V �.-too .`�C• as({lres� �•�. .`J�k �J FQ sites �S�l•�C'.�'ZVl•l.L�' . . ' . •• :'. .L�� 'W�Q�O • !ai9r,7neeco: SASS I atn a sole proprietor general eontracto or homeowner(Girt!e one)and have hired tht contractors listed below who have the foiiowinc workers' compensaNun polices: Lnmannv name: T>,0Q_1P1, . /'V- Q CO �AAVIJ • CC C , 70 t3oX 3.a3 . city: �.S�t�f2�/C�L-�• • • . .. • 'nhbite•ti� �•-t'Z-� 3'�2 1 • 1llsUrsrice co.' IF4YZ Y1-V AUt.2-04. M•Q-UAL-.: policy N �V'C' `'� tr Z�� . 41 1 �n 1,ram•' t;D ItllfaoY n1I71C• 1+^I L-Io Cr�,,y .��m. e>INj C-0 city o51 L—ay I WC.' Cr,1.00 2.1 I UA Failure to secure covtrage as required ender Section 25A of\1G1. 152 can lend to the imposition nfcriminat penalties of a fine up to 51,.500.00 And!or nnc yenrs'impri}ouaicnt us well as civil prnaltin is(be furm of a STOP AVORK ORDER and a tine of$100.00 a day against(tic. f understand(lint a cnp)'of this etatcment InAy be forwarded to the ornot of fnvestigatinas of 111e lltA for eoverngc verification. I do hetebv cerriJy under she.pains and`penald erjury that the irrforntarion provided above is true and eorrea. Signature `' t atc J C\ Y Printnumc VAXZ'A 1J0kAQ S6UZA Phcnc4 `1Z IOG n(ricial use only do not write lit this area to be completed by city or town umcitll L ptrinMiccmtc N mBuilding Dcparttnen( �rAcensio�Board medlaie rchponse is required CjScltctmtn'a OlnceQHcalth nepartment: phnite mother t![Vicfd V01 i1A! r'6 S•a'"r',��',�:A',i?.2"i.}�Tc!:�''�:L�i�31M,. .. <n;r•n'r�i�.�'"V,, v�„ "Ir.• T � ��ir a r�.:�'0��5i�.'�3.�;r.+tka::fi< ( i am a sole proprietor. goner 1 contractor r homeowner(circle one)and have hired the contractors listed below who have ' the following workers' o ices: r(I J1RnY R LRle 1�/�� COLC '1 Q NME7e— / 0. arf d ress 3,--) 7741 Jn' : `738 • >l`/-1 ��iggn,�����Vnnr�)arice co,�••��..ppyyt.�y�t.�y����J����J:�/'��. 1��-+(' �. policd7l• y""��/ �•�5���,�y��p P:YCAIJN'L�CtL'/�9M.SM' /.:7 �ir�ianv n�mc ".&(a lY OW A)e�� City- in5urince cam_ Gf;()�C:•(`��iC,�/�'••l��C/'`l V��Gd�olicYtJ' ••(N��(�vLJ ��, '• �1� •-�f.�; •.'��Gz'tl"�'G".�i`�G.�L�t7i,��•nu•'. Ytp:r n . , - ,, I am a sole propriet ;general contractor, omeowner(ein:le one)and have hired the contractors listed below who have the following workers comp !on po ices: ygmpoov n,mc �QIC.�W� Pl-yM13177AX .. - //' �/LJ� D' h nc•N� -- qD lit�� iu7 ranceco /Q/y' l '� /7 L •`•" � �f41icy71' city �LJ/� [1��—� . . �111t19ny R'1 T�H���-+�S C�J \ �`�Y•�cI LLB►-a //la'(�• .. . addi P lL/LJ XII City- insur�ncecQ_% ��1'�ic-_.�/�-s� �.i��l��T... ...•• enlicyt!' W�CJ�••-/•��/�7LS / ••• ' �t���iS.tr�,1.s'��lc��rr a ..w��..'r�i7�.�!•`�. ?t"y n ' .'v *t ';s��i' Cqr-I am a sole proprietor general contractor,or homeowner(c1I one)and have hired the contractors listed below who have the following work ers �dom�pen,a !on/polices: 1 1 �w Lttnonv n lMc `yVv7 C F� ..l� �I c0 N a07 oT. H. City- '7� in.ur1nce� >�l �� (' _ . ..•. nnlicy 11' ��°,Z .. -,.. .. . . a °FTMe rqy, . .y The Town of Barnstable • sAtrsTnsM • . Department of Health Safety and Environmental Services 'O�Eo Ma's" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: AU01-114V Est.Cost 1 5 5 J O� Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the a ent of the owner: Date Cont racto a U Registration No. 'R OGtc2 �lvzw �NC OR Date Owner's Name A. ? HOME IMPROVEMENT CONTRACTORS REGISTRATION .Board of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , .Massachusetts 02108 HOME IMPROVEMENT. CONTRACTOR ! Registration 100134. Expiration 06/09/98 -- '-=--� '---- —'"-- -- " T.y pe PRIVATE CORPORATION c Q ,� HONE-It`dVQN Registration 100134 ROGERS & MARNEY , INC . k Type -. PRIVATE CORPORATION Charles D . Rogers e Expiration 06/09/98 PO Box 310 _ Osterville MA 02655 R06ERS & MARNEY, INC.. Charles D.- Rogers 0,,Box'310.- U"sterville MA 0.2655 ADMWISTRATOR -- *. — 7717-7 COMMONWEALTH< DEPARTMEr1rIOF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTO.N,MA 02108 - i—LL:ENSE :: - ' . �,CAUTION 5 y EXPIRATION DATE 1�r?v't.1G/ 1997 l=U�lSi �Ur=s:rt .�!�'i . . — _ FOR PROTECTION AGAINST ..: CT E LIC NO RIGHT-THUMB EFFECTIVE DAT THEFT, PUT R ,:.. RESTRICTIONS PRINT INAPPROPRIATE vJr'/@1/ 1994 @oi979 c,J BOX ON LICENSE:_''' :'... _•- ..::�ti.. ' .." , ,. .:,:-' •:':: ->-:.::....,. . GPY BLASTING OPERATOR S ...;,::,::�. •- -- - ��_," :i-4454: 1t33 t*iAF?IN.Ef; C.LR!�L>=;:::.°:.::": MUSTINCLUDE PHOTO. PHOTO(BLASTINGOPR ONLY) FEE VALID U'i.SIGNED BY UCENSEEVAND OFFiCW�.Y._L : � Nft sta HEIGHT STAMPED oR SIGNATURE Of THEGOMMISSgNER � � 0 Ta r SIGN NAME IN FULLBOVE A SIGNATURE LINE ::r "•'-? IS DOCUMENT MUST BE; 4 i - :•,� ` _ .e SIGNATU OF NSEE� 'CARRIED ON THEPERSONOF I�.�e �:..� � '•7,::�' �.:; , • :;: '..-.-'.°-- •.THE HOLDER W OTHE ��• '� j r ;�� - 0 •l bob- - - c 0 s� COMMONWEALTH DEPARTMENT OF PUBUC SAFETY Q 1010 COMMONWEALTH AVE. OF n MASSACHUSEI'TS ®OSTON,MASS.02216 �' ENCLOSE CHECK OR MONEY ORDER LICENSE FOR REQUIRED FEE, EXPIRATION DATE COHSTR- SUPERVISOR MADE PAYABLE TO 0613011993 M 6 EFFECTIVE DATE LIC�dO. S ~ RESTRICTIONS '�; .r ¢ "COMMISSIONER OF PUBLIC SAFETY" ` NONE G 06/30/1991 022135 . C. ANDREW S. MACDONALD - {D T SEND CASH). 64 JOHNS WOOD R D. �l'! n SS N 267-33-5807 ROSLINDALE .MA 02131 PL EASE h0TE N INCREASE PHOTO Ie+uTND CPA oNLrI FEE:100.00 E F F$_T Z E& `1I+l 1289 - NOT VALID UWFIL sgNED SV UCERW AMC OFNICIALir SIGN NAME IN FULL•ASOVE SIGNATURE LINE HEIGHT: STAMPED-OR-SIONkFURE OF THDCOMhUSH IER }}�.P•["+`J1. D08: 11 /07/1960 D OT DETACH LICENSE STUB n THIS DOCUMENF Muss aE SIGNATURE OF LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE A CMMW ON THE IPE"OX OF •' ` h+ THE HOLDFA WHEN FMUMI- !:�!p��/ OTHERS-plonk INUMD PINT EO IN THIS OCCUPATION OGMh4S81GJ1EFl ~I . .._. __.._.--._—_ . .. .......... 1 V-, C) 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0 l Permit# `l Health Division r16�-�6l/� � 7 �� _I�K ZBate Issued- Conservation Division ZZLQo P e fc �2w Tax Collector 37?0 SEPTIC SYSTEM M UST br -Alil4i tINSTALLED IN COMPLIANCE Treasurer c�e�P / � WITH TITLE 5 ENVIRONMENTAL CODE AND Planning Dept. TOWN REGULATIONS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address I .S ' Village M :1) S. t'1 P. e� Owner R C�10J & hlovlvti•e Uvc.nes Se. Address ex2s•rohc r Mrs o Z 1 t9 Telephone G, 1:2 - Z2'7 •340 f Permit Request Cogs uok cLAA 41m o� 2__ Bed cvow,S , zy l�A4c Square feet: 1st floor: existing 2.81 9 proposed t360 2nd floor: existing W(n. proposed 61 R Total new Z oo R Estimated Project Cost 2,%O iR20.0 Zoning District CZ-F Flood Plain Aj/4 Groundwater Overlay 6 F Construction Type Lot Size 1 Z-,4,2 Ar-, Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ,Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 24o On Old King's Highway: ❑Yes B IC Basement Type: Er rull 21�r`a­wI ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) Z9'SS' Number of Baths: Full: existing —1 new Z Half: existing O new CU Number of Bedrooms: existing S new _2- Total Room Count(not including baths): existing new First Floor Room Count 9 Heat Type and Fuel: alnaA�oFireplaces: Oil ❑Electric ❑Other Central Air: ❑Yes 0' Existin New Existin woo coal tov : ❑Y g 2 �_ g d/ stove: es Flo ` Detached garage:❑existing ❑new size -- Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 21To___ If yes, site plan review# _ Current Use _4S 4P__ r:na wA tl�e Proposed Use t2 w^A i BUILDER INFORMATION Name 9 oe e r-z, t Mann v , =XNC� Telephone Number So 8 - 118, 610 6 Address a► o License# f7sTen.