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HomeMy WebLinkAbout0041 TANBARK ROAD �pTHE ram, Town of Barnstable Permtt# P� 0 Expires 6 nrontlss from issue date Regulatory Services : =wxrtsT�s[e X-P r639- Thomas F. Geiler, Director p �� lfD MAC� " Building Division MAY 14 2012 Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstab le.ma.tUs TOWN OF BARNSTABLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Yalid without Red X-Press Imprint Map/parcel Number Property Address WanSuj j n M A—Z, 1"18 . ❑.R'esidential Value of J/ 55 ? Minimum fee of S35.00 for work under S6000.00 Owner's Name & Address �( h{1 F-gn� Contractor's Name .il�'tJ Telephone Number Home Improvement Contractor License#(if applicable) Q Construction Supervisor's License#(if applicable) �l CIC� rl ❑Workman's Compensation Insurance Che�c •one: ES I am a sole proprietor ,❑�p am the Homeowner LI I have Worker's Compensation Insurance Insurance Company Name 6of �� 7 Workman's Comp. Policy # \JC Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping.. Going over existing layers of roof) ❑ Re-side #of doors replacement Windows/doors/sliders. U-Value t (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other totivn department regulations,i.e.Historic,Conservation,etc. i ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. GNATURE: t'�z— The Commonwealth of Massachusetts l Department of Industrial Accidents Office of Investigations ` IIiI 600 Washington Street �� r`� Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizadon/lndividual): Address: & J! tmA & tam \rzac2 City/State/Zip: L �/� C��te' Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.N11 am a sole proprietor or partner- listed on the attached sheet. # ? Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] of 3.❑ I am a homeowner doing all work right of exemption per MGL I l.❑ Plumbing repairs or additions myself [No workers' comp, c. 152, §](4), and we have no 12•❑ Roof repairs insurance required.] t employees. [No workers' 13 C�S-OtheV11,kQo r,- comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ksso 24/kTc ifa,- ::i�_ Policy# or Self-ins. Lic.#:W C. wu(g>Q10 Out fl Expiration Date: Q ;, Job Site Address:( t 1 �_ ` CZfo—S y ZrU��/State/Zip:_ Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby erufj unde the pains and penalties of perjury that the information provided above is true and correct. Si ature- Date: i�; .1 Ol Phone#: 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other .r s r�ti Town of Barnstable o 1. Regulatory Services r , Thomas F. Geiler,Director Eo Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Ha i ,� I �+� , as Owner of the subject.property hereby authorizer r�; .�� to act on my behalf, in all matters relative to.work authorized by this building permit application for: (Address of Job) Signature of Owner v Date H�iC l ' 7��1 ' Print Name If Property Owner is applying for permit pleas e complete the Homeowners License Exemption Form on the reverse side. License or registration valid for individul use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation I 10 Park Plaza-Suite 5170 ' Boston,MA 02116 I C�etalaasjapun 6�p VW'3-1�1A2131N30 NNd1}�J13R!`dW OS i Not valid without signature f= NNf1O'd Or Ienp!Aipul ZL0Zt5Z/9 :uo14elldX3 ' -- _..... . I :adA.L 64L LOLL`':uonej3sl6ea - 1 I I i101WHIN031N3W3A02IdW13WOH \� aogsle�SP8 j8 snel}V jamnsaoajo a3g}0 mod' Restricted to: 00 00- Unrestricted ' 1G-1 2 Family Homes 1,90bZ :tYl �'""" """"• Zt0Z/SZ/S :uoilendx3 Failure to possess a current edition of the ZE9Z0 HW '3111/�?131N30 Massachusetts State Building Code s .y H31 NNV 31HVW 00/t�Z6 X08 is cause for revocation of this license. NNnG d NHOr Refer to: WW.Mass.Gov/DPS Fs;'. 00...01 palolgsaa W LOOyI So :8suaDI-1 asua31-1 JosinuadnS uo!hntisuo0 . sp.minnclS pur. suoeleln:)H :uipl!n8 jo paro8 �I�.IrS )il(lnd.t0 1uaw1.ncdad -sllasnyirssr.1.