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0030 SPUR LANE
�� L � r _ �: Town of_Barnstable Bti11C11 ng Post This*Card So That rt is.Visible'From the Street Approved Plans Must be Retained on Job and,this Card Must be Kept Posted Until'Final Inspection has Been Made Permit eaructR Where a Certificate ofOccupancy is Required,such Buildingshall,Not be Occupied until a.Fina.l Inspection has been made. 1 mi Permit No. B-18-1076 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 04/13/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/13/2018 Foundation: Location: 30 SPUR LANE,MARSTONS MILLS Map/Lot: 027-034 Zoning District: RF Sheathing: Owner on Record: DONNELLY, PEGGY A TR ) Contractor Name '^,,SOUTHERN NEW ENGLAND Framing: 1 WINDOWS LLC. Address: 30 SPUR LANE ,� 2 MARSTONS MILLS, MA 02648 - --Contractor License: 173245 s Chimney: Description: replacement windows(2) Doors(3) Uvalue.29 ! Est. Project Cost: $21,822.00 i Permit Fee: $ 111.29 Insulation: Project Review Req: / Fee Paid: $111.29 Final: Date: 4/13/2018 a ` Plumbing/Gas Rough Plumbing: Final Plumbing: Building Official r 1 Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. this permit shall conform to the approved application and theca Final Gas: All work authorized by P pp pp pproved construction documents for which this permit has been granted. iAll construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. i 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 Electrical work until the completion of the same. ff Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work:L�...—...... _ __. e _ _ .. __.�..-- '' 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: i Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT of Town of Barnstable wPermit pExpires 6 monitrs front issue date 1 a l Regulatory Services Fee s>Ae�KAM _ \�1 III aq 9� 16 9. ,0m4 Richard V.Scali,Director `\ I Building Division Tom Perry,CBO, Building Commissione 200 Main Street,Hyannis, MA 02601 PROfte. www-town.bamstable.ma.0 APR 1 �� Office: 508-862-4038 �® /�/"- QN-LY 1 2�Fx: 508-790-6230 EXPRESS PERIVIIT APPLICATION - SEDEN Not Valid without Red X-Press Imprint L Map/parcel dumber _(��'7 ('}-�_-( C Property Address 3d SQU( /-ot✓le /'(Q� QY!i I [Residential Value of Work 3_,2 1,12-2 — Minimum fee of�$35.00 for work under$6000.00 Owner's Name&Address CSC 1�/ l�ont'�e�f!y 44,o e Mar,-4 S t (i ll S ' Li`-1 -. (e Lt r Contractor's Name ^ ,-,,- ,tj Telephone Number��(O( 2— Home Improvement Contractor License;"(if applicable)7 44 S Email: Construction Supervisor's License#(if applicable) Z c7 7 12<orkman's Compensation Insurance Clieck one: ❑ I am a sole proprietor ❑ jAm' the Homeowner L�rf have Worker's Compensation Insurance Insurance Company Name F' r-p tne--LDS" In-!z U r,6 Workman's Comp.Policy# W C A 31 5 8 7 2 9 — 2 L 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 O Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) side Replacement Windows/doors/sliders.LJ-Value Z (maximum.32)#of windows #of doors: _ ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& Fire Permits required. *Where required: issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property wrier must sign Property Owner Letter of Permission. A copy the Home Improvement Contractors License&Construction Supervisors License is require SIGNATURE: C:\Users\Decollik\AppData\Local\i4licrosoftiWindows\Temporary Internet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc Revised 040215 Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England y g Peggy Donnelly Legal Name:Southern New England Windows,LLC 30 Spur Lane RI #36079,MA#173245,CT#0634555, Lead Firm#1237 Marstons Mills,MA 02648 wixoow RE I....rxr 10 Reservoir Rd I Smithfield,RI 02917 H:(508)292-1583 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com Buyer(s)Name: Peggy Donnelly Contract Date: 03/29/18 Buyer(s)Street Address: 30 Spur Lane, Marstons Mills, MA 02648 Primary Telephone Number: (508)292-1583 Secondary Telephone Number: Primary Email: peggy.donnelly@comcast.net Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively, this "Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $21,822 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $2,000 Balance Due: $19,822 Estimated Start: Estimated Completion: 8 to 10 weeks 8 to 10 weeks Amount Financed: $19,822 Method of Payment: Cash/Check We schedule installations based on the date of the signed contract and secondarily on Financing the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: Taxes paid in Barnstable MA; Financed via greensky plan 2521 Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 04/02/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renewal ndersen of Southcrn New England Buyer(s)6 2v6W- � Signature of Sales Person Signature Signature Josh Ocharsky Peggy Donnelly Print Name of Sales Person Print Name Print Name UPDATED: 03/29/18 Page 2 / 10 � dice of Consumer Affairs and Business Recr lation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Horne Improvement Contractor Registration Registration: 173245 Type: Supplement Card SOUTHERN NEW ENGLAND WINDOWS LL Expiration: 9/19/2018 BRIAN DENNISON 26 ALBION RD =- . LINCOLN, RI 02865 Update Address and return card.Mark reason for change. Address Renewal - Employment Lost Card =-Office of Consumer Affairs&Business Regulation Registration valid for individual use only before the -----HOME IMPROVEMENT CONTRACTOR expiration date. If found return to: `= Office of Consumer Affairs and]Business Regulation Registration: 173245 Type: 10 Park Plaza-Suite 5170 Expiration: 9il9/2018 Supplement Card Boston,NSA 0=116 ;OUTHERN NEW ENGLAND WINDOWS LLC. 3ENEWAL BY ANDERSON � 3RIAN DENNISON ?6 ALBION RD -� _INCOLN, RI 02865 lZ"adersecretary Not valid without signature , ,�-��...^r�.{i Li.�..eLi.�.+ ai QiS L: i ll �Ji ui Gi � i l care of Building Regulations and S;andar s i s ; CS-095707 BRIAN D DENNISON 7 LAMBS POND CIRCLE CHARLTON MA 01507 .onelt issIGrier 09 08/2C18 I w The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A licant Information Please Print Le ' 1 Name (Business/Organization/Individual): e Address: 2& A lna) J City/State/Zip: p Phone##: �,p/ _ 2�$= FEW Are you an employer?Check the appropriate box: Type of project(required): 1,KI am a employer with ZO 1temployees(full and/or part-time).x T. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp-insurance required.] 8• Remodeling 3.O I am a homeowner doing all work myself.[No workers'comp.insurance required_)t 9• ❑Demolition 4.R I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole I 1-[J Electrical repairs or additions proprietors with no employees. 5.❑1 am a general contractor and I have hired the sub-contractors listed on the attached sheet 12. Plumbing repairs or additions These sub-contractors have employees and have worker comp.insurance., 13.E]Roof repairs 6.R We are a corporation and its officers have exercised their right of exemption,per MGL c. 14.[�Other�.A � d ./o d,/ 152,§1(4),and we have no employees.[No workers'comp.insurance required] re? 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 contactors must submit a new affidavit indicating such. !Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: klre men 5 Policy#or Self-ins.Lic.#:W C�3LS�7 Zq — 2-0--,Expiration Date: 1- L ' Job Site Address:_ 30 �Ov r L.a/t-, City/State/Zip:-('►araurS �-f q Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration Ate). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation piln.ishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th airs andpenalties ofperjug that the informaiion provided above is/true/and correct T Signafore: a D2te: ( �1 Phone#: CIO I- 2Z 92.--IT Pe7D Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspector 6.Other Contact Person: Phone#: A R ® CERTIFICATE E OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 12/29/2017 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 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 CoBiz Insurance, Inc.