� �>_L 0,&14 o2 6S5 ' Home Improvement Contractor# t o p t 34 i Worker's Compensation# \,c(G QS2 9 Z on; ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN le VS y TA <` C SIGNATURE DATE pppppp— FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/PARCEL NO. : ADDRESS - VILLAGE OWNER `. DATE OF INSPECTIOLV FOUNDATION FRAME INSULATION c' FIREPLACE �� J b ELECTRICAL: R9, UGj! V FINAL ( PLUMBING: RO J M < FINAL GAS: ROUGH C FINAL' FINAL BUILDING DATE CLOSED OUT _ ASSOCIATION PLAN NO. OVVN CLERK BARNS GABLE. MASS. Town of Barnstable ���! FED _7 PH 2. � ' Zoning Board of Appeals Notice-Withdrawn Without Prejudice Appeal2001-12 - Burnes 2001 - 12 -Appeal of the Building Commissioner Summary: Withdrawn Without Prejudice Petitioner: ichacd-M._Burnes Jr.._and Nonnie_S.Burnes__,,. Property Address: 1635 South County Rd.,Marston Mills,MA Assessor's Map/Parcel: Map 097,Parcels 022:001-022:002-017,-020,021 and 025 Zoning: Residential F,Resource Protection Overlay&Groundwater Protection Overlay Districts Relief Requested&Background: The applicants are appealing the decision of the Building Commissioner in refusing to issue a building _ permit for.an addition-to the home that includes a second kitchen:. : The._propety.consists of six. totaling 21 acres. The existing dwelking:is located on Parce1.022.001. That lot is 12.62:;acres in area and'is developed with a 1 &1/,2.'sfoiy':6:bedroom 4;537 sq.ft. single-family dwelling. Ati accessory structure-a barn-of 900 sq.ft.is also•located on'the property. The dwelling was originally built.in 1984 and added to in 1997. Today,the applicant'seeks to addanother addition of 2,040 sq.ft. (1,3201irsi floor, 720 second floor). The addition is to contain 2 bedrooms,-2.baths, a family room and a second kitchen. Procedural&Hearing Summary: This appeal was filed at the Town Clerk's Office and at.the.Office of the Zoning Board of Appeals on November 28,2000. An extension of time for holding the hearing and for filing of the decision was executed between the applicants and the Board. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened January 24, 2001, at which time the applicants through their representative requested and the Board granted to allow the appeal to be withdrawn without prejudice. Board Members hearing this appeal were; Dan Creedon, Gail Nightingale,Ralph Copeland,Raldoph Childs and Chairman Ron S.Jansson. Attorney John Alger represented the applicants. At the opening of the hearing,Mr.Alger stated that he had received a building.permit for the requested kitchen upon the commissioners review,and based on the fact that the kitchen would not be isolated within the dwelling and could not be closed off from the remainder of the home. Motion: At the January 24, 2001, hearing, a motion was duly made and seconded to grant the applicants request to withdraw the appeal without prejudice. The vote was as follows: AYE: Dan Creedon, Gail Nightingale, Ralph Copeland,Raldoph Childs and Chairman Ron S.Jansson NAY: None TOWN CL� K Town of Barnstable QARN,.)TAP1 . MASS. Zoning Board of Appeals _7 j 2: 4 j Notice-Withdrawn Without Prejudice 2001 FEB Appeal2001-13 - Burnes 2001-13 -Variance-Section 3-1.4(1)(A)Principal Permitted Uses Summary: Withdrawn Without Prejudice Petitioner: Richard M. Burnes Jr. and Nonnie S. Burnes Property Address: --1.635= outh County_Rd—,-Mirstons M llss—MA`S Assessor's Map/Parcel: Map 097,Parcels 022.001,622.002,017,020,021 and 025 i Zoning: Residential F,Resource Protection Overlay&Groundwater Protection Overlay Districts Relief Requested&Background: The applicants were seek a Use Variance to Section 3-1.4(1)(A) Principal Permitted Uses-Single-family Residential Dwellings: The applicants are seeking to add 1,320 sq.ft.to an existing single-family dwelling, inclusive of a second kitchen. The property consists of six lots totaling 21 acres. The existing-dwelling is located an Parcel 022.001. That lot is 12.62 acres in.area and is developed with a.1:&1/2 story, 6 bedroom 4;537ssq.ft:single-family dwelling. An accessory structure-a barn-of 900 sq.ft..is also located on the property.The dwelling-was originally built in 1984 and added to in 1997. The applicants desired to add another:addition of 2,040 sq.ft. (1,320 first floor, 720 second floor). The addition is to contain 2 bedrooms, 2.baths,.a.family room and•a . second.kitchen. Procedural &Hearing Summary: This appeal was filed at the Town Clerk's Office and at the-Office of the Zoning Board of Appeals on November 28, 2000. An,extension of time for holding the hearing and for filing of the decision was executed between the applicants and the Board: A public hearing before the.Zonirig Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened January 24, 2001, at which time the applicants through their representative requested and the Board granted to allow the appeal to be withdrawn without prejudice. Board Members hearing this appeal were; Dan Creedon, Gail Nightingale,Ralph Copeland, Thomas DeReimer and Chairman Ron S.Jansson. Attorney John Alger represented the applicants. At the opening of the hearing, Mr. Alger requested that the appeal be allowed to be withdrawn without prejudice. Motion: At the January 24, 2001 hearing, a motion was duly made and seconded to grant the applicants request to withdraw the appeal without prejudice. The vote was as follows: AYE: Dan Creedon, Gail Nightingale, Ralph Copeland, Thomas DeReimer and Chairman Ron Jansson NAY: None Ordered: Appeal 2001-13 has been withdrawn without prejudice. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17,within twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. Ron S.J �sson, hairman Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable,Barnstable County, Massachusetts, hereby . certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. 94— Signed and sealed this day.o/x,.�0Q .j under the pains and penalties of perjury: -Linda.Hutchenrider, Town Clerk 2 oFt Town of Barnstable r + Regulatory Services a s vsn MAASS. '� Thomas F.Geiler,Director ;9.�A`0 Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 MEMORANDUM DATE: January 24,2001 TO: The File FROM: Elbert C.Ulshoeffer,Jr.Building Commissioner REGARDING: Second kitchen at 1635 South County Road,Marstons Mills I have spoken with the contractor and have confirmed that there will be no separation of space between the addition and the existing house. Nam, I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I ► I I I Checked by/Date ► I I CITY: Boston STATE: Massachusetts HDD: 5641 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-8-2001 COMPLIANCE: Passes Maximum UA = 468 Your Home = 393 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 2076 31.0 0.0 71 WALLS: Wood Frame, 16" O.C. 2170 19.0 0.0 130 GLAZING: Windows or Doors 282 0.360 102 DOORS 126 0.330 42 FLOORS: Over Unconditioned Space 1446 30.0 0.0 48 SLAB FLOORS: Unheated, 0.0" insul. 