� JOHND-1 OP ID: KG ^ DATE(MMIDDIYYYY) �C�RO CERTIFICATE OF LIABILITY INSURANCE ma/11 IS FE5 TIFICDOESSNOT AFFIRMATIVELY VELY AS A EOR NEGATIVELY VELYR OF I AMEND, EXTEND OR ALTER AND CONFERS NO RIGHTS OVERAGE AFFORDED ABY THTE OE POLICIES ICATE . THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE SENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. ANT: If the certificate holder is an ADDITIONALINSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to s and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the ate holder in lieu of such endorsement(s). CONTACT 508-771-1632 NAME: FAX I. d Ins.Agency,Inc. 508-393-2955 All No Ezt: AIC NoStreet,Suite 9 E-MAIL Hyannis,MA 02601 ADDRESS: INSURERS AFFORDING COVERAGE 'NAIC ri INSURER A:The Norfolk 8r Dedham Group INSURED John Dunn Aluminum and INSURER B:Associated Employers Ins. Co. Vinyl Products INSURERC: P 0 Box 924 INSURER D Centerville, MA 02632 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. INSR ADD SUB POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MMIDDIYYYY TEN LIABILITY EACH OCCURRENCE $ 1�������� 09123/11 09/23/12 DAMA AMERCIAL GENERAL LIABILITY R1051735A PREMISES Ea occurrence S CLAIMS-MADE OCCUR MED EXP(Any one person) $ iness Owners PERSONAL B ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 i PRODUCTS-COMPIOPAGG $ GEN'L AGGREGATE LIMIT APPLIES PER: f n POLICY nPRO- n LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ BODILY INJURY(Per person) S ANY'AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident HIRED AUTOS AUTOS $ ;DED LLA LIAB OCCUR EACH OCCURRENCE $ LIAB CLAIMS-MADE AGGREGATE $ . RETENTION$ $ WC STATU• OTH- WORKERS COMPENSATION I AND EMPLOYERS'LIABILITY Y E.L.EACH ACCIDENT $WC5004658012011 09/29111 09/29/12 500,000 B ANY PROPRIETOR/PARTNERIEXECUTIVE --I OFFICER/MEMBER EXCLUDED? N/A 500,000 E.L.DISEASE-EA EMPLOYEE $ (Mandatory In NH) "'as tlescribe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I 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 'THE EXPIRATION DATE THEREOF, NOTICE- WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD a 4 oFT > Town of Barnstable *Permit# p� ~O Expires 6.-nonthsAam issue date Regulatory Services. Fee 5sr • BARNSTABLE.- 9� mass. $ Thomas F. Geiler,Director Ow 1639• AIF0 MAI p Building Division X-PRESS PERK Tom Perry, CBO, Building Commissioner- . 200 Main Street, Hyannis, MA 02601 NOV " 6 _20,1-. www.town.barns table,ma.us Office: 508-862-4038 I O�fa -�1/�0 ��Q EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid withDui Red X-Press Imprint a Map/parcel Number.a,?5oS3e) 3L Property Address Io-js esidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name &Address Oeiyl sC..0 Fc—oa (261 r'`�/����� f'�t(� d-3 Contractor's Name<�Ot ✓ Telephone Number 21 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#,(if applicable) L(C)o ❑Woekman's Compensation Insurance Chec one: I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance Insurance Company Name K Workman's Comp. Policy#-.- t5z"rpCEO f o 1 - Copy of Insurance Compliance Certificate must1accompany each permit. 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 rooO ❑ Re-side p� #of doors 9,-flacement Windows/doors/sliders. U-.Value E✓ >CJ (maximum .44)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission.. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. AGNATURE: v The Commonwealth ofMassachusetts ( 1 Department of Industrial Accidents - 1 d Office of Investigations ��'•; 600 Washington Street. Boston, MA 02111 www.mass.gov/dia - Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information' Please Print Le ibl Name (Business/Organization/Individual) �pJt� a Address: City/State/Zip: Ct��dl�� �����. Phone #: '3)0 k--zif��,�5 Are you an employer? Check the appropriate box: Type of project(regtired): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New.construction _�e loyees(full and/or part-time).* have hired the sub-contractors. 2.� am a sole proprietor or partner- listed on the attached sheet. ; ? ❑Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their I0.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL ME] Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4), and we have no 12.❑ Roof repairs j insurance required.] t employees. [No workers' 13.0 OtheTWIU, ,,) comp. insurance required.] *Any applicant that checks box k I must also fill out the section below showing their workers'compensation policy information. { t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. Expiration Date: q,• 1 Job Site Address: ��t j a.