-CO NAME: PHONE 1401 Lawrence St, Ste. 1200 303-988-OW uc No:303-988-0804 Denver CO 80202 EDngIL COMaiI cobizinsurance.com INSURERS)AFFORDING COVERAGE NAIL 8 INSURER A:Acadia Insurance Com an 31325 INSURED ESLERco-01 Southern New England Windows, LLC. INsuRER B:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southern New England INsum c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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 NTH 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 TYPE OF INSURANCE AODL SUER POLICY EFF POLICY EXP LTR wvDPOLICY NUMBER MM/DD)YYYY1 (MMIODNYYYI LIMITS A X COMMERCIAL GENERAL LIABILrrY CPA3158728 1/1/2018 1/12019 EACH OCCURRENCE $1,000,000 G�LAIMS MADE OCCUR GrT6PREMISES occurrence) $300.D00 MED EXP(Any one person $10.0130 PERSONAL&ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,0D0,00D X POLICY ECT LOC PRODUCTS-COMP/OP AGG $2.0W.000 OTHER: $ A AUTOMOBILE LIABILITY N CPA3158728 1/12018 1/12019 COMBINED SINGLE LIMB Ea accident $1 000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AAUTOSWNED PROPERTY DAMAGE $ Per accidentl $ A X UMBRELLA LIAR X OCCUR CPA315872B 1/1/2018 1112019 EACH OCCURRENCE $10.0D0.00D F�OEDX E CLAIMS-MADE AGGREGATE $10.00D.000 RETENTION$ $ B WORKERS COMPENSATION WCA3158729-20 1/12018 1/1/2019 X PER OTH- AND EMPLOYERS LWBILfTY YIN STATUTE ER ANY PROPRIETORMARTNER/DO=CUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A EL EACH ACCIDENT $1,000,0m (Mandatory in NH) EL DISEASE-EA EMPLOYEE $1.0D0,000 if yas describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1.000.000 C Pollution Liability 7SM0733400DO 1/12018 1/12019 Each Occurrence $1,000,0m Claims-Made Policy A99regate $1.000.0110 Retroactive Date 0620/2013 Detluctible $10.000 DESCRIPTION OF OPERATIONS/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 ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I pF �G Town of Barnstable *Permit# EVirw 6 mondwfio=is=dme Regalatory Services Fee thonmas F.Geiler,Dzrector Bnzldnng Division Tom Perry,CEO, Building,Commissioner 200 Maus Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT'APPLICATION - RESEDENTTAL ONLY Not Validwi rwzdRedX-Prw.Tbnpnnt Map/parcel Number PropertyAddcess �� /� (�-- ,/�f �•�y.-y� �//� Residential Value of Work 7(! Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /✓�li(/� Contractor's Name s Se h , ' -;.,,' L C.C Telephone Nmrtber C 5'Oa)!Y 8— Home Improvement Contractor License r(if applicable) X'PRESS PERMIT Construction Supervisor's License r Cif applicable) dWxlanan's Compensation Irrssurance Check one: ❑ I am a sole proprietor I am the Homeowner TOWN OF BARNSTABLE I have Worker's Compensation lasurance Insurance Company Name M61+ro114 Un i or'-, ire l 1St�rOL r\CQ o Woslmaan's Comp.Policy# 1r;!C 6fsG ,�4foo� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(checkbox) ARe-roof(stripping old shingles) All construction debris will be taken to �s+� ❑Re roof(not suippin& Going owe# existing layers of root) ❑ Re-side of doors Q Replacement Windows/doors/shdws.U-Value (mammm .44)r of windows *W1=a rcqu=F: Issuances ofthis permit does no:cccmpt compliance-m&od=town dep=ma regolafions,i.e.Ebr=c,Conservation,ctc. ***Note: Property Ovmer must sign]Property Owner Letter of Permission. A co y of file Dome vement Contractors License&Construction Supervisors License is req SPIZ Q'lwPFMES\FORMSU•imld;p c Revised 09080.9 r , c � t f The Conanonweaft of�lassackrese�s 1 De�arl�nEnt o,�'Indrestria7.,4cczde�rEr � . ®ffr�e 4flrz�eskgakorfs 600 WarhBT0n.t ry wM*e&Cc:xat a > boy/pia g Ursa#io�� a� nerslCoffirectorslectri A I!�E�nfermaiox� clansJPJa hers ' NameB Please I'riatL Q oa!laaividv y" ra.S—Y �ans-�UC'�EQ rlLLB AddtiDss: Ciiyl�elZip; ��vrf l�(,q ���5 p i Are�eBaa em i er? bane : Sag— 5�28 ' 1 P oy C,freck�e approg�Tea` 0�"2�07 i• I ace a etapIoyerw E L[ism a geucaal r and I Type° prO (I 'd): 1 Z-flemployees(full anH(or—) ,ctors New IanzasaIeproprie�rC1_ Ie �s�eet suction _ slapaadhaveIIp�FloYeas Thw--sub-caAizactomhave Z- ❑Re�odelae j worg for a auy rapar�iy employers andbave warless' 8 boa j:+Fo workers'coar>ir3saracce camp ice t 9. Bm7ding addition j 3, I am a omeownerdo" $ We a C°P�on and its 10.�$l icxl Iepairs or addit4ons ta?�elf aII wcrlc officers have exercised thr jNo tvoz}Cers' P. tFgict of exempliaa pet MC,i I I[]Pimaburepabs or addrliors I msnrauce rem T a l §I(4�,zed we Dave no I2�Roof tepzirs 1 employees.[No worms' 13.0� " aPP tSaLe>;rcksl oa: I�+sako gyp-b3m-once re�Q,) ' �EorReowaeswhos�bmitII�s�avitmdi�gty��A�S�g�'/01�� °aPat+c9�oa thazc��k&�6aorxmrsra2ack�fl�z�diaaaels)ce��[$ �votkaadrhrafivaotm4desoaC�a��{yQ�a��ud2vitmdi�sacTt i�aY°� ifthesubc�IIagnrsbaveempTsYus,�e9�ur °A/ t5eamaeoffarsn6-odnjrsaIIdstatewSetherortoi�oseentiflesbave gmvide tfiea svarices"cn xa all ." ��t��F�3�eT�tisprari�o7+�rTre�s'co � I ormertwn adog rr�ee orftsy em�vlvyeps.Bekv&rlie•Fol&7 and job site t --=a=Company Name: ar7�! Falic)2 or Self4ns..LiQ,#: site Ad G� Aplon I?ate g z� as/� Attach a copF o€ibewoaloz9 coat ' Fzz afin �mretoseccaecoverageas PFolieyaleciatationpage(slwwiagffiepo�cyaanaberand Eumd�'Sectioa 25A ofMGl:c Iz"2 can Ieadbo*e" po rwa of czamnal"�penahies crFa �e n sto$T,500.00 anchor one-year#pziso=mt asw'n as civilpenalties iafheform ofa SIGP WORK ofnp to S250 DQ lL daY%a'0sf tite violater. Beadvisedthat a ORDER and a to Ia iousof�eDIAfiar cecac• COPPof ssta�meotma�'befomm.dedto&eOfceof �v�ation. ; I do herevy cer is d aia18e4 a er' ',P fF .�f&at'fhe i�}or�ox,paovirled t8bove is Qadcvnrcf ate: anew --- O�Fa4ZuseonZy. D0AQf)WZZi'n1hT;arm,folec°rrrplgPdl}y'r yMtown offluaL CL'�'or raw= �'ermzYf�ieeuse# 1�5 .-AA15orify(d d iL one): �.Board ofHealih Z.I�dmgDepsrfatea4 3.Ciiyl7Cowu�7esic �d.Fdecbricsy � .S O}�IPT •erector 5.�Imabiz���� 3 CoIIficF3Pe35onr: Phase& i • I 1 . i FR4SCON-01 MOSU CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOOLJDIER 1Tils 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 cerUffeate holder is an ADDITIONAL INSURED,the poliicyges)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and condWons of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu ofsuch endorsement(s). PRODUCER (508)676-0309 Nc° FFT Suzefte Moniz Vrveiros Insurance Agency,Inc. PHONE 375 Airport Road Arc.No. :508-676-0309 (.Aoj[C,No:50S-324-9147 Fall River,MA 02720 ADD IRew-SMoniz Viveiroslnsurance.corn INSURER(SI APFORDING COVERAGE NAIC y wSURERA:Nationai Union Fire Insurance Com an INSURED Fraser Construction LLC INSURER 8• P.O.Box IM INSDRERC• Cotu)t, MA 02635- INSURFRD: INSURER E COVERAGES INSURER F: 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPE OF INSURANCE AD L POLICY F POLICY EXP LIMBS . ER MMIDD MM/DD GENERAL LIABILITY I WVD POUCYNUMB RENCE COMMEP.CIAL GENERAL LIABILITY S EACH OCCUR P EMISES Eaoaurrence S CLAIMS-MADE OCCUR MED EXP(Any ona pecsopl S PERSONAL&ADV INJURY S GENL AG GENERALAGGREGATE S AGGREGATE UMITAPpUES PER: POUCY jR LOC PRODUCTS-COMP/OPAGG S AUTOMOBILE IJABILrrY S COM3INED SINGLE LIMB ANY AUTO Ea actldent S ALL OWNED SCHEDULED BODILY INJURY(Per person) S AUTOS AUTOS BODILY INJURY(Per accident) S HIRED NON-0WNED ' AUTOS PP�acc end tDAMAGe S UMBRELLA LViB S OCCUR EACH OCCURRENCE S EXCESS LIAR ICLAIMS-MADE AGGREGATE S OED I I RETENTIONS WORKERS COMPENSATION S AND EMPLOYERS•UABILn 8 YIN Y X T CSL M OTH- A ER ANYPROPRIEroW,-ATNERADECUTIVE COOSS30601 9/26/2012 9126/2013 E.L.EACHACGDENT s 500,000 OFFICERIMEMBEREXCLUDED? ❑ N/A O(Myyandamry fn beun I EL DISEASE-FAEMPLO S 500,000 ESCRII ION OF OPERATIONS below E.LOISEASE-pOUCYUMfr S SOO,OOD DFSCRPTION OF OPERATSONS/LOCATIONS/VcZiICLES(A1ta0 ACORD101,AEdlgonal Remaft SeheduIG lfrmam space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 13owdoin Rd ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee,MA 02649. AUTHOFMIM REPRESENTATIVE ACORD 25(2010105) The ACORD name and logo are registered Marks Of ACORD D CORPORATION. All rights reserved. Fraser Construction, LLC <10' >CONSYRUCTION P.O. Box 1845, Cotuit MA. 02635 ROOFING & S ' SPECIALISTSEmail: fraser- construction@verizon,net www.fraserroofing.com FAX 1-508-428-0123 508-428-2292 HICL#112536 CS#97668 RE=ROOFING PROPOSAL Z DATE: �� r PHONE: l - j NAME: EMAIL: MAIL ADDRESS: JOB ADDRESS: FRASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Fraser Construction will include a 4 Star Upgraded warranty with the selection of any 30 year shingles or any Lifetime shingles. CertainTeed SureStart Plus- The extra measure of protection when a credentialed company installs an Integrity Roof System. 4 Star warranties have a 50 year Non-Prorated Coverage for any lifetime shingles, which will cover incase of any in warranty repair, Labor and Materials, any Tear-OH, and any Disposal Fees. Upgraded wind warranty available on the following products when special application methods are used. See description below and in the CertainTeed SureStart plus brochure enclosed. ASK US A-BOUT OUR OVFRHEAD CARE CLUB! Supply and Install- CERTAINTEED LANDMARK: LIFETIME WARRANTY CLASS A FIRE RATED,ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. . With a SureStart Plus upgrade customer will receive 10 year 130 mph wind-resistance warranty with sic nails in common bond area, Fraser construction includes sk nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. �c� Color: PRICE-$ 6 7q Initial 1 . Supply and Install- CERTAINTEED LANDMARK PRO: CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered,Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15 Year Warranty against ALGAE Containment. Landmark PRO is engineered to outperform ordinary roofing in every category, keeping you comfortable,your home protected, and your peace-of-mind intact for years to come with a transferable warranty that's a leader in the industry. With Max Def colors, a new dimension is added to shingles with a richer mixture of surface granules.You get a brighter, more vibrant, more dramatic appearance and depth of color. And the natural beauty of your roof shines through. With a SureStart Plus upgrade customer will receive 10 year 130 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. nn Color:A/4x �� ZKIR 17 9I�AA) PRICE-$ �J Initial ✓` 7� Supply and Install - CERTAINTEED LANDMARK PREMIUM: Limited Lifetime Warranty, 10 year sure start protection,CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter& CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$ ``j Initial Supply and Install - CERTAINTEED LANDMARK TL: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty, Wind warranty upgrade to 130 mph when CertainTeed starter& CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$ 7 Initial Recommended Options Recommended Options Con... i>� ���C' v Product & Installation Details Supply 8a Install — (Soffit Tenting) Hick's Ventilated Drip Edge or S» Aluminum Drip Edge with existing soffit vents. Smart vents over white drip edge. Protection against damage to the roofing materials and structure. The most effective system is a balance of air intake and exhaust that creates a uniform flow of air through the attic. This system creates a condition in which the roof temperature is equalized from top to bottom, supplying a uniform air flow along the entire underside of the roof deck. Supply 8s Install— CertainTeed Winter Guard or Carlisle WIP: (Ice & Water shield) (WIP- Water & Ice Protection) Waterproof Underlayment System (aft. on eves and valleys, 18" on rakes, walls, and skylights) Water and Ice Protection (WIP) is a self-adhering roofing underlayment used on critical roof areas such as eaves, rakes, ridges, valleys, dormers and skylights to protect roofing structures and interior spaces from water penetration caused by wind-driven rain and ice dams. WIP may also be used as covering for the entire roof to prevent moisture or water entry. Supply 8s Install - Surround, Underlaymeaat (A Typar Brand) A smart alternative to felt, it is water's toughest opponent, creating a secondary water barrier that reduces the incidence of leaks caused by storm damage, wind-driven rain, ice dams and worn roofing materials. It is a waterproof, synthetic polymer material that will protect your home against moisture intrusion. 3 • .Supply 8s Install-CertainTeed Swift Start C With self- adhering asphalt starter course on all eves, and rake edges. CertainTeed requires this product for Integrity Roof Systems and upgraded wind warranties. Supply & Install- Aluminum & Neoprene Soil Pipe Flashing Supply & Install-Ridge `lent - Shingle dent H High performance ridge vent with external baffle. (As recommended by CertainTeed) Supply & Install-Pre-Cut CertainTeed Hip &Ridge shingles Shingle Ridge meets the hip and ridge accessory requirements for the CertainTeed Integrity Roof System which is comprised of underlayment, shingles, accessory products and ventilation all working together. The Integrity Roof System is designed to provide optimum performance--no matter how bad the weather conditions are. (As recommended by CertainTeed) Clean & Remove - Debris from work area daily. PAYMENTS ARE DUE IMMEDIATELY AFTER JOB COMPLETION. Payment Schedule to be worked out prior to job. Payments accepted are: CASH -CHECK-MASTERCARD -VISA- AMERICAN EXPRESS r Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. SKYLIGHTS- Fraser Construction recognizes that all homes are not created equally, however, this is a constant, incorrectly installed skylights leak. Even a skylight installed days before can possibly leak during the installation of a new roof system. This being said, all quoted projects from as, as a qualified installer, will include an option for new skylights. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour,plus 20% mark-up materials. FRASER CONSTRUCTION Warranties the labor for LIFETIME of roof. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 yeais. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. 4 f Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should' carry fire, tornado and other necessary insurance upon the above work. We, if not iaccepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: d meowner Fraser Cons uc ion, LLC For cos ay-use on Date Da to Received Date Started: Date Completed Job estimate: Dean/Mike # of squares: Billed Material ordered Extras Paid Available Discounts i 5 oF� row Town ®f Barnstable 3-PerEt# O� Expires 6 months fro issue date $ Regulatory Services Fee BARWrANA Vki Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner Q 200 Main Street,Hyannis,MA 02601 C www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 IEXPPXSS PERAUT APPLICATION - RESIIBENTIAL ONLY Not Valid without.Red X-Press Imprint Map/parcel Number -1 Property Address ` WS ❑Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address SINM 1AIS Contractor's Name s Se nr,4} � —; .� L C C- Telephone Number_(Soft)4 ?8 Home improvement Contractor License#(if applicable) Construction Supervisor's License t(if applicable) 8 ff Workman's Compensation Insurance X-P R E S S PERMIT Check one: ❑ I am a sole proprietor I am the Homeowner DEC 2 0 2012 I have Worker's Compensation Insurance Insurance Company Name l nsur Y1 jaa>nr BARIVSTABLE Workman's Comp.Policy# 1nfC abQ91�fob f Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) IN Re-roof(stripping old shingles) All construction debris will be taken to �;ay-V_Aw(Mo\ ❑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 pennir does not exempt compliance with other town department regulations,Le.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 req SIGNATURE: QAWPFMESTORMS1b umg permit forms�FXPItESS.doc Revised 090809 The C'ormnonwealth o,f'�ygassachreset& t DepwmxW 0f1fidtrat4ad.R1cide.4 i Office Of Invesfigations 600 Washbwan sbeet Boston,NA 62111 wW-fi2ass gov/din i Workers'Codnpensatioa h urance gnformation 'BunderJContraetorsMIectriciansJPltimbers ' Name Please 1PriatIV (B Qrganrzaaonllrrdividnai): -`l'"a se Y_ (fons-M� Ate' City/SsatelZip: RA 4?b3S Are sa emploYM'Check the appropriate bog: Pbone#' I.[ Yam a employer vi t`d 5 e n i am a general caatracxor and I $yPe of project(Iqui ed): I employees(full and/or pmt time)* have trued the sib E. 2.�]i am a sole proprietor or partner- listed on.the attached New con ;on strip and have no employees These sub-contractors have �' ❑Remodeling f work�g for me is any caps , employees and have woticers' 8 Demolition LNo workers'comp-i:uscaance camp insUr ace Y 9. Q Bailding addition �1�ed-J 5. We are a corporation and its 10.Q Electrical repairs or additions 3.[�1 am a homeowner doing all work officers bave exercised tires• myself.[No workers'comp. right of exemption per MCL I LEI Pltmrbing repairs or additions insurance recgrited I f c 152.§1(4)>and we have no 12-El Roof repairs employees-(No workers' 13.0 O& Comp_msumnce recprired] I Ho eowcaut hosuukthox#!n=alsofillouttheserttoabacwshowirgtheirwork , PHoraeowaets who sahaoit this aft&S-ting fitey are doing an work and rhea bite outside as potieg won r tGbnhaamrs tha awkv&boot ra=Wtacbg=addidaoal sheersh wad'=tmlb® anewaMdavir indicatitlg such._40Yees Ifthesub-confiners-hWe=Ployec,they��ethem Wasters-comp esab eontt�porsaadsra�whetberornot23toseentideshave P07ioY number. d am an employer thous prvvi4mg werAm,conrpensadon aurrrance or i btformalfon f my employees,-Below is thepolicy and job site i .l'nsruance Company Name: Policy#or Self-ins.Lie,#: GlJ C O[ 38 1�tpirationDate: Ocj z<6 ago/� j Job Site Address'- Attach a copy of the��orkm'coarlrensation policy declaration City/State/Zip:��< Farltue to sec[ae coo as re page(showing the Po�Y number and expiration date). e 4 tm�er Section ZSA of c 152 can lead to the imposition of cr iminal fine rip to$1,SQQ.00 and/or one-year impasomnertt as well as civr7 _ Penalties ofa Of up to S25Q.00 a day against the violator. Be advised that a copy of Qs s[atement Ma STOP WORK ORDER and a fie Investigations of fire DIA for imstaance coverage verification- y tO the��of I do hereby certi dpenaldes ofperjury Char•the&formation Si provided above is true and correct one#: M +� ate: ® Z ! o$Cfal use only. Do not wrke in this area, he Qa;to c orrrpletedby cr3y or town official Cary or Town: PermiVUcense i Issuing Attth*r*(eircie oIIe): L.Board of Health 2 ,ridding Department 3.City)Town Clerk 4.ElectiialinspedtorPlumbitgS Other Inspector If1 ' Contact Person: j Phone#; f FRASCON-01 MOSU �- DATE(Mr,3n12 ) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. IS 1 H 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 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 (508)676-0309 NAME: Suzette Moniz Viveiros Insurance Agency,Inc. PHONE 375 Airport Road ruc.No Ext:508-676-0309 FAX Noy 508-324-9147 Fall River,MA 02720 lL ADDRESS:SMOniz Viveiroslnsurance.com INSURERS)AFFORDING COVERAGE NAIC INsuRERA:National Union Fire Insurance Com an INSURED Fraser Construction LLC INSURER 6: P.O.Box 1846 INSURER C: COtult, MA 02635- INSURER 0: INSURER E: 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. LnTR TYPE OF INSURANCE DL 3UR PO Y EFF POLICY u, GENERAL LIABILITY IN SR WVD POLICYNUMBER MMlDD MMIDD LIMITS S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE-Q PREMISES Ea occurrence S CLAIMS-MADE OCCUR MED EXP(Any one person) S PERSONAL&ADV INJURY S GENERAL AGGREGATE S GENL