0 0.0 0 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4 .4 . Builder/Designer Date JACOB 0. ALUM No.637 s� o MAS `� MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Release 3 DATE: 1-8-2001 Bldg. 1 Dept. 1 Use I I CEILINGS: [ ] I 1. R-31 I Comments/Location I I WALLS: [ ) I 1. Wood Frame, 16" O.C. , R-19 I Comments/Location I I WINDOWS AND GLASS DOORS: [ l I 1. U-value: 0.36 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location I I DOORS: [ ] I 1. U-value: 0.33 I Comments/Location I I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location I I SLAB-ON-GRADE FLOORS: [ ] I 1. Unheated, 0.0" insul. , R-0 I Comments/Location ' I Slab insulation to extend down from the top of the slab to at I least 0" OR down to at least the bottom of the slab then I horizontally for a total distance of 0". I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or I gasketed to prevent air leakage into the unconditioned space. I 2. Type IC rated, in accordance with Standard ASTM E 283, with no I more than 2.0 cfm (0. 944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I I VAPOR RETARDER: [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. I I - MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can I be determined. Manufacturer manuals for all installed heating I and cooling equipment and service water heating equipment must be r I provided. Insulation R-values and glazing U-values must be clearly I marked on the building plans or specifications. I I DUCT INSULATION: [ ) I Ducts shall be insulated per Table J4 .4 .7. 1. I I DUCT CONSTRUCTION: [ ] I All accessible joints, seams, and connections of supply .and return I ductwork located outside conditioned space, including stud bays or I joist cavities/spaces used to transport air, shall be sealed I using mastic and fibrous backing tape installed according to the I manufacturer's installation instructions. Mesh tape may be I omitted where gaps are less than 1/8 inch. Duct tape is not I permitted. The HVAC system must provide a means for balancing I air and water systems. I I TEMPERATURE CONTROLS: [ ] I Thermostats are required for each separate HVAC system. A manual I or automatic means to partially restrict or shut off the heating I and/or cooling input to each zone or floor shall be provided. i HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the heating/cooling system is I not greater than 125% of the design load as specified I in Sections 780CMR 1310 and J4 .4 . I I SWIMMING POOLS: [ ] I All heated swimming pools must have an on/off heater switch and I require a cover unless over 20% of the heating energy is from I non-depletable sources. Pool pumps require a time clock. I HVAC PIPING INSULATION: [ l I HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F must be insulated to the following levels (in. ) : I I PIPE SIZES (in. ) I HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-l" 1.25-2" 2.5-4" I Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 I Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 I COOLING SYSTEMS: I Chilled water or 40-55 0.5 0.5 0.75 1.0 I refrigerant below 40 1.0 1.0 1.5 1.5 I I CIRCULATING HOT WATER SYSTEMS: [ ] I Insulate circulating hot water pipes to the following levels (in. ) : I I PIPE SIZES (in. ) I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I HEATED WATER TEMP (F) : RUNOUTS 0-l" 1 0-1.25" 1.5-2.0" 2.0+" I 170-180 0.5 1 1.0 1.5 2.0 I 140-160 0.5 I 0.5 1.0 1.5 I 100-130 0.5 I 0.5 0.5 1.0 I ----NOTES TO FIELD (Building Department Use Only)------------------------- t ESTINA TED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) Zoo B square feet X$1151sq. foot= (above average construction) square feet X S96/sq. foot= (average construction) square feet X S57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X S20/sq. foot= DECK square feet X S151sq. foot= O=R square feet X$??/sq. foot= Total Estimated Project Cost �ciz 230 A2. X 3.to *?Is. 8S' f FZHE Tp� The Town of Barnstable 11AM!r A1)L F- ' MAS& Department of Health Safety and Environmental Services rfoy� B1lilding Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT IIOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MCL c. 1d2A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Wort: A pc) mom Est. Cost S30,g20, 0 0 Address of Work: t,)^r4 0UNT-!j Owner's Name Ptet:+A et�, A NON Aid C. 13OPV4 _-S Date of Permit Application: I Hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. v Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING rl-lEIR OWN I'ERM1'f OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE I•IOME IMPROVEMENT WORK DO NOT HAVE. ACCESS TO 'I'I-IE ARBITRATION PROGRAM OR GUAI .ANTY FUND UNDER MCL c. 1,12A SIGNED UNDER PENALTIES OF PERJURY . I hereby apply for a permit as the agent of the owner: (' zz.oc es k- Ma&1 ,E aQNc 1 on139 Date Contractor Name Registration No. OR Date Owner's N:1111e ......... , The Commonwealth of Massachusetts Department of Industrial Accidents -- Office offorestigaUons - 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit EIMM name: location: city phone s _ I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this job. company name: ROGERS & MARNEY, INC. address:: P-.0: BOX-310 city: OSTERVILLE, MA 02655 phone# 508-428-6106 insaratice>co�, EASTERN CASUALTY WC95798003 policy# I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who the following workers'compensation polices: company name: SEE ATTACHED SHEETS address:. city: phone tl... : . insacance::co::.. oli #. companv;namr. phone#• insurance:-co: policy# Y-- Failure to secure coverage as required under Section 25A of 1%1GL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/ one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do hereby certify under the pains-and pe ties of perjury that the information provided above is true and correct Signature -�-^ Date m /� Prinunae �O PJI.� V C.� Phone# SC) A•W-41 8 • 6 1&. official use only do not write in this area to be completed by city or town official city or town: permit/license H flBuilding Department 1+- oLicensing Board f. check if immediate response is required y oSelectmen's Office 011ealth Department _ contact person: phone#; 00thcr ;w I revised 3/95 PIA) r - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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 not 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 such 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 section 25 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, 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits 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. City or Towns 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. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. �'• lye Yi The Department's addr=_ss, wk;phcn�: and fax r. The C*olunl, 1)ctiart-r2n o,- �dusit•:�! ir_::_:' Il Mice rot Inuestioalljous 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 AgpRD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YY) TM 05/22/2000 PRODUCER (508)775=3131 (508)790-1677 The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9 Y HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR P.O. Box 430 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 619 Main St. INSURERS AFFORDING COVERAGE t ^terville, MA 02632 �._ p'D Shoreline Construction, INSURER A: Essex Insurance Co 87 Pond Street i ` INSURERB: Hanover Ins. Co. Osterville, MA 02655 ` INSURERC: Granite State 11 I INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSK i LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY 3CE2855 05/01/ ' 00 05/01/2001 EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $ 50,000 CLAIMS MADE FXJ OCCUR MED EXP(Any one person) $ 500r A PERSONAL&ADV INJURY $ 300,000 GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 300,000 POLICY PROJECT LOC AUTOMOBILE LIABILITY AMNS155119 05 4/2000 05/14/2001 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY $ B X SCHEDULED AUTOS (Per person) 100,000 HIRED AUTOS BODILY INJURY $ it NON-OWNED AUTOS (Per accident) 300,000 PROPERTY DAMAGE $ (Per accident) 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC1250169 07/25/2000 07/25/2001 ToRYLIMITs ER EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 100,000 C E.L.DISEASE-EA EMPLOYEE $ 100,000 E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL IS DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 1— Rogers & Ma rney BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY •)G4 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Osterville-West Barnstable Road Osterville, MA 02655 AUTHOBIZEDREPRESENT V H RD CERTIFICATE OF LIABILITY INSURANCk;D 0� DA0DD/YY) YCO 1 3/23/28/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE McAlpine Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1')nD Post Office Sq ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. iterville MA 02632 �none: 508-771-0105 Fax:508-771-1258 INSURERS AFFORDING COVERAGE INSURED INSURER A: Vermont Mutual Insurance Co INSURER B: Savers Property&Casualty Ins C _ Bay Colony Concrete Forms Inc INSURERC. Pilgrim InsurancqXcompany 32 Third Ave �INSURERD: Osterville MA 02655 I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE T MS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR• Ob-BUTYPE OF INSURANCE POLICY NUMBER DATE M 01YY) POLICY LIMITS LTR I DATE MMIDDM' DATE M! GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY BP17030923 03/30/00 /13/30/01 FIRE DAMAGE(Any one fire) $ 50r000 CLAIMS MADE OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY S 1 r 000 r 000 / GENERAL AGGREGATE S 2 r 000 r 000 _ GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPIOP AGG i S 2 r 000 r 00 0 PRO- I17 POLICY I�ECT I I LOCI AUTOMOBILE LIABILITY r / COMBINED SINGLE LIMB (Ea accident) S C ANY AUTO PMC7129126 03�11/00 03/11/01 C ALL OWNED AUTOS PMC7129214 03/30/00 03/30/01 BODILY INJURY S 2500000 X SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY S 5000000 , NOWOWNED AUTOS (Per accident) PROPERTY DAMAGE S 1000000 (Per accident) GARAGE LIABILITY AUTO ONLY.EA ACCIDENT I S ANY AUTO OTHER THAN EA ACC S F AUTO ONLY. AGG S EXCESS LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S DEDUCTIBLE S RETENTION $ S WORKERS COMPENSATION AND X TORY LIMBS "ER B EMPLOYERS'LIABILITY WC 0000753-0�/ ( 03/31/00 I 03/31/01 �E.L.EACHACCIDENT (S100r000 I E.L.DISEASE-EA EMPLOYEE S 100,000 / I ! j E.L.DISEASE•POLICY LIMIT S 500,000 OTHER I r DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES[EXCLUSiONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Concrete Forms 1 CERTIFICATE HOLDER N ADDITIONAL INSURED:INSURER LETTER: CANCELLATION ROGERS 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOIN DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Rogers & Marney NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL FAX##5 0 8-4 2 0-3 5 5 0 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR PO Box 310 Osterville MA 02655 REPRESENTATIVES. John McAlpine ACORD 25S(7/97) ©ACORD CORPORATION 1988 OctG-0 : 2 p bur mac ins 508-771 -1258 p. 047E IN.N10G1Y'i) 1D 02 I 10/12/ 0 coo CERTIFICATE OF LIABILITY INSURANC�p,RGER1 Q --� I THIS CERTIFICATE iS ISSUED AS A NIATTER OF INFORIWATJR I ONLY AND CONFERS rt RIGHTS UPON THE CERTIFICATE PRODUCER HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND Burlingame Insuranae Robert Burlingame ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 200 Post Office Sq INSURERS AFFORDING COVERAGE Centerville MA 02632 —�_----- Phone: 508-7T1-0105 Fax:508-771-1258 ;It,yJFP Jeont Mutual Insurance Co.NSCR 0 /)1 / I _s��e�B -_Kempery !N SURERC:Barqer Mascnry, Inc 4aSuRERD'Po Box 219 ----- Cotuit M:>, 02535 I!r�,u?E^=• COVERAGES Ep TO THE iNSU4ED NAh1ED ABC�E FOR THE POLICY PER!CD I;ICA.- ED.NO'"'I ' THS?:FIDE o THE POLICIES OF IW9URANCE LISTED BELO'JY PAVE BEEN ISS: r OR:ONCITION OF ANY CONTRACT OR QTHER DCCL'U:ENT WITH Rc5?cCT TO'N!iICH THi3 CERT!FICP.TE MAY BE ISSUED CR ANY R='OUIREMEy„TERM - pN'Y pERTP+W,THE INSURANCE AFFORDED MAY Y THE POLL REDUCED 6 BPAId CL141MS SUBJECT TO ALL T iiE TER S.EXCLUSIONS AND COWD;TiOWS OF SUC . POE!LIES.AGGREGA-'.E_WIT -F t C. c Idc '>Y PUL4T!, tIMITs LTR 1 IT — TYPE OF tMSURANCE POLICY NUMBER' I DATE tAM1VDOfY I CATS MMIDOIYYi EALF!1CCURQEN"E }$ 5GG,000 .KSM —' GENSRALUAfi!L1TY � 09/26/GG , 09/26/01 Ic!RE_,4,uAC£(Aoyor:e5rei �50 000 j AnvcneCQrs ,t s 5�000 MEC EA. ( _ — J_.._ .._------ A X I COMMERCIAL CENERAL LIAEIL(fY } gp17013142 Fu.S^HAL 3 AOY IN,:LP.Y 5 500,O00 _ }—F ]CLAIMS M4DE X j OCCU4 } __ __ — ---- -- `-� -4 I rcNERAI AGCREGATE S 1,0 OG,OGO. ! ( I � o00 F?GC'JCiS-GGA1PlOo AOG s 1,00.0 -_I /� yy �1 L AGGREv?.7E LIM!7 P.PPLfEo'PER j I -( PRO' r 1 I � POLICY' PRO PRO•' -0C / I GOtABINED SINGLE LIMIT^ S iAU T CMOBILE LIABILITY ----- I I AIaY AUTO i SCOILY IN,WkY (Per gersm) ALL OWt.cD AUTOS S�fE0ULE0 AUTOS i BCC4Y IN.YJRy i 8 1 (Per a_=denq yIRECA'JTUS I r I __._._._.---- -...----'-- NON-0WNEO AUTOS 1 - PFO;--RTY DAMAGE IS 1 ' •I � I AU7U ONLY•EA AGC!D347 --_. ACC GARAGE LIABILITY ` AU 0 TNJL^! 1 I AUT ONtY: AGO S �ANY AUTO !� ------ I '` I EACH OCCURRENCE I V I AGGREGATE _._ S -------- Excess LiAOILITY I ------ 1 —I OCCUR I CLAIM,',MADE ) I Y L DEOUCTIEIL E ' ------ RETQJT1vN S I — �__TORY LIMiTs1_L.-R - ---$ WORKERS COMPENSATION AND � 0/09/00iI 10/09/O 1E.L EACH�ACC_IO-E.-N---(S-1-01.000 _ `EEE(PLOYERS'LIABILITY 7CJ946593 100000- . SOO ODG ISEASE-FOUCyL!M:T - - I ! IOT4ER I I 4 I I DESCRIPTION OF OPERATIONSILOCA710NSIvF1.iICLESfEXCW5101:5 A.70E='6V ENDD? EMFJvT1,'=Ci4L•'SO�`s'�'!�S Masonry CERTIFICATE HOLDER I N A,DDIT'CNALMSURM:IN57R£R LE7TER: _� CANCELLATION cZOGERS 1 I ShGULD A�,OF THE ABOVE OESCRIBEO POLICIES BE CANCELLED 3EFOF.E THE ENRIR N :4TE THER:CF-T4E ISSUING tNS'JRE,Z ViILL ENDEAVOR TO NtAIL 10 oars.rwT-,_v i NOTIGE 7O THE:ER11fICATE HOLCER NAMED TC THE,EFT.BUT FAILURE TC OC•SO E-O, ers & Marne:y #506-420-3550 INPCSE NO OFLWATION OR_IA3:UTY OF ANY KIND U°CN THE INSURER ITS AGENTS OF BOX 310 REPRESENTAiIVEs. erv_11e MA 02655Robert Bsrlin ameACORD 23- (7197) ................. .......................... ::. .::.. ::.:: .�. .:: ..; : .;::.; ;:. ;:. :::::.;:. :.;: ..;;;: .;;:: : :. : . :.::.> :.; :::.: :>:.::. ;.. �-.. . :.; . .;: ;:.::;.::;.>:;.;:.;:.:::.;:.;;::;.: DATE(MM/DD/YY) r?::: : :F :CAB:::::: ::::::: ....:[/ B: : :t::: ::::: :::::::: :: :. : ::::: C. ..:..- .......... ... ...... ...........E ... ... . ... . 'I'1 ... . 1 .l ...... ............................. ACORD ........: ::::.:::::.::.::.::::::::::::::::::::::.::::::::::::::::::::::::::::::::::::::::::.::::::.:::::::::::::::::::::::::.::::::::::::.::::::::::::::::.::::::::::::::::::::::::::::::::::::::::::::: . : ::::::.:.:::.....................::::::::...X::::::::.::.::.::.::.::::.::.::.::::.::.::.;:.::::.::.::.:::::.:..::::;:::.;::.:::.;..::.;:.::.::.::.::.::.::.::.::.;:.;:.::.:::.::.:::.::.::.::.::.::;:.::.;:.::.::.::.::.::.::.::.:::.::.::.::.:: 12/21/2000 D U C E R:.>;:.;:. ................................................ ....................................................... PRO ::.:.;::;FAX.;.:;: :::............................................ ::: ........................................................... (SO8)997-6061 (508)991-3283 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE t h e a s t e r n Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. r .0. Box 79398 COMPANIES AFFORDING COVERAGE ..................................................................................................................................................... N. Dartmouth, MA 02747 COMPANY Merchants Insurance Co. Of NH, Attn: loan Leger Ext: A ...................................................................................................................................................:.................................................................................................................................................... . INSURED COMPANY Safety Insurance Co. David G Holcomb B HolcombPlumbing & Heating ............................................................................................. .......................................... PO Box 170 COMPANY Merchants Mutual Insurance Com /� C Osterville, MA 02655 lY .......................................................................................................................................... COMPANY D CQv . .. . ...... .......................... LOW HAV�,........•N.1....•.•..•. D T THE INSURED NAMED ABOVE FOR THE POLICY PERIOD TIF 'THAT•THE.P"LICIES�OF INSURANCE LISTED�BELO E BEE SSUE 0�THIS�IS TO CER Y O INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE?POLICY EXPIRATION:: LIMITS LTR DATE(MM/DD/YY) DATE(MMlDD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 ........................................................ X ;!COMMERCIAL GENERAL LIABILITY : PRODUCTS-COMP/OPAGG: $ 2,000,000 CLAIMS MADE X : OCCUR:: PERSONAL&ADV INJURY $ 1,000,000 A >:»>:...... CMP9138499 12/18/20/: 2/18/2001 ............................................. .. .............................. OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 11000,000 .................................................................................. FIRE DAMAGE(Any one fire) . $ 50,000 .....:......................................................i i ........................................ ................................. MED EXP(Any one person) $ 5,0 0 0 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT : $ ANY AUTO ........................................... ................................... ALL OWNED AUTOS BODILY INJURY .'"'' (Perperson) n) 1 X ".SCHEDULED AUTOS ° 1500507 /1218/2000 i 12/18/2001 .................................................................................... HIRED AUTOS i BODILY INJURY $ NON-OWNED AUTOS (Per accident) 300,000 ............................................................. PROPERTY DAMAGE $ f 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ .................................. ANY AUTO :OTHER THAN AUTO ONLY: ......................................... .................................. .....,:.::..................................::. EACH ACCIDENT $ .......'................:....................................: ........................................: ................................... AGGREGATE: $ EXCESS LIABILITY EACH OCCURRENCE $ ........................................... .................................... UMBRELLA FORM :AGGREGATE $ ..................................................................................... OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND :TORY LIMITS: ER : : `'4::':'::>>:?:: EMPLOYERS'LIABILITY ; .............................:..........:>:...................... ........ C WCA9089132 12/18/2000 12/18/2001 ,ELE.'1CF:ACCIDE,.T , .. , 10010001...... THE PROPRIETOR/ PARTNERS/EXECUTIVE INCL EL DISEASE-POLICY LIMIT $ 500,000 OFFICERS ARE: EXCL : EL DISEASE-EA EMPLOYEE $ 100,0001 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS or any and all operations performed during the policy period. ..C.ERTIFICAT.E.HOLDER......................................::..:.::.::::::::::::::::.::::...:::........:........................................................................:.:...:.....:.............................................................................::.::: ......:::.:.::.::::::::......:....:.:...:.:.................................:- :::: • •::...:.:..:..::::..:..::.::...................... ................................................................................................... . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Rogers & Marney Inc. Po B o X 310 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. O s t e r v i l l e, MA 0 2 6 5 5 AUTHORIZED REPRESENTATIVE loan Leger ORA::OP{:f9&8 ACOR{3..25:.S:..1./95.:::..::................................................:...........::::.::::::::: ::::............................................................................................................................................... ........................... ........#.........................................::.::::::::::::.::::::::::....:...............................................................................................::......................................................................:..::::::.::::::::::. DATE(MMIDDfYY) AC �ERTIFIGATE OF LiAB1LITY INSCRANCE 11/28/2000 PRODUCER (508)994-9688 FAX (508)991-5461 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION UTKOWSKI & KESTENBAUM ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 414 COUNTY STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 BOX 5911 COMPANIES AFFORDING COVERAGE ............................................................................................................................... NEW BEDFORD, MA 02742-5911 COMPANY Commercial Union Attn: Ext: A .. .. . ............................................................................................................................:............................G rani to.....................tate................nsu rance............................o......................... .... INSURED COMPANY Randall C. Agnew Electrical Contractors e RandallAgnew Electrical Contractors ............................................................................................................................... PO Box 1270 COMPANY Cotuit, MA 02635 ............................................................................................................................. .. COMPANY D COVERAGES:........:: ....... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ........... ....................................................................................................................................................................................................................................................... ...... .. .. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MMIDDIYY) DATE(MMIDOIYY) GENERAL LIABILITY GENERAL AGGREGATE S 2,000,000 X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG S 2,000,000 ....... ............................._......................... ............... CLAIMS MADE X OCCUR PERSONAL&ADV INJURY S 1,000,000 A " NBFB41863 11/16/2000 11/16/2001 OWNER'S 8 CONTRACTOR'S PROT EACH OCCURRENCE S 1,000,000 ........................................................................... ... FIRE DAMAGE(Any one fire) S 100,000 MED EXP(Any one person) S 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO 1,000,000 000 i ............................................................................ ALL OWNED AUTOS BODILY INJURY S X SCHEDULED AUTOS (Per person) A CBXE04239 11/16/2000 11/16/2001 .................................................................. .. X HIRED AUTOS BODILY INJURY S X NON-OWNED AUTOS (Per accident) ...._. E .......................................................................... .. " ""' "' .. PROPERTY DAMAGE S 0 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 'S ANY AUTO OTHER THAN AUTO ONLY: .......................................................................... ... EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S ................................................................. OTHER THAN UMBRELLA FORM S 7CSi ATU- WORKERS COMPENSATION AND TGRY LIMITS ER EMPLOYERS'LIABILITY ..................................... .......:::::::::::::::..:::.:.:: . EL EACH ACCIDENT S 5 00,OOO B WC6523895 06/23/200006/23/2001 THE PROPRIETOR/ : INCL EL DISEASE-POLICY LIMIT S 500,000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA.EMPLOYEE S 500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. Rogers & Marney Inc BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO BOX 310 OF ANY KING POt HE COMPANY.1;,5-4GEN, 0 RE RESE TATIVES, Osterville, MA 02655 AUTHORIZED REP A IYE ACORD 25S(1f95) (ccACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANC ID KG OA 05/2DD/YV) O-1 5/25/00 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Eshbaugh Ins. Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 805 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. •.nnis MA 02601 -one: 508-771-1632 Fax:508-778-1789 INSURERS AFFORDING COVERAGE INSURED INSURER A: MASSWEST INSURANCE ��/ INSURER B: EASTERN CASUALTY INS. COMPANY Harmon Painting, Inc. ( / INSURER C: P. 0. BOX 86 x�J INSURER D: Osterville MA 02655 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MMIDD/YY _DATE(MM/DD/YY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIAL GENERAL LIABILITY ART036057100 04/01/00 04/01/01 FIRE DAMAGE(Anyone fire) $50000 CLAIMS MADE FRI OCCUR MED EXP(Any one person) S 5000 PERSONAL&ADV INJURY f 1000000 GENERAL AGGREGATE js2000000 GEN'L AGGREGATE LIMIT APPLIES PER� r PRODUCTS-COMPIOPAGG f 2000000 17 POLICY PRO LOC JECT El AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS i BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS LIABILITY / EACH OCCURRENCE $ OCCUR CLAIMS MADE / AGGREGATE $ S DEDUCTIBLE E RETENTION $ 1 $ WORKERS COMPENSATION AND I TORY LIMITS X ER B EMPLOYERS'LIABILITY WC97798007 01/04/00 01/04/01 E.L.EACH ACCIDENT s 500000 -F E.L.DISEASE-EA EMPLOYEES 500000 i E.L.DiSEASE-POLICYLIMITI $ 500000 OTHER A Commercial Applica TBD 04/01/00 04/01/01 I DESCRIPTION OF OPERATION SILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CERTIFICATE HOLDER I N I ADDITIONAL INSURED;INSURER LETTER:_ CANCELLATION ROGERS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Rogers & Marney, Inc.P. O. Box 310 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Osterville MA 02655 REPRESENTATI lHous ccounts ACORD 25-S(7/97) ©ACORD CORPORATION 1988 r ✓!ee 1L'anamo.eu�eal!/ a�,�`la:wacliuoe!!.t . BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 016174 Bi rthdate: 05/07/1939 Expires: 05/07/2002 Tr.no: 26118 Restricted To: 00 CHARLES D ROGERS 300 BAXTER NECK RD , \4A0CTnWq Mil I Q uA n9PAA Orl n+iniefrafnr ,3 O� -�amm� d i Board of Building Reaulat ions-; and Standards One Ashburton Place Room 1301 T.r`Ip r'.. (101-16 -a`. .. �„ • ice, .n 7 G - T,r��n _ r•.. .. ^t..� r^. - .- - � 7�ee L omrKonuxa�llE e�..lliu,;ac�rr.�, HOME IMPRHEMENI CONTR.ACIOR. Registration: IOOI?4 Ezpira ion: 6J9/02 i;ha r I e F:ou ;r s �. ' I'm: Private Corporat ie Ustervi l le MA 026`%: ROGERS 8 MONEY, In. Charles Rogers Kam. 445 M Si 89RNSIA8LE RiP LAW OFFICES OF JOHN R. ALGER, P.C. ATTORNEY AT LAW S PARKER ROAD P. 0. BOX 44S OSTERVILLE, MA 02e55-044e TELEPHONE(SOB)42S-S594 FAX(50B)420-aie2 December 1, 2000 NOV '0 5 2000 Building Inspector Town of Barnstable 367 Main Street f Hyannis,MA 02601 Dear Building Inspector: My clients, Mr. and Mrs. Richard Burnes, Jr., desire_to add an addition to their existing house at 1635 South Gounty Road, Marstons Mills.,'The petitioners own 20.28 acres of land and have a single family dwelling with a foot print of 3000 square feet and would like to add an additional 1320 square feet consisting of two bedrooms, two bathrooms, a family room and a second kitchen. Is it the position of the Building Department that a second kitchen must go to the Board of Appeals even if the property is not to be rented separately? Ve truly yours, i JRA/db ;•.It a.', _ fit;-,ai-'� a .�.'..r.y-, .. . '•:�� .ti:[e:r CFa1� '� .. f Pik .. - - .. .. ... _ ?,_ ... ... t ., ,..:,':. .', r DEC. C, '[000 (FR1) 1 2:45 JOHN R AL:ES 5084203162 ?ACE. 1/1 LP.W ;?F'FICES O� JOHN R. ALGER. P.C. ATTORNEY AT LAW 5 FARRK.ER ROAD Imo. O i3G;c 4aav 08TERVILLE, MA 026t36-04•40 TELEF'I-!ONC (5oe) FAX(509)420 Iea Dece.mbcr 1, 2000 Build.i.n.g Inspector Town of Barr:stable 367.Maiu.Street Hyannis,MA 02601 Dear Building.Inspector: s. My obelits, Mr. and Mrs Richard.Burnes,-Jr., des're to add an.addition to their exist.ing.h.ouse at i635 South,CountyRoad,Marsto.ns:Mi.11s. The petitioners owta 20,23 acres of land and have a single family dwelling with afoot p.ri.nt.of 3000 square feet and would like to add an additional-1320 square.feet-:comistingtof.two bedrooms, two bathrooms, a family room and a second kitchen. Js it the position.of the Building Department that a second kitchen must go to the.Board of Appeals even if the propet1y is not to be rented separately? traly yzur.�, 1RA/db i Engineering Dept. (3rd floor) Map C1 Parcel 'j&o D, / Permit# 3 59 House# -3 S_ PJ.S. Date Issued S 8' Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:30) F "� .F Z 'Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) T4``� 'a'd ,'�; , Planning Dept. (1st floor/School Admin. Bldg.) Definitive Plan Approved by Planning Board 19 •.BARMABLE. MABB. q, TOWN OF BARNSTABLE Building Permit Application Project Street Address L6 S SoU 7• 6O!'fJ6� y Tom/ b-cs a0 a Villagej '% d�s Gil L(a S Owner dlG Address Alv6�f •moo Gp�/(/T y J , Telephone Permit Request '90 X eve, zPAI 47v/10� 6 ; 1 V I?a First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ —/d o 67 Zoning District Flood Plain Water Protection Lot Size j`d_4- ac2P) Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ 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) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name -��ed-6 gg�' lf/,/tifiL ' //V/G Telephone Number li f'7 Address �glo PLC} ,,fv,��}J�l t� License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS IPROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PER 4IT DENIED FOR THE FOLLOWING REASON(S) ''.kCol(e r�, c FOR OFFICIAL USE ONLY _ PERMIT NO. - DATE ISSUED - - MAP/PARCEL NO. ADDRESS VILLAGE + OWNER i - liz DATE OF INSPECTION: _ FOUNDATION FRAME s INSULATION ` FIREPLACE ELECTRICAL: - , ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: . •-ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' �i�i'YIIY � ' 6�7i�1i4' y' ll�'11v11�'11Y.,�1��/�YII'VIIY1 Y' Y/Igf1Y11Q ll IIYI�YI�Y�IY V �Y��Y��Y Y � Vas Certificate of Ilium k%e5t5tance A C I p� REGISTERED Date Work Performed �• APPLICATION ISSUED BY CONCERN No. GRANITEVILLE COMPANY t%�•.