€ (UL '� City/State/Zip: k"i)J, Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisoriment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office-of Investigations of the DIA for insurance coverage verification. I do here certify and rr th�and penalties of perjury that the information provided abo a is tr a and correct.. Si ature: 1,^� Date: \'� Phone Official use only. Do not write in this area, to be completed by city or town officiaZ 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 JOHND-1 OP ID: KG ACORO' CERTIFICATE OF L!ABiLITY INSURANCE DAT 10/28OIYYYY) 10/28/11 THIS CERTIFICATE ISASSUED SAS 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 endorsements . CONTACT PRODUCER 508-771-1632 NAME: Northwood Ins.Agency,Inc. 508-393 2955 PHONE FAX 540 Main Street,Suite 9 A/C No Exl: (AC, AC No): Hyannis, MA 02601 EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURERA:The Norfolk& Dedham Group INSURED John Dunn Aluminum and INSURER B:Associated Employers Ins. Co. Vinyl Products INSURER C P 0 Box 924 Centerville, MA 02632 INSURER D 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. 1POLICY EFF POLICY EXP �TR TYPE OF INSURANCE ADD SUB POLICY NUMBER MMIDD YYYY MMIDD YYYY LIMITS GENERAL LIABILITY '• EACH OCCURRENCE $ 1,000,000 A COMMERCIAL GENERAL LIABILITY R1051735A 09/23/11 09/23/12 DAMA PREMISES Ea occurrence $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ X Business Owners PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY EO aBIINdEeDISINGLE LIMIT— (Ea ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per aCCitlenl $AUTOS AUTOS ( ) I NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per'accidenl $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB Id CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ I WORKERS COMPENSATION WC STATU• OTH- 1 AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A WC5004658012011 09129/11 09/29/12 E.L,EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) - CERTIFICATE HOLDER CANCELLATION WIANNOC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Wianno Club ACCORDANCE WITH THE POLICY PROVISIONS. Mark Williams 508-428-9036 AUTHORIZED REPRESENTATIVE Osterville, MA 02655 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I t Town of Barnstable Regulatory Services • Ll.1WSTAB[.$ v ' MAS& Thomas F. Geiler,Director �fa �' wilding Division Tom Perry, Building Commissioner j 200 Main Street, Hyannis,MA 02601 i n'n'R'.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 5 Property Owner Must Complete and Sign This Section If Using A Builder � i as Owner of the subject property i hereby authorized P . g to act on my behalf, in all matters relative to work authorized by this building-permit application for. Signature of Owner. Date Pant Name If Property Owneris applying forpermitplease complete. the Homeowners License Exemption Form on 'the reverse side. f - License _ or registratio valid for individul^ y before the expiration Office.of date. If found use only Consumer Agairs return to: 10 ParkPl and Business Re Boston a 0 Suite 5170 gulation MA OZ116 � Ir NO t valid without signature ' i i Office of Consumer Affairs&B sines Regulation HOME IMPROVEMENT CONTRACTOR 1 ITJOP. Registration:-401149 Type: Expiration: _U25%2012 i — Individual I I UNN John Dunn 80 MARIE ANN CENTERVILLE,'MA 0?63 •:�s% Undersecretary i1 IChU Bo.lrV of gu s - pclta1-t U117" nt P COnstrUction.� Ra ul or Rest, Ciceose: Cg SUper�`ttiou.l:tpublic'Sai�tt �cteato: 00 t4007 �sor Cice�se4nVards JOHN P eOX 9 DVNN OENTE4/80 A4, R RIE It,�E ANN T A 02632 ER — _� uq�nUx•,iune• - r Expiration. ~ T (16t 012 24 /r I r� � � Town of Barnstable *Permit# Expires 6 months jroyrissue date anRxsraa �-- Regulatory Services Fee S ��J.; y� Thomas F.Geiler,Director A STABILE Building Division Tom Perry,CBO, Building Commissioner © " 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTUL ONLY �t Not Valid without Red X-Press Imprint Map/parcel Humber f v Property Address /�/ 1 T-a 6r k 0MC rs n 5 A J XResidentill Value of Work 52",0� Minimum fee of$25.00 for work under$6000.00 Owner's Nane& Address 1 Contractor's name 1� 1L Telephone Number Home Improvement Contractor License#(if applicable)_! �l Construction Supervisor's License#(if applicable) / ✓ ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name t -e- +)e-. h u r Vie- / Workman's Comp.Policy# `()(_ 00rL G� O `O Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 