AGGREGATE UMIT APPLIES PER: PRODUCTS-COMPlOP AGG S POLICY PRO- LOC S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S ANY AUTO BODILY INJURY Per person) S ALL OWNED SCHEDULED ( P ) A�OS AUTOS BODILY INJURY(Per accident) S HIREDAUTOS NON-OWNED AUTOS P RTY DAMAGE S Per acc dent S UMBRELLA LUIB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE g DED RETENTION S WORKERS COMPENSATION S AND EMPLOYERS'LIABILITY X T RY L MITE OER A OFFICEERIME BEREXCLUDED?ANY ECUiIVE Y❑ N!A WC009930601 9/26/2012 9/26/2013 E.L.EACH ACCIDENT S 500,000 (Mandatory in NH) Ifyes,describe under EL DISEASE-EA EMPLOYE S 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION • SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fraser Construction LLC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 31 Bowdoin Rd ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee, MA 02649- AUTHORIZ�ED_R_EP�REES�ENTATIVE ACORD 25 2010/05 ©1988-2010 ACORD CORPORATION. All rights reserved. ( ) The ACORD name and logo are registered marks of ACORD i Office of Consumer Affairs and VUSness Regulation 10 Park]Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement COI;t' : tor Registration Registration: 112536 �. Type: DBA Expiration: 3/23/2013 Tr# 209024 FRASER CONSTRUCTION CO. DEAN FRASER P.O. BOX 1845 COTUIT, MA 02635 Update Address and return card.Mark reason for change. E] Address ❑ Renewal Employment Lost Card OPS-CAI Co SOM•04104-GIO1215 �,,��� OfSce�f'Lo�i me'r�'l�a�i�'!§izsines�s egu a`0 13 License or registration.valid for indlvidul use only \ HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 112536 Type: Office of Consumer Affairs and Business Regulation 10 Fark Plaza-Suite 5170 Expiration: 3123Z013 DBA Boston,VIA 02116 WFR CONSTEWCTION.CO. DEAN FRASER 104 TWINN VIEW aNE E FALMOUTH,MA 8i:536 Undersecretary Not vale wit ut si re ' "iissathusett§- of Public`SafetN' Board of-Building Regulations and Sttin/dards . Gohstrudion Supervisor License -License: -CS 97668 �.;, •.os,::,•rig: '.;':'Fz DEAD . $ R .4, 104 N111f� !Ilf=1f�:`•�F[JE 4 EAST PALfti`6(itilA 62536 Expiration: 817/2013 Commissiosii r' Tr#: 16692 Fraser Construction, LLC CONSTRUCTION ING P.O. Box 1845, Cotuit MA. 02635 ROOFING SPECIALISTS' ' Email; faser_construction cc verizon.net �vti�-w.fraserroofing.com FAX 1-508-428-0123 508-4Z8-2292 HICL#112536 RE-ROOFING PROPOSAL DATE: �'�, c� / PHONE: NAME: <3 AJI '�� (. Gr "i— EMAIL: �/ ('�e�� e2�:_c..e AK , MAIL ADDRESS: JOB ADDRESS: FRASER CONSTRUCTION hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Fraser Construction will include a 4 Star Upgraded warranty with the selection of any 30 year shingles or any Lifetime shingles. CertainTeed SureStart Plus- The extra measure of protection when a credentialed company installs an Integrity Roof System. 4 Star warranties have a 50 year Non-Prorated Coverage for any lifetime shingles, which will cover incase of any in warranty repair, Labor and Materials, any Tear-Off, and any Disposal Fees. Upgraded wind warranty available on the following products when special application methods are used. See description below and in the CertainTeed SureStart plus brochure enclosed. ASK US ABOUT OFAR OVERHEAD CAS CT IMF Supply and Install - CERTAINTEED LANDMARK: LIFETIME WARRANTY CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. . With a SureStart Plus upgrade customer will receive 10 yea:. 130 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color: PRICE-$ Initial 1 Supply and Install - CERTAINTEED LANDMARK PRO: CLASS A. FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi- Layered,Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15 Year Warranty against ALGAE Containment. Landmark PRO is engineered to outperform ordinary roofing in every category, keeping you comfortable,your home protected, and your peace-of-mind intact for years to come with a transferable warranty that's a leader in the industry. With Max Def colors, a new dimension is added to shingles with a richer mixture of surface granules.You get a brighter, more vibrant, more dramatic appearance and depth of color. And the natural beauty of your roof shines through. With a SureStart Plus upgrade customer will receive 10 year 130 mph wind-resistance warranty with six nails in common bond area, Fraser construction includes six nails in common bond area at NO additional cost. See actual warranty for specific details and limitations. Color:A114x YbE�A A)A PRICE-$ '71 1�? `J`' Initial ✓ I Supply and Install - CERTAINTEED LANDMARK PREMIUM: Limited Lifetime Warranty, 10 year sure start protection,CLASS A FIRE DATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty Wind warranty upgrade to 130 mph when CertainTeed starter& CertainTeed hip && ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$ c�"Initial Supply and Install - CERTAINTEED LANDMARK TL: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, triple-layer thickness, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 15-year Warranty against ALGAE Containment. 10 year 110 mph wind-resistance warranty, Wind warranty upgrade to 130 mph when CertainTeed starter& CertainTeed hip & ridge are used. See actual warranty for specific details and limitations. Fraser construction includes six nails in common bond area at NO additional cost. Color: PRICE-$ �j c6 Initial Recommended Options kz-p,-_4� CC- q ,. .02 .�° Recommended Options Con... Product Installation Details Supply 8s Install— (Soffit Venting) Hick's Ventilated Drip Edge or S" Aluminum Drip Edge with existing soffit vents. Smart vents over white drip edge. Protection against damage to the roofing materials and structure. The most effective system is a balance of air intake and exhaust that creates a uniform flow of air through the attic. This system creates a condition in which the roof temperature is equalized from top to bottom, supplying a uniform air flow along the entire underside of the roof deck. Supply 8a Install—CertainTeed Winter Guard or Carlisle WIP: (Ice & Water shield) (WIP- Water & Ice Protection) Waterproof Underlayment System (3ft. on eves and valleys, 18". on rakes, walls, and skylights) Water and Ice Protection (WIP) is a self-adhering roofing underlayment used on critical roof areas such as eaves, rakes, ridges, valleys, dormers and skylights to protect roofing structures and interior spaces from water penetration caused by wind-driven rain and ice dams. WIP may also be used as covering for the entire roof to prevent moisture or water entry. Supply Install — Surround Underlayment (A Typar Brand) A smart alternative to felt, it is water's toughest opponent, creating a secondary water barrier that reduces the incidence of leaks caused by storm damage, wind-driven rain, ice dams and worn roofing materials. It is a waterproof, synthetic polymer material that will protect your home against moisture intrusion. 3 + Supply & Install- CertainTeed Swift Start m With self- adhering asphalt starter course on all eves, and rake edges. CertainTeed requires this product for Integrity Roof Systems and upgraded wind warranties. Supply & Install- Aluminum & Neoprene Soil Pipe Flashing Supply & Install-Midge Vent - Shingle Vent II High performance ridge vent with external baffle. (As recommended by CertainTeed) Supply & Install- Pre-Cut CertainTeed Hip & Ridge shingles Shingle Ridge meets the hip and ridge accessory requirements for the CertainTeed Integrity Roof System which is comprised of underlayment, shingles, accessory products and ventilation all working together. The Integrity Roof System is designed to provide optimum performance--no matter how bad the weather conditions are. (As recommended by CertainTeed) Clean & Remove - Debris from work area daily. PAYMENTS ARE Dl.i"E IMMEDIATELY AFTER JOB COMPLETION. Payment Schedule to be worked out prior to job. Payments accepted are: CASH -CHECK- MASTERCARD -VISA- AMERICAN EXPRESS Any payments not immediately paid upon job completion will be charged 0.005%for every day after the given 5 day grace period upon day of job completion. SKYLIGHTS- Fraser Construction recognizes that all homes are not created equally, however, this is a constant, incorrectly installed skylights leak. Even a skylight installed days before can possibly leak during the installation of a new roof system. This being said, all quoted projects from as, as a qualified installer, will include an option for new skylights. Possible Extra-After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$6.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. Possible Extra-Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$75.00 per hour, plus 20% mark-up materials. FRASER CONSTRUCTION Warranties the labor for LIFETIME of roof. FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. 4 Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements confingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: ;5? J a meowner Fraser Construction, LLC For co"Wany nse only.