� GRANITEVILLE SC CIF RET�O F-76. 2 2/12/97 803-663-7231 This is to certify that the materials described on the reverse side hereof have been flame- retardant treated (or are inherently nonflamable). FOR ASTRUP COMPANY AT 2937 WEST 25th STREET CITY CLEVELAND STATE OHIO 44113 Certification is hereby made that: (Check "a" or"b") _ � f ' (a) The articles described on the reverse side of this Certificate have been treated with a flame- retardant chemical approved and registered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the State of California and the Rules and Regulations of the State Fire Marshal. Name of chemical used Chem. Reg. No. ' Method of application ~` (b) The articles described on the reverse side hereof are made from a flame-resistant fabric or X❑ material registered and approved by the State Fire Marshal for such use. Trade name of flame-resistant fabric or material used GALA TENTAGE Reg. No. F-76. 2 The flame Retardant Process Used WILL NOT Be Removed By Washing (will or will not) T. L. COLEMAN By J. GRICE KEEL, GC SUPERVISOR Name of Production Superintendent Title We hereby certify this to be a true copy of the original"CERTIFICATE OF FLAME RESISTANCE" issued'to us, "original copy" of which has been filed with the California State Fire Marshal. The ASTRUP COMPANY By 3007. 000 YD Control/lot# Quantity EITH TENTAGE GALA 51817 31IN WHITE Customer order Description 390506 768427 Astrup Invoice # Product Code JESSE G. WILLIS OF 725_1V7 tj' _A77— A�v�fd e60&W1Y1&, 586 PLEASANT ST WATERTOWN MA 02172-2408 / ���✓ 7©/F i i Z Certif irate of Slame Ro ' Lance p.9 CA"`' REGISTERED Date Work Performed ' APPLICATION ISSUED BY �+ s' CONCERN No. GRANITEVILLE COMPANY 11/22/97 11,41+�p GRAN I TEV I LLE , FRET F-76 . 2 SOUTH CAROLINA �. This is to certify that the materials described on the reverse side hereof have been flame- retardant treated (or are inherently nonflamable). Z FOR ASTRUP COMPANY AT 2937 WEST 25th STREET M .. CITY CLEVELAND STATE OHIO 441 13 Certification is hereby made that: (Check "a" or"b") (a) The articles described on the reverse side of this Certificate have been treated with aflame- M retardant chemical approved and registered by the State Fire Marshal and that the application of said chemical was done in conformance with the laws of the State of California.and the Rules and Regulations of the State Fire Marshal. Name of chemical used Chem. Reg. No. I Z Method of application Fx1 (b) The articles described on the reverse side hereof are made from a flame-resistant fabric or material registered and approved by the State Fire Marshal for such use. Trade name of flame-resistant fabric or material used GALA TENTAGE Reg. No. F-76. 2 Z ILLThe flame Retardant Process Used Wu10 will Nnot) Be Removed By Washing I T. L. COLEMAN By J GRICE KEEL, QC SUPERVISOR Name of Production Superintendent Tine :. :. :. .. We hereby certify this to be a true copy of the original"CERTIFICATE OF FLAME RESISTANCE" issued to us, "original copy" of which has been filed with the California State Fire Marshal. The ASTRUP COMPANY By Control/lot# Quantity 3514 YDS Customer order # KE I TH Description TENTAGE GALA 51817 31 I N WHITE Astrup Invoice # 630641 Product Code 768427 JESSE G. . WILLIS 586 PLEASANT ST WATERTOWN.. MA. 02172-2408 i oft ~ T11C (7fy,1111t111ti-calth t)lAfassachusclts Departn1e11t ojludustrial Accidetlts OflfceollQyestlgatfcgs 600 Street •� ''.. :��,�:� Burton,•Muss. UZIlI F�. . .• Workcrs'*Compcnsation Insurance Affidavit �, �__•___.__...�_._ Keith B. Wauters Jesse G. Willis Inc. 586 sli.N Watertown, MA nhnnc> 617-527-0037 I am a homeowner performing all,work myself., I am a sole proprietor and have no one working in any capacity ,� -. •_-- _ ® 1 am an employer providing work ers'..compensation for my employees working on this job. n 1 vany Jesse Gc Wills,. Inc. ddr c • 586 Pleasant St. Watertown' MA 617-527-0037 ''INSURANCE CO 02 WB CB6578 ITT HARTFORD _ ins urance Co. .r.•.._ . •�.; .q^r.�....���,.�-w.r�Jww^'^,• .f1r"'•r:w."'aaa�.+!.�•t�^!.'w.' .w+�'�M��';'CL ..•. ^ L_....r.r•.�+�_• '.. 1 am a sole proprietor.general contractor,or homeowner(circle one)and have hired the contractors listed below who have the followin;workers' compensation polices: m a v n Ir • v tl insun-ince co. r�r• rr' _:. ;^'r.•='sr�—.-•va-^^.4••r�!,.i►.w�st.Rr::,i.•...._ ..1_ .,.=sy�„—... -.a.i..:.s 1 r c• its phone tl: noliev N insurance CO. ces .�W T -Attac addilltnalshceifie �liy'Y•�N^�+r-M - ..Nis:.'Lti Failure iu:ecure coverage as.required uader.Section:SA of 11iCL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/ur unc wars'imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a 11ae of SIQ0.00 a day against me. 1 understand that a copy ortliis statement may be forwarded to the Ol ice of Investigatloas of the DIA for coverage verification. 1 do hereby c �•underthe pa its and,p ??�!l •ol-np!luri'that the ir{formarion provided above is true and correct./I?Af%) �//�/f)��/�jy Signature ate Print name ••• �- _ hone# lyl 7�•'3—Z 7'oo.�"j official use only do nut write in this area to be completed by city or town official city or town: permit/licease q r-tlluildini:Department DWcensing Guard check if immediate respotsat 4 required ;,.;;.,., ,•• QSCICCImeA*x Off1CQC3Ilealth Depanmeat contact person• phone ll: �nUther • imised 3M PJA1 RECEIVED 19- 0 LI Q co A DIRECTIONS: 2020 From Hyann,s - Take Route 28 into ASSESSORS REF: 49 7-1 OSle,,ille: At the lights take a ell onto P—al 022-001 South Co..,ty Road., moo 97. B�RNSTABLE CONSERVATION in Site is on he right. #1635. A OVERLAY DISTRICT: Cp Aquifer Protection District FLOOD ZONE.* Zones Ar( ;..7: , .. 0 CL 12)&X ,r, Community Panel No. ------------ 425001 C 0544 j July 16. 2014 LOCATION MAP: Scale: 1'= 2000'1 ZONE: Rr $1 Area(min.)87.120(RPOD) r,onlo?e(rnin) iSO too ------- Width min) -- I I ------- SelbaC kS: Front 30' Side 15' Reor 15' f I IN a\.3 3 it h, A. 0 N "a ffo 71. . ........ ia 3.00-C -o ---------- i4 ' .: ; Lot 19 229.470 N LCP 13104 F SW -11 23-00'\" c, -A S, Y� p/. 50 1?4 ---------------- Joy AVO I Warrens �A CIO Lot 20 . Cove LCP 73104 ----------- ------ ----- L o Q 94;C Z A LCP 131,&S 207.460 -1 'L f 22 ------------------------- S70. 51' 44.00- Ho ------ vl LCP 13104 fu, AB, .00-C if 0 Lot 21 If N63, V 109-00' G ,I--\,\\ 7 7 LCP 1310T \N, I Lo t t 3 k Lot 12 -------- rCP 13W4 C LCP 73104 0 657.220 S64* 21�19.00,w 9 Lot-91 LCP 5725-38 R=190. 122320 V6 S6 1" 4 00*W Lz SMO ey TITLE: PREPARED BY. PREPARED FOR. NOTES, Sketch Plan 1.)A field su­ey-as NOT Delle,med. The o,ope,,y line information sho_ as —ai$ed from­il.bf.,­,d inf.—lior. Ln Wetland Resource Areas Engineering& Morsions Mills River Irrevocable Trust 2.),the,Iopo toph;c into,mat— as obtained Pram LiqaSTheq z a s,uc re.. drNe..y.and trails were obto.ed rom ci� on At South County Rood Irrevocable Trust aeries oh.fog,phy. The dolum used s NAVD'88 .fi.,d mean SullivanConsulting,Ina sea 1­1"atom.1635 South County Road (W4M3U :0.Om 6& Ptul­Awd.OV-41%MA OM65 1635 South County Rood Nominee Trust J.)Vef.ted-ell.nds.—been flagged but net loc.lea, The --ullt—V.— 50'00fe,to Me B.V.W. +ilf be­rn.—Ily de—led Bamstadle (Marston Mills) MaSS. conself.lion iln Conse—lion Staff. (3.) he Field. intent oil th,s plan is for the permalrq man g"ol JOD go 0 40 so 160 320 Restoration ONLY.A liela s—ey to confirm p,opemy"co' DATE: SCALE.