- Dcde Received Date Started: Bate Completed Job estimate: Bean/Mike # of squares: Billed Material ordered Extras Paid Available Discounts 5 OF`HE Tp�y Town of Barnstable *permit Expires 6 months from is uP date Regulatory Services Fee >lwxrtsTnatE Thomas F. Geiler, Director MAss v g V t679. Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 w-, w:town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid withotit Red.\-Press Imprint Map/parcel Number 7Residential ertyAddress U r Value of Work " �U U Minimum fee of$25.00 for work under $6000.00 Owner's Name & Address Li-4v � Contractor's Name U - M� A)S 6C t 111 Telephone,Number �- 7i 7 C� Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance Check one: Vam a sole proprietor X-PRES RMIT am the Homeowner 4�have Worker's Compensation Insurance SEP 2008 Insurance Company Name ��� Cum �`�� � 'd'CWN OF BARNSTASLE Workman's Comp.Policy# V Copy of Insurance Compliance Certificate must be on file. Permit Request(check.box). ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Replacement in s/doors/sliders. U-Value y l (maximum.:44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign.Property Owner Letter of Permission. A copy of the Plome Improvement Contractors License is required. SIGNATURE: Q:\WPF[LES\FORMS\building permit forrns\EXPRESS.doc Revise020108 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invesfigatians 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Tnsurance Affidavit: Builders/Contractors/El ectrician.s/Plumberg Applicant Information Please Print Le 'bl N e (Busincss/Organisation/Inciividuan: D t ` �&S 0 c- 11 3 Address: h,) . City State/Zip: 0on-S 0 c-tt4- a �`' oaWphone.#: � �° 7t 6(1Qv Are ou an employer? Check the appropriate boy-: Type of project(required): 1. I am a employer with �(� 4. ❑ 1 am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the shb-contractors 2_ElI am a'sole proprietor or parincr- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition erDployees and have workers' working for mein,any capacity. $ 9. ❑ Building addition • . [No workers' comp.•Mgurance wrap.in r-orpoe. 10 Electrical repairs or additions rtmtir�] 5. [] We arc a corporation and.it, ❑ p 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself; [No workers' comp. right of exemption per MGL 12 f repairs insurance required]t c. 152, §1(4), and we have no 13. Other 1^(�tmO�Ir en�loyees. [No workers' �� snip insurance required_] L *Any applicant that check box#1 tvnat also fill out the axtion below sbowing tbcir woricas'coropaisation policy infmrration- t Hmncowocss who submit this of tizvitindicafmg they are doing all work and thrn hire outside contractors must submit anew of tizvitindicating such lcontractms that check this box nest art uhcd an additional sheet showing the name of the sub-eanhactam and state whether or not those,entities have employers. If the sub-conhvctms have avplayccs,they must pruvidb their woTkm 'arrnp.Policy number. I am an employer that is providing workers'compensation Enguraitce for my employees Belowis the pofiry and job site information. �-QG CU �. WLJ \l J 4-v et• Insurance Company Name_ 75 SExpiration . U 0 Policy#or Sdf--ins.Lic.#: D atc: D Job Site Address: OUT City/Statc/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to 31,500.00 and/or one-year uIIprisonmcnt, as well as civil pcnalties in the form of a STOP WORK ORDER and a fine of'up to $250.00 a day against the violator. Be advised drat a copyof this statr=iit maybe forwarded to the Office of Investigations of the WA for insurance coverer c verification. Ida hereby certify under the paba.and penalbis of perjury that the information provided above•is true anal correct Phone#: q0 . � ��- 104U0 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Tsgtdng Authority(circle one): 1.Board of Health 2.Building Department 3. City/Towu Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other r- vo Phone#: Sep ('12 08 CJ7:5Ga Michael Bedard 1-401 -2,"S-28i-3 Fa)dD: To:Denise 0,11m:9117.-'07 I:L'.PW Insurance At:Hinter Insurance,inc- f.'IF-ID 1H A C tyeLt -E OF LIABILITY INSURAN(3, THIS MIRTIFICALTEI-9 ISSUED A8' RouUM! ONLY AND CONFERS NO RIGHYS,UPON CERTH HOLDER.TH18 CERTIFICATE DOES NOT M-A END,E;(',E141 ),t,T l-vorar-cf.. InC ALTER'T-.HE COVERAGE AFFORDED BY VKE 13OLIC:1 3 L , ,139 Old Td_'e-: 028.-j:3-0001. INSURERS AFFORDING COVERAGE -vc:4 01-7169 Lr 4E f;g 114.LIIER I ff,wl—1 co o o imSLMER B ino'--b Coo IMURER C* --sen of RX by 36.ndt, Eas,F: D- rLv.-, 111SUREAD. INSURER E: ------- ISSUED TO THE INSUREDNAiviEO ABOVE FOR 1VE POLICY PERIOD-INOICATeD.NOrWI-,1-iSTM:)I1-`; jj,SIpAix--t:S-WBEL�)`W�WIE BEEN RArT OR 0—DOWAU"T""TH RESPECT TO wHICH THIS rEPT1FIcQ-E MAY Be ISSUED OR ANY 171:d.]M%i:Nr Tumt or(':XDmON'-IF MY C�tr ",ECT TO ALL DIE 7EMIS,EXCLUSIO?,,S MO COKOETIOP*OF s.ICI .,,;,jP.�WZ-AFFORDE(-UVVE..M,ICIESDpscneebHErEIN is POLICI r LL)I, E3 LIMM7��gjWWWy)IkVF-BES14 REDUCED By PAID CL11f r., PODGY NUMBER DATE I WVWM DATE(Wi NS. C.b0l ME OF.5�:S_UqAtACE EACH 0 -zw�ERAL LvBf.FTY LaPS26619 09/16/o7 09/15/DV -PRE:1AsE-1-LEmsw*-s) :Efi)EXP A. o.pwm-) OCCUR PERSONW.S"0"IKUIRy -f 1011 ?.0.:.a C, CY ';-- - I;: LIM'T AL' J-10- o9"rJ.61()o (S. W,AJ- BIS26619 og/16/0'1 JA EKV:)ILV If-JEP:-f 30:E[)-A.ED:JJTC-3 Do-Ky 1H:;v-,r .[P,r IJU.01WED I.11.)S _=�..—. ---•-- — AUro ONLY-G!-AccICLI`IT t;ABILT" VEWER At I I1rt0 AUTO ON.T IVI( 1)0 L C 09/16/07 09,116108 7:W rx x, CLAU-S Ivoc ClUS2663.9 A 3 1110 00 pr,.v_,4 n ON Fx fo-r(7N AND V.�rwc cc.m7..tj 10/01/07 JO/DJ/108 El. EAr- A(;r.TC1ENr B 28S$6 'im PR"-r;m.,:cRipotRTr4r'-V.-TxEmr;VE E OISEAC-r EA Emwrto" 0 DISEASE POLICY L1111 (�n I C D----- DESCFI; j&j _s IE cLLTS ON AD ED 8TENoQAGEv6/Sp=— CER CANCELLATION TI F�Cfi-.E I-XILD EF., SHOULD ANY 0 F THE AD OVE a ri;�cRIBCo PoLk FM-31-CJU4CELIr:*19 E 71NO is X:I HOOKASS DATE THE.REOF,T"o.Ita UING INSURER IME.I.6 t OW 110 R TO WO L f'-:' dt.-m NonCETOTHECERM1 AT9FtOLDERNIIAIEUT071iii'-EFT.9137 clj:z,. %)v Andlizzen iMP064NooBLIGArONORLIABILrTYIDFAtIYI,:NULI-011TFiEft4t 21.ajiit Drive! REPRESVWAIMQ. 0209S ATIVE ` - ng Reauiations ,nd Standards FI�IVIE IMPROVEMENT CON7RAG 'flR �' t� c� 4 119535 Fegiti�atio►�: 7/24/2009 ' Tr# 130185 f TYPE Private CoCc�rpO,ration MOON' a��ODC ijiC � r JAMES 1 IV PARK FAST ok � Adininistra.+.or I I r • r Al w ,-Tt g�. f gam. .REr a. fig• y » m Floor Plan G 8� •3 �O ^ •o ID Numfmr _ -� 8 tU�wf`� �6 � a �- v l gg �3��, d �.gw'4f1 ff <.M,�4o t g�.Q.P• �. �' pp m0 g n 8 a= n '. n duct style i a+ _ 11 it g r Q'�R.q a '9^ Frame Type Qb S a� '-b � -•b factory Applied t t].» tt'� T T 11 Bridcmouid B + n c �� rr 8 ^ s n o y R y A Actual Width In Inches S $• B' B to the nearest 1126' Fr " A R Actual Height In Inches m E n o 5'r S� to the nearest tlt6' I3 +� to•,g, c ag o^, C• „� sill An9le a ��g it na r'maF] -a lac IL OMp I ^ac i$p� Mullion sequence CD g•��� % •g•R E IILL� Sash ratio k CD a Color Exterior F-w .mot —}-�8 '�� M ) � `( � Color interior �� g,� �••1 '��111 1 wxnFr cv r«u,nF r 53� GiYxing y C1 C. p Giaxing n 9 n°c "° o Q Sash Lifts or Pulls ' n n 2 _ foawxanrw.�yasere a '� � \ sash Locks per Sash O � s D ar.mx a.rww,p'frwF. ' nr o rYtw,M NCi � c Hardware 0ptlon A 'a b0c Fmsont tern(Mlo(my.n f S,y C1i � Fa+.edrt«ew..�m>n � d E �",is 11 Sveen IXep��. t s..n.«..e>d. e "Cj Grille Pattern C.bau'9n.�na"'00� i= 9 k, r s ^ Grille Type w Q aFa rn y J sn Grille Profile Z 0 ir n st s3 tr of Liles W(Je t ^ Stls3 .. •t' of Uts HIGH - O N p e \ I ( If of Lit es Wide b = t ! sz 0 of"s High pti J o � W \)A Estimated Aa Width N❑. K W< 3 � fig ' 4 m lr,. �^ o Estimated •'.� SE \ \ \ Height CazingMethod Cwasin?S�tyieZra --- X for Special Order Engineering Dept. (3r oor) Map Zc�7 Parcel. jj3q FJ5 Permit# �o q- House# Q 4=JJ DateAsued A Board of Health(3rd r)(8:15 -9:30/1:00-4:30) K0 /d Fe¢jtp,01 O Conservation Office(4th floor)(8:30-9:30/1:00-2:00) G ®Slv 6 0 B� Planning Dept.(1st floor/School Admin. Bldg.) . Q Definitive Plan Approved by Planning Board 19 .. AID 4 BARN-A�L6t� ➢� fD MA.S TOWN OF BARNSTABLE Building Pe rApplication fy( a�, ;? Project Street Address Village 7-6 Owner Address Te ephone ` Permit Request �X 3 , First Floor �, `� square feet Second Floor square feet Construction Type Estimated Project Cost $ ���p y pry Zoning District Flood Plain Water Protect on ) Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family b/Two Family ❑ Multi-Family(#units) ~' Age of Existing S;7ull a C,t/ Oistoric House ❑Yes X-No On Old King's'Highway ❑Yes �'N0 Basement Type: ❑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 b ): Existing New First Floor Room Count Heat Type and Fuel: ❑G Oila s ❑Electric ❑Other Central Air ❑Yes No Fireplaces: Existing New Existing wood/coal stove es ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) V❑A ached(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 � S��/ Telephone Number"��/S Address o2ct License# cs-a (iVt j:) CZZ n 7—,r—K—J Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ��=nz DATE §UI DING PERMIT DENIED F THE FOLLOWING REASON(S) � ►� , L ........ 