- I Review: Como./Review:JOC Como./Review: I...9—1y. -911,11d-et nds.and banksProject- 20055 Project: banks July 27. 2017 1 80' should be preformed for any future vermilting. I 1_�— 3 RECEIVEDo •.cam BARNSTABLE CONSERVATION c'�,LZot61.8ti V''9` ©BUTZ+KLUG 2019 7 I b A—' 'n I I = M O ; 7 ❑❑ \ 1 O O ° n \ A C 00 m uo 8� k Z 8i;Z �"� ^�.= Race# yRa9ck mW �m BUTZ +KLUG Architecture q gg ? y C 157 W.NeM SI..BM—,MA 02118 P617536.7399 F 617 507.5680 mbat+arcn.c°m cn A 35 7N serum N S.- i00t m tWi1 OO ' NZn my Gn AU°?JOIX P7NA 02UIX P�IB n+rn °. ., N P(5,7)M-> 161>t)Oc(Jc00t 2 , L'1�.�.•y�...:'.....i.1.1_.L.�..�a..—•..�._:.._...___....._�._._.........._._�___.�___.__.�__.�.._ .�.._........._�.� _....__.__ —.._—... _--_...__.._. .—...,• __T�•---_T—.._..�...._1 Y+.T-1'IFfT—' �•f RT.. LoT o ti. ! Ex\ST IZ•4v3 L�KlSf. 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'� I�fJFE551vuAt_ LA-IJO SU2VE�bO: utgEMEMS or R-1E TAW Ur- BtPJ-•sWEt. �G ^:s�.' : •�•tTtPt� Lx Nx> lA I W II� �� 1�J �r ` t �•� vua ItJ' 1i \ �����' � �LS �.. c�rr✓'�ll�.c�,VA -- - - q gi5�?o 7-- 7/.,03 Jy c Lo 1• Nor (q� U. 1 W� tiE ALLEY O:STERVILIE. iy O vM UUTy:.R a!`LE Q O f (' ° F M Jn Ur- tl-° � � � ' .. �6' S6 F` •yEy'4'P�c,�;�p Yea""'`.'"uH�L L•$ .F, LO�,gT �6: T I I t, , •` a L OC U-SnP"N S 9.� •1 JU j 9. St. Mory's Islond Trust 3� 2 � .,y; _ _ •-�s..--�� 1•�7/ .•�V�. +,"�,.�.t�;!,�!�,:... 'qL:� ^ut�"o�c":- ."as• 1 ±'� �'.,ir'n r_+ r3i`�"�`ct,?' °�,�.;Y x 0. 0 20. �q /a 5'44628 S. F 0R 12 503 ACRES a ( 540248 r S. OR i2 4 �,v-<�E--3 � of ��? •: UPLAND ' 2 39147._ C• r � �., l .r pTA �_ . / � '`. . - - -; _- 0••� Z ti N• :5\O•:. ��. -. .., ��';:. . 0 /0 P L 4 o � v T + c BEING 4 w 81 m o /7 Z' jg' o J Irr. I� t:ri• ''i . PnCIO.YD fEIMCE ♦11 0 1 O S!O w D D l T q iEroUfl / � •'�! . . :ice- /: / �// _ I �;' tip,-�•_ 7�.. -^ � I I II SMOKE DETECTORS O.K. DIE I` BARNSTABLE BUILDING DEPT. nEc 19 aioo V' T w—In Uc SITE PLAN ISSUE DATE ALBERT. RIGHTER & TITTMANN �1" �vVoo BURNES W� � " ` ARCIII'I'�C'CS INC., �. . SCat.F.:vls_=1'-0" s •�a..�` �""""�"'T " "'" � MAEZS'I'UN MILLS, MASSACHUSE'I"1'S 1. 0 TTJ: nr9_UI-D1W �wS nl]-.l1-YDM 1 yam•,, _•.._ 8 > ' m : : ti tiff R Kw t C h[:ogc•-7ZItl �iE 1EON EMT. TO To aonE Y Cf wd-/USTwG 4 Ij • t ,I ... .. CO1E wcTEaM4:i+...: ..,•.f ' /_. iOE C<Ev31n4 C'YG::%!'�• tj ....'............................................ E_Ev.•S'-B]/: 1 ...\TOE Of EUSTK:cac b _f LLE. ji• I FE .T E w_ .lr o'..f w cor.c..�! fa.o.Td w.0 to � `'�• FLFv,•)'-c Yf Kd./rf.Gi Oi EfEI wG � �^:; I ICVO.id 9fLf-.� . • Top QP Kw COK:DBf o� '.—Vpi� 30 G•' /EtEv.-)'-n]i•' C•iil ` cc• �O•FtIM. ... .. .. ..........................................................................1... ..... _............ ♦ .e.• lEv. :i v.--.sr l rd Gf ElorTa' i -- • r: I I U Ear OF taK ... 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WALL .—___ __—. .,_. —_.. _ ._. —_ } t MANUFCT S --• i- 1 - � —�---.-- .f - WN' # Ifil'IG'r.i '410iH TYPE UIIANIIfY 0 A PELLA 2957 DOUBLE-HUNG 4 ARCHITECI SERIES 6/6 -iC 7/8" 2'-5 3/4" 2X6 12 9 PELLA 3359 WD. DOUBLE-HUNG r,_• ARCHITECT SERIES 6/6 5'='i/9" '-9 S/.' 2x6 4 0 -EL:'. "Q. WD DOUBLE-HUNG S - ( PELLA 3371 ARCHITECT SERIES 6/6 6'-U 7'-9 3/•*' 2x6 2 o p PELLA wll. CASEMENT 1t25 :I I ARCHIIECI SERIES 4 lignl T-? 7/P," :'-9 .S/w. Ixti 9 n I NOTE: USE rEmPERED D-AS S TOR ALL WINDOWS w/ . �I I(Ei _°wocovrl= SILLS LESS THAN !B" .4.F.i. of i , J i 1 I I ! biI i i :i t '•�.I ^I I E rr t I I al 1 j i I^I i cy; pjy .I I .I ifI 9 rk ®ra MTMDO"—/ i r—coal Mle t0 • Y el/ 9 oaf . fir^ / � ....._ - —._ rt1i 'np: bI __.... tl -- - I --- • 7 !> hvw°..d OFt ... 4 4 4 �—__°::=._.�.__— - 1 � :r.� .c-o' I �_�� 'e_,.� i +_u� I n•ri• y.,�.. � r-�rvar �,� I . i I : I I I _ I , I i D 0 I E NEW > —EXISTING > b':! I _ DEc 1 9� °..�'e,.'lOic FIRST FLOOR PLAN ISSUE DATE "` • `°. ALBERT. RIGHTER & TIT'1 MANN cM nr.OA 00i00 o¢ D T T D;�T C SCALE:V9- =r-o- "� 17 lJ .l� 1 V s �Ig c, ARCHITECTS INC., —• - Tg ' y' """"'� " ""°" ""°""' MARSTON MILLS, MASSACHUSETTS VrwG r.'•., Tra. el>-.m °>.° v"r. °I>-"°I-CN4 - 8 c <r' —>, s•_-o.'. � y._�.. ._..Lam._.�-o.. E I I OO (TEaPEIED G,.LI 'I -- ' ^I O WE tE�CNED Q+19 _____________-- --- I of i O PP 1AE TE�EIfD 4ass 71. / l. ;�; I .- - . C __ _ _ _ _ _ __ _ r____________________ ____________________ 1 _. I -F_----r-----------------------r-------------- f � , 1 I I > r.-.r .-..... --.... .------------------ - 1 < NEW ? EXISTING / DEC y I i � ! am UJa ux SECOND F(OOR PLAN ISSUE DATE' s!n vay ca...a e.!DA 12/If3/00 . ALBERT, RIGHTER & TITTMANN SCALER/4' 1'-0" ARCH('(�GCTS INC.. BURN � LL. I\ l y-� 2.2 �y M.DNTY,N TTI t:Pf,Np TON,N>02M MARSTON MILLS, MJ\SSAC tUSE'I'TS r•..+.Grw:•1 r` TfA, el)-.11_>y.e I�i elr- >I-�xn. . 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Z w O , RELOCATED 0 ` h Y SEPTIC SYSTEM 34 r ✓' T RF RO N � RIVE L , AREA ` _ d 4' , Li ��d E .-� o+l y c� 333 w .o O a� E OF o 32 8 ;Y } �, DG `� _ E w „ a' xmsm nwn:v.pur AL ararr - Amit xrswv� Ii ICHR�� RlU-5 TAO=LOC.TM. 143.5 SO " CW NET R Y ; � -^ �} '" "'R w, _✓ mARSro))S M1u5, rrt a\,. ,„.... - ` ."^"'•.+r.,.•,,,,, .. u_\ ,....:e .,.,.,,.,: Tbit projea by ai^.M hY Ig—A ap orda O�rAOdld= . 22 w,w ❑ 16 18 24 -,. �. OR ono.. 20(14 1w_ -~ '-- aPrROx n SCALE 1" = 20' 26 —m--.� _ � o. � �,�.=, 0— P pBOI'ER END OF L�_ Yj1bP WWb.amddraW= ' COASTAL BANK 28 w .. � l DW Title: PREPARED BY- PREPARED FOR: Notes/Revision: SITE PLAN PROPOSED ADDITION Sullivan Engineering, Inc. RICHARD BURNES ;b, PO Box 659 17 PICKNEY ST 1635 SOUTH COUNTY ROAD 0sterville, MA 02655 BOSTON, MASS 02114 MARSTONS MILLS, MASS (508)428-3344 (508)428-s115 fox o m , 10 20� 0 20 40 80 Field Draft: Date: Scale: Comp.: Review: DECEMBER 15, 2000 As Shown `1 Revision Incorporate Conservation Commissions Date:01/10/01 Proj # Drawing # Comments cs' CCU -3� + pit, • . 45.6 so a2 . . . . . . . . . . . . . . . . . . .. . .. . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r va a ,po . . . . . . . . . . . . . . .37- . . . . . .: . . . • 3 A TWELEV.39.82_ . TOP OF HYD. 34, 3 , CBDH r + O+ + • I ... . . . . . . . i- ♦ r O �. • . . . . .33� . . . . \% r L_ - �4 ^., ' ' a 001 CBDH _ . . . . . . . . . . 35 0 OF COASTAL BANK 36 - TOP . . . 3,. . . . . . . . . . • . . . . . . _ 0 „ - 40 .. . . . . . ' Z HOUSE *3. SEPTIC SYSTEM . . • a2 Q � � -----CIS �._� . .• ,. . . . . . . Io \-8/Wry • �. . . . . - 102'-10' PROPOSED 8'X6 SPA + . . . . -0 Z. . . .. . . . . •' •'♦ Issue Date Description BURNES RESIDENCE 1635 SOUTH COUNTY ROAD OSTERVILLE, MASSACHUSETTS IV STEPHEN STIMSON ASSOCIATES o LANDSCAPE ARCHITECTS, INC =•�_ �% GRAPHIC SCALE 15 DEPOT AVENUE FALMOUTH MASSACHUSETTS '. r` 50 0 25 50 100 200 phone 508 548 8119 fax 508 548 7718 ssa@cape.com 0 Scale: Date: Drawn by: Checked by: f' 1" =50' AUG. 1, 01 DCB SSA _ ( IN FEET ) 1 inch = 50 ft. SPA LOCATION L 1 .01 • / r l;F .............. 60 \ 44 23, 1979 ,79 11!4T- TNC 1 ,. Y ': n; :. � . -... - `• 9 .V I 1 'gyp. ?o +G EGG. OKIJj. 1 1 , I I py °�f �.;�`T:%-�l'�L.G Wf,4C�/ OF AH _ AJt 1 v OJALA � .{ y �` • \, \\` �/ �.` o 1 ' ' V " #26348 � 7CJG. `0 ¢ 6 " p ✓ram v'. /c9.C .se ,\ �' \ �� I � � lq 9£GISTER��pQ _ __- -� f d�,• 5 SUR'4� .room : ` j' , 6" 1 /eon r Jew v 16 � � �`Q,•. \ � � \ \,�`�•` .�, `�' ' q� --....,.,_ 29 -,-lie `\ ` -` t � � + 4A TXW t it 1 ,CJ;ra�T Z M/n. 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