0 �� R FOR OFFICIAL USE ONLY PERMIT NO. , DATE ISSUED- MAP/PARCEL NO. ADDRESS 1 VILLAGE r OWNER DATE OF INSPECTION:' FOUNDATION FRAME INSULATION r '. EIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ':'_;^ ROUGH FINAL FINAL MILDING DATE CLOSED OUT , ASSOCIATION PLAN NO. _ t , - i -- - ---------"- —-- . ..........__......... — o � s4 t ul J S o d . s Y co I S j , co �I i - I i a� � ry} moil SA r- I N c1FTMe -� The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissions For office use only Permit no.__ Date AFFIDAVIT HOME HVIPROVEMENT 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: 16 X 2�—? 4SJ.L a-0?vyJ Est.Cost _'000 Address of Work: 3 s ��ei.✓2_. ✓ S ` Owner's Name Date of Permit Application: •2 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 agent of the owner. 7;77 Date Contractor Name Registration No. OR The Coninton ivealtlt of Atassac h Uscas Departinent of Industrial.9ccidents OMeo//nyest/ga1/offs 600 11'ashingtonStreet Boston. Alas. 02111 Workers' Compensation Insurance Affidavit al�nlic:irit information: ^� Plcise PR(1VT'le �j`•_'"�"`"'"�'— "�'—�r ••�'�� --��� ~- - nlmc* Ec�� Inc•ttinn• �� ,� (.c�0✓Gt�•Sr'L� ��'c- city �� .e.� � eo nhtme 0 rJ I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity O •..� w.��•�.7rrw...s++s.�lr•w..n+•ltr!r+�"�q.� .. ..�.i.�w.�.�.�.....�.r+.....�.+..•q..•.....�...►..w.•..��....���..... I am an employer providing workers' compensation for my employees working on this job. comnam• name: /�� ��_ Opp /���� address: t wC.� CC ,K7 !mil/CJ-- . city: // phone!t• J insurance co. noiicv$0 0 ��Q to 6' �• / G¢ ['l I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the followin_ workers compensation polices: cmmyam• name: addresr. city: _phone fl• insurance rn noliev N comnnov n•tmc• add ress: rite: phone insurance co policy N Attach additional sheet if neccs_sary���.� _i �'di yy.'��_ _•!I �� _'1�: ^` —�.... `+ +C"^a:`_ Failure to secure coverage:is required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 a ndiur une tears' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a dad•against me. 1 understand that a cope of this statcnteut may be forwarded to the Office of investigations of the DIA for coverage verification. 1 do herchv cerrif.ruuler the rips and enaltics o pe 'uty that the information provided above is true and correct. S i_nature Date /CJ Print name TV Phone# C� ..+..`.rc—y - 'romciai use univ_ do not write in this area to be completed by city or town official T� sit%•or town• permit/license# ntluilding Department Licensing Hoard check if immediate response is required aSeleetmen's Office F C311calth Department contact person: phone#: nOther Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the employees. As quoted from the -law". an emploree is defined as every person in the service of anotlicr'under am• contract of hire. express or implied. oral or written. An eynplurcr is defined as an individual. partnership, association, corporation or other legal entity. or ally Iwo or Inc. the foregoing_ crignued in a,joint enterprise, and including the legal representatives of a deceased emplover, or the receiver or trustee of an individual , partnership, association or other legal entit)�, employing employees. However tl. owner of a dwelling_ house haying not more than three apartments and who resides therein, or the occupant of the dwcllin`, house of another who employs persons to do maintenance , construction or repair wort: on such dwelling_ he or on the `_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioye ate or local licensing agency shall withhold the issuance or MGL chapter 15'_ section :5 also states that even st renewal of a license or permit to operate a business or to construct buildings in the commonyealth for un• applicant ,%yho has not produced acceptable evidenceof 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 been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to ;your situation ana supplying counpany 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 require: 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 legible. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have an,. questie please do not hesitate to give us a call. I 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 fax r#: (617) 727-7749 r.t�nnn.1?• (ri7) 777-490n p.t_ 406. 409 or_37_5_ hqTl 3a >R isat.it�n A.T����CD �D�y S.I •: JfFr166t07s » r�s TCHE1t'Ot NER 0t; s ,noMiNis�an7op� �apl�ogthA g2549��"'T`�L - �`� . DEPARINENT OF PUBLIC SAFE0 CONSTRUCTION.SUPERVISOR LICENSE Ausber ~Expires: ...Restrided jo: 16 - FRED.-3 FISHER 205 NORCESTER ST FALHOUTH, HA 02540 L : � . , �. � , � � / i1` • `, _ , U •� ��,� � � � �+ � � i ♦ !� t� � ��i �� �� ��� J; , ` 1 � � ....� �� � 1 � � � �� � � � � � �. � .� � I � 1 ��� � � r � .,1 ►i �. . . �. i� �� �! l �. / � � �I � I ��� ..- . . . . � �� jam~ ���� ��� �� � � � � � �� '� XftlIbe mm box a a c yp _ as P rs e� 43 4 4 7 r of u -3/8 d stone. a Existing * Leochhn syetem / 100.65 T. l 3 43 s i 88.9 LOT ,,, 4 5 Cb 2097 �1 SF. 68'` 88. 8 44 1000 Gallon septic tank / lo- 46 ,�.Foundohon 6 Xd Leaching N pit with 2'of stone — Distributi n 32 63'± O all around box M 168' to ro osed well 26' am �. Well B6. to' Off_ •.� � n. - Reserve area. tee• 147 Z•Proposed Well B.M.8 3 067— _ 16 3.7 2 i BB C.Basin g4 3 85 4 86 . SPUR c Private 40' wide ) L A N E I CERTIFY THAT THE FOUNDATION, WELL AND SEPTIC SYSTEM ARE LOCATED ON THE LOT AS SHOWN-'AND THAT THE LOCATION OF THE FOUNDATION CONFuRMS TO THE MINIMUM SETBACKS OF THE O TOWN F B RNSTABLE ZONING BYLAW. hOWZ3/900 A -NOTE *. Date Registered Land Surveyor 1) A COPY OF THESE PLANS MUST BE KEPT ON THE SITE DURING CONSTRUCTION. 2) A COPY OF THESE PLANS MUST BE FURNISHED TO CONTRACTOR CONSTRUCTING SEWAGE DISPOSAL SYSTEM, 3) BEFORE BACKFILLING THE SYSTEM,THE CONTRACTOR SHALL NOTIFY PHILI P D.HOLMES AND THE BOARD OF HEALTH AGENT TO INSPECT THE SYSTEM AS CONSTRUCT PLOT PLAN _ FOR JOSEPH POLCAR 0 0468sheef 2 IN MARSTONS MILLS BARNSTABLE, MASS. SCALE:=40' DATE': &AY 245 � DRAWN BY RS,.1 CHECKED BY t PHILIP D. HOLMES c CIVIL, ENGINEER LAND SURVEYOR 301 MAIN ST_ FALMOUTH. M4s.S N 7A 4A nwr_ s14 0 Assessor's offioe (1st floor): ;.. Assessor's map and lot number ... .7....`��.; .':.... ' SEPTIC SYSTEM E'.,3c,. Hof T"E ro` Board of Health (3rd floor): INSTALLED IN CORC,; Sewage Permit number ............... WITH TITLE F. = BARESTGDLE. LvT V Engineering Department (3rd floor): S' ENVIRONMENTAL C 'oo 2639 House number .................................... d... 1)L r-. e, A.POLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING .^INSPECTOR T p . APPLICATION FOR PERMIT TOl� If' ....... �/.. itlCdl !V .11�/........ TYPEOF CONSTRUCTION ..........,(/Of--1 ........:....................................................................................... p ...............f..�........---..............19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............S...Plz12..:.. k.'4....... .!ti .� S....11�!.t.1,.,5............................::....................:............................... Proposed Use ............................................................................................................................................................................. . ZoningDistrict .............._...`.......... .................`..............................Fire Distriic�t .....C...n.................................................................... .. Name of Owner ..:. t'T ......1✓. oN.N.E.ILy................. ........Address .....L[t�ce ....Im 1�?� S yht��5 ��c45 � S �� �.�.✓lt0b ?l 2 n 1 Name of Builder ..............j��.C.J1.1.1.. $.7/ $......%fit!L..... ...Address �.i '.....h�V� 4'S....� . ..... ......�i. K.`t. is.... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .Ql.... .......... .......f .�i:{. ...................Foundation .............................................................................. Exterior ...... .....................................Roofing �-n il,! . .............................,.. ................................... Floors ......................................................................................Interior .................................................................................... Heating ......GLc.................................................................Plumbing .....Vh,.r....... .4:�. .............................................. Fireplace ..................................................................................Approximate Cost ....... 64.0...... ...... Definitive Plan Approved by Planning Board --------------------------------19-------- . Area !..��.. t .! Diagram of Lot and Building with Dimensions // Fee ......1.................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name f ... /� /, -7 Construction Supervisor's License 0455 �J... .................. DONNELLY, PETER No ... Permit for ....Build Dormer ................................ Sin .le Family Dwelling ............................................. Location ....3qjj?:tAr..L.a.ne.................................. Marstons Mills ............................................................................... Owner .......Peter...D o..n.......n e 1..1.y.............................. .... . Type of Construction ...,Frame............................. .......... ............. ................................................................. Plot ............................. Lot ............................ Perrnit'Grantecl .......AiAgus.t.J...............19 86 Date of 'Inspection ........ .......19 Date C mpleted .............�/"" ;..F :7 0 . ..............19 Assessor's offioe (1st floor)- THE Assessors map and lot number ... .......... T Board of Health Ord floor): Sewage Permit number ......... �. ..�... Z BAUSTADLB. i E gineering Department (3rd floor): T 4` _ ° rasa 16}v House number .3v A.... ° 0 '0��MAY a. 'APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only. TOWN -,OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..:. � C..S....... TE .....//llC( ✓.��........................................... TYPE OF CONSTRUCTION ............./... ..........-....................................................................................................... ............ .. ./...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. ...SPv. .:... �'.'�- .......V. ...1....g .IL`�I(5...j!!1.\1. 5.................................................................................. ProposedUse ............................................................................................................................................................................. ....................................................Fire District .............................................................................. Zoning District .......D........... {� ,�-I 1 Nome of Owner ....4.� .....1✓�.N .lw.l.t v ................ ........Address S 5 U F2 L4�c e (�QS jotnC- l�►c.............................. ..............................�5 Name of Builder < . �d /F l!,S„ �ii ....... �( 1�1�Gti7rrs..... .5��1�....�1�.�,..$.�`........�1.1�'.C...........Address ............. ........... .... . . Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms . ....M..........�.......� �c.{."�...................Foundation .............................................................................. Exterior ......��. �.......5�.�ll(. .�.e. .....................................Roofing �-� .�0(,4- ................................................................ Floors ..................................................................:...................Interior .................................................................................... Heating ......��C..................................................................Plumbing .....0l;E.......!..J[�� Ll .......................................................... Fireplace .................................................................Approximate Cost ...... .� .. Definitive Plan Approved by Planning Board __________________________ v 19 Area ........... .. .�...0 .! .,.. Diagram of Lot and Building with Dimensions Fee ...... ....................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of .Barnstable regarding the above construction. Name .../.............. .. ..................... ..................... .... t. Construction Supervisor's License o/5� ......t...... DONNELLY, PETER A=027-034 No ..... Permit for ..Pu.i.1.d..D.p.r.rqe?;........ Single, Fami ..D 11ijig.............. Location .... ................................... ..................Mar s.t.o.n s..Mills.............................. Owner ...Peter D.o.ne.11.v....................... .. Type of Construction .Frame.............................. .................................................. .............................. Plot ............................ Lot ................................. Permit Granted ............ ............19 86 Date of, Inspection ......................................19 Date Completed ........................................19 �o/"/pL z- Assessor's map and lot number �' '� `� -- �� C`...................................... Qy�F TN E rO� Sewage Permit number ........!?......:....................................... Z 9ARASTAILE. i House number ........................ rasa... ......�......................... 'moo UU 9� OYPya\ TOWN OF BARNSTABLE BUILDING INSPECTOR � I<���.. APPLICATION FOR PERMIT TO ..........................................................................................................................:.. TYPE OF CONSTRUCTION .........Y66. .........J, A !'4'I ...........................:....:....................................... . .......................... cam' ............y...................................I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L n ...# 4� f'� h kA/l/l� �i 10;C 7-4,4!�:C.....M ILL i............................... '............ ... .............. . . Proposed Use ........ 04' . 1 F .4' Zoning District ......... .�.,�..............................................Fire District .........+,::.. ............................................ .... Name of Owner . �- � � A1141— ...............Address d /7�} ���ll=� � " A - . .............. .... ........... . ........... , ................. Name of Builder 1 y�. �/7-LO � ..� /iw, r Iz- /,_ Lam............. I.....................`........ ....:..:.,..:.....Address .......................:...........,.:........... .......... Nameof Architect � � ....Address............................................................... .................................................................................... Number of Rooms ................................Foundation .../.... .'.:::� .E : a F• � r��f� � ....;. ....... ................. R... Exterior ................:.............*..........:....,.....,.:...........................Roofing ..�....:...._......:.....:......... ..... .... ..,.. .,.,. .,. .... Floors ..................................................Interior ................,..... ;.................................. Heating ,_ .. ...... ... ....i. r:..............................Plumbing ..........�....r ...............:. Fireplace � 1}1�?f ...........................................Approximate Cost ......... ..............................: // ......... Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ...... �-�.!!.....:�r............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH UO 1. d _ t ^ f :1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. L Name �`:. '� ..... ...... .................................................... �WALD, ELLEN A=27-34 No 22285.T _Permit for .,,1 1/2 Stc,4ry r ......... _ Single Family Dwelling Location Lut...#.45...3.Q.:.Spur...Laxle............ ..............Mars tons..Mills............................ Owner .Ellen„Wald .. l.d...................................... u } Type of Construction .Frame .............. ............................. Plot ....... Lot .............................. Permit Granted ......June 2 c.............19 80 Date of Inspection ..... ..........................19 Date Completed .... ...........:_.............— 19 PERMIT,REFUSED .. .............. 19 . j.. .......... . ..... I . * ............. .......... .... ......................................... ................................. ............. ................. .. Approved ................................................ 19 r Assessor's map and, lot number ....:� FTHEr r Sewage Permit number ..... ... ....Y/................ ..... SEPitC SYSTEM e� US STADLE, H use number IN COMP E ' P TITLG 6 '�TFCYP�r►�9 S / • fl i Q TOWN OFBARN M! TOONSND BUILDING IRS�PECTOR APPLICATION FOR PERMIT TO ............. .w.`.'.- ......................................................................................... TYPE OF CONSTRUCTION ......... O:Q.Q.......f1.A #k. . ............................... S TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....L.Q..T... .. .........15 4....44N.�C..........� :17..D!..X.....0!oy .L.4.S................... (� .. �+ __. Proposed Use V.t/!.< -,:....... . .... s3...e.......................................................................................... ....... . . . ZoningDistrict .......... ..............................................Fire District L o.: ...C.7o................................................. Name of Owner ... .��• .r!/.....('1�.! 1 �G/................A dr fie.. . .' LM/ .... .. ..1................ '7 . ro �� �• Name of Builder d.4�1.. 1..�d / 1...(/ ...1C1.L� �.Address ... .... .. �1t.....�rrI1e� ...., r�............. Name of Architect ................./v.�.!Y.�..........................Address Number of Rooms .................Xr... ...............................Foundation �5�. R. TE!.% F.. Exterior .......4!..D.O.4.....1J..61A).6...........................Roofing ..Ae l.A1 AZ,.7.....U.�T � �1..... Floors ........4L).U-... .k /,11.y4...............................Interior ...........X L5,7C1COCdE................................. Heating .........E4..5".C.:7---/- ..%C............:..................Plumbing .........../ .: ......................................... 00 Fireplace .................wMO ,44W...........................................Approximate Cost ..........a.!22.. ............................. Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area .....1...G ..............:......... Diagram of Lot and Building with Dimensions Fee . ... SUBJECT TO APPROVAL OF BOARD OF HEALTH UO r -1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A 4 Name ... d• AA,! a- - 3 I WALD, ELLEN `Nf --xn .! Permit for 1 1�2 Story ......Sin.gl.e...Family....Dwe.Uing............... Location Lot...##g.5......3A...5. ux...',ane....... ` .............. ............................... Owner ....El1.ela-WAId.................................... Type of Construction ...Frame.......................... ................................................................................ Plot"............................ Lot ................................ Permit Granted June 2.0, 19 80 Date of Inspection ...................���...19 Date Completed ................. .. ... .. 19 � Q. &ERMIT REFUSED ......L m..........................:.... 19 N C ......... ®. ....... ....................... ..... ...........I 8 ..A..�. .......................................... Q . .s .�.!= co Approve"& M...... .................................. 19 ............................................................................... d�� '�„�•"" .e TOWN OF BARNSTABLE Permit No 22285 Building-Inspector - Cash $65.9 7 tlx 0 '1 saasrrua .o (b. !. ♦ NYL ,°yp, OCCUPANCY 'PERMIT Bond _x___ "'No building nor structure.shall be erected, and no land,^14uilding or'structure,shall be used for a'new; different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ellen Walt. _ Address } lot 44.5 10 Smir Iane. Marstcros Mills Wiring Inspector Z/o t''� Inspection date Plumbing Easpectoiy. p Inspection date Gas Inspector n Inspection date ✓Engineering Department_ Inspection date ` THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY- COMPLIANCE,•-wITH TOWN REQUIREMENTS. .,_ r.........._..._...._, 19, Building Inspector I E TOWN OF BARNSTABLE BARISTAME. s639. 0 MA*f BUILDING . INSPECTOR ls" ol?vl V( APPLICATION FOR PERMIT TO ......... ............. .. ............./......................................... .......... .... .. ....... . ... .. TYPE OF CONSTRUCTION ........ ................ ...... 4 ...................... .................... ........&! ,E............ ................................................19.......• TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..../,..a...r *./�.............Sfu./Z.....�.,A.��......... SA AITU 17— . . 1. .... . .... ........ ..... ...... ... 7* ............................................................................................. ;L J 416- 6 Proposed Use ....... .............................................U�ry.................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner M -d P. ...................A d d r es s �S_ /'Ofi 477 9 1 9 rZ / 7-1,9.2- C/P, �/D/1� 10 ........................ ............................................... .................................. Nameof -Builder ............... . ..................................Address ............. ....................................................... . .. ......... .... ............. ... 5r Name of Architect ......Itl....Address ..MA✓�....A"4............. ......................................... Numberof Rooms ................................................................;.Foundation ............................................................................... Exterior .... .-5.....................Roofing ......................... ... .......... ............................................ 121 Floors . ... ........ .. .......=7 ..... w/_ "q Interior ..... ... ..........................r.......................... ............. . ......................................... Heating ... J.................................................................Plumbing .....-�-.zetzzCI eif)v............. ................................................................Approximate Fireplace ...... Cost ...... ....I...................................................... Definitive Plan Approved by Planning Board ----------------------------- cl f)q Diagram of Lot and Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH 'FEE- L" < _j (f) - - Ld Cry CD U') X ir Di a. 1;1 C) r� '�\ M Lr) 2- Lj_ Ljj a-\- 0O to L11 Nyp > z > 3: >0 0 _j 00 Uj Ld _j CL LLJ U) U) 0 < < Cl- 0 0- < _j erf < I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ................................................. M & B Builders No 15.7.QQ...... Permit for: ,.am ],y residence ........................ J".............................................. N Location �At..4 S.. 1�1±.. 1?�Q.... Santuit .... � . Owner ... .$4..B.. ilders. . ... Nlaxshfield... r ...... . .... ...... Type of Construction ...;V.x1TRQ...........:............... ................................................................................ Plot ............................ Lot :.5......................... Permit Granted ..Novemb 24- 72 � Date of Inspection .rr.-A ............19 i Date Completed ......................................19 q I ` PERMIT REFUSED ................................................................ 19 ............................................................................... I l� .............................................................................. ............................................................................... d Approved ............................................... 19 ............................................................................... �. ... .................................................................. y THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) Pill DATA x., ,e r4 iz6, 1 ,r e ;x rr1 ry .00 t ... r.:... ----------- 20FT. (Minimum) _Ouf let pipesfrom Dist.Box shal I b6 10 FT (Minimum) level for at least 2fee1 from box �h F+ F. Floor Elev. =90.00ass ed Removable li o s — — concrete covens Tight joints K r s �'P -�- P1PC Removable conc.covers 4 3 c�0 4 7 Finish rode—min.slo a of 2% tiwa from s stem — �r 4i kAc 40 PVC AJf . f I ;' W%T max. 2 5'+_' rlGyr-✓oiiurs 0 S = 0.07 Liquid Level'\ l -0.03 =0.03 R 2'la rofliol -3/8' - O�y`c�c --- ° 1 •• • o • ye O Existing 0 washed stone. ; Leochin system - Dlst. po o -SEPTIC TANK- 800c Ill -a; 6 Ff.. . . ' 1 Epp 6 T00 Effectivedepi�hi;� `-I000 GAL. rn co v �1f 16 6 � a. 6 M 1 • •• . o 11 _ m 88.9a0 — -- o fn Go � � , 1 • • • • 0 1 - 1 r . LOT x 45 • l Cb W w Precast concrete s ,/ 2017 . ` m U Leaching Pit S.F. c 'c 6ft. diameter - 68 88 8 — 44 1000 Gallon septic ,� e . 2, k tank 10, 46 SECTION OF SANITARY SEWAGE DISPOSAL SYSTEM � +•• 4 ' �• 0) ou dation co NOT TO SCAL E _Lof 3/4 to 11/2 washed stone ao , r� , � a' 6 X6 Leaching ' all around precast pit providing 0 ,Q u pit with 2'of stone — Distributi n � 32 63— — • a�`'effective diameter of IO- an around — box M \ _DESl§A CR I T E R I A t +1 Nbraber of bedrooms (equivalent to 330 gal.per day). 168 to ro ased well - 26'- " GENERAL NOTES _ a 135- well Garbage disposal unit None 0,.,-_ 1) No change to this system shall be made unless &e . 'Reserve 1) Leoching arVocapacity required 330 gal. per day, 9 Y approve In writing by Philip D. Holmes. m°. 147 � eProposed Well Side Area proposed 188 square feet. 2) Subject to inspection during construction b 163.72' B8 Bottom Area proposed - 78 square feet. ) p I y 3067 `-84 3 — S5'4 66 • the Hoard of Health and PHILIP D.HOLMES . c. Basin - Proposed Leaching Capocity 549 gallons per d v �' S P U R ( Private 40' wide ) L A N E aY• 3) Heavyoonstruction equipment shall not travel Water supply_ private well over disposal system dunng or after construction. Precost-concrete units;H=10-foadirig. S01 L LOG 4) Disposal system to be constructed in accordance with Title 5 of the State Environmental Code. r I CERTIFY THAT THE FOUNDATION, WELL AND SEPTIC SYSTEM ARE LOCATED ON No I ( THE LOT AS SHOWN AND THAT THE LOCATION OF THE FOUNDATION CONFORMS Surface 5) Flood Plain Hazard Zone C j TO THE MINIMUM SETBACKS OF THE TOWN OF B RNSTABLE ZONING BYLAW. EI v.= 87.5 AMAyZ31940 NOT E . Date Registered Lan Surveyor subsoil 6) Zoning District RD— 2 <y 1) A COPY OF THESE PLANS MUST BE KEPT ON THE SITE DURING CONSTRUCTION. 8t fi I I 2) A COPY OF THESE PLANS MUST BE FURNISHED TO CONTRACTOR CONSTRUCTING SEWAGE DISPOSAL SYSTEM. 84.5 3) BEFORE BACKFILLING THE SYSTEM,THE CONTRACTOR SHALL NOTIFY PHILIP D. HOLMES AND THE' BOARD 7)BenchMark center of catch basin front of lot 44 OF HEALTH AGENT TO INSPECT THE SYSTEM AS CONSTRUCTS . Elev.=83.67 approx. sea level datum. PLOT PLAN i 6100 coarse SOIL TEST REFERENCE: FOR s •� sand ;I JOSEPH POLCARO Date of soil test__ SEPT 27 1978 Land Court Plan 348466sheef 2 IN Test taken by PHILIP D. HOLMES LOT 45 i� MARSTONS MILLS BARNSTABLE , MASS. ¢ Results witnessed byFbul Murray.Paul Gardner — SCALE: 1 "=40' DATE: A 4 DRAWN BYB,S.,1.— CHECKED BY 75.5 Percolation rate 2 'minutes per inch. —_ _ PHILIP D_. HOLMES . -- -?--� - No ground water encountered. Assessors Street aLot,N' CIVIL, ENGINEER 'LAND SURVEYOR 301 MAIN ST. FALMOUTH MASS. JO N 78298 DWG.NQ A 69 SHEET I