19 Re-roof(stripping old shingles) All construction debris will be taken to a A&I ❑ Re-roof(not stripping. Going over . existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (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. Hom .Improvem t Contractors License is required. SIGNATURE: , Q:Forms:expmtrg Revise071405 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 17 /'t G Ba-a'h CfiS r Address: u.S W0AJ �. �-- d City/State/Zip: CPiK41el 'd-►l elj 0Phone #: D— 7,) 0 63,f Are you an employer?Check the appropriate box: Type of project(required): 1.XL I am a employer with_ 1 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t . Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its r 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL I LE] Plumbing repairs or additio myself. [No workers' comp. c. 152, §1(4),and we have no 12�Roof repairs h� insurance required.]t employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. /I_ Insurance Company Name: 6—yra vi tie, 17K �r�✓te (�O Policy#or Self-ins. Lic.#: 6 LOL 74?g6)ql/v Expiration Date: 111h Job Site Address: t5� 7zlq bar. - —AZT,—k= City/State/Zip: Ir4n Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided abo a is true and correct. Signature: Date: /� d Phone#: 6 J 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#: ,p�'Of1F4E sn�xsrnHte, Town of Barnstable -9. Regulatory Services Thomas F.Geiler,Director j Building Division Tom Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, e I t� 1 C Ie r_ ,as Owner of the subjectproperty p p ry hereby authorize f! L a rS�05(S 4e5s toact on my behalf, in all matters relative to work authorized by this building permit application for: aN bar- �- &0-,a?// .-Ae-54n6 (Address of Job) Signature of Owner V I Date i r Print Name I Q:fbnns:expmtrg Revisc071405 91te o Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 141078 Type: Private Corporation Expiration: 1/6/2008 E.A. BARSNESS & CO., INC. ERIC BARSNESS 54 ANGUS WAY CENTERVILLE, MA 02632 Update Address and return card. Mark reason for change. DPS-CA1 is 50M-04/05-PC8698 Address Renewal ❑ Employment ❑ Lost Card ' � .;/fZC TDom7/1I't0'l7.lIJPdGG/Z Il�✓�/(�-ddCLCftfC6EC�0 r Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 141078 One Ashburton Place Rm 1301 E ipiratio' ;1/6/2008 Boston,Ma.02108 Type:;Private Corporation E.A.BARSNESS.&_CQ.,"INC; ERIC BARSNESS:, 54 ANGUS WAY G G--� `` ------ -- ----' CENTERVILLE,MA 02632 Administrator Not valid without signature JUN-13-2007 WED 02:21 PM MF&T INSURANCE FAX N0, 781 261 2097 P. 01 '^— =RF ' ATE(MMfDOfIVYY) Aonw. CERTIFICATE OF LIABILITY INSURANCE Eo6 13 07 ,•I,oii;icir'+ �- ��—"" -- — �- ��� TtilS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ::^Ic,c7nty.cc L'ay S 'T]lrryor Ins A`1Y HOLDER.THIS CERTIFICATE DOES NOT AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 47 Accord !'ark D.riv;: Unit 5-1 -- t•Iv.rw07 J. MA 02061 T�YIos,L±: '10:L-7.(i. 2000 F'ax.:761-•261-2099 INSURERS AFFORDING COVERAGE NAIC# rJ!;Ur{i:v {-INSUKERA: rancOCO. ___.,• -__ I iKSURr_R5-- Granite StatO Ins CO. - . . .__ —_....,•------- EIA ':3ar:)nv--<;s & Co Inc Lt4 :0.n:,u:, slay INSURcF p --...... C�)nL't�i;vil.3ts Md 02632 � WR WSUHF.R I; �.-- 1 illi I'U!!CIL'S OF IPrIIIRAril.:1:LW, CI LOVf1!AVr UI-EN C>$JEE•10 TIT INSURED NAMED P.EOVC.FOR THE POIJCY JIFI f Gl'NOICA ED.VOTWITHSI'AVOINC A 4 RG'�!.:;L,21,'.41,TCt^A Uii 40PJ7111(J4J C!Y APJY CONTfL1C i Oli O TIir.R DOCUMi NT V,7TH RL6PGCT TO V M1;ICI1 THIS CERTIFICATE MP:Y 3f.IC_UEO 0!4 im?Y I'i ItrP.IN,TI!!i ili'ot!TiANCL':V'I QRC'f.l)I:Y'I KG.POLICIES OFSCRINcD NEREfiv IS SUHJF-CTTO ALL IHF.IFF, ,EXCLUSIUVS AIJp CONCIT!JN$OF SUCH Pnt U'.q 7 /'•J.'.,,ti OA1I:1IAIli ri St!G YN MAY I IAV„:CCCN Ri CiICf:❑OY PA,r.�LA!MS - - - "POL(CYEFFECTIVe P�ICY EXYIRATIOId LIMITS 47 ft IPiS!iIX_- TY i'F,U_IN$lllil;,'J!-L IWNA ~ POLICY HUMP.ER DATE MMOONY T UATE MMJO DlYY - •y�:-_.—•_ - — "j ,."'._—'""�'— I EA,::*+c:ccuHlaeNG1: a 1000000 I I(,kN!i01.LIbII1L,0'f I UArdl1(,;r7oft!:NTF.U.._........ ------•• . 4 I caruai.11[aN.GC.Iv!.!7AI LNI11'.a'Y NC624588 ! 02/07/07 1 02/07/08 ±r1zk-h1S1?S;E_cxurn!u I00000 =-- IC:IN6ISPAAGC Ix IUCWRI 1 r EXFiM'i,Ono P 5000 cr:or_) 5 -_ - i DvINJURY 1000000 AliRALAGr;rf.GAte S __ 200 "r f I PRODUCfS-:70PAi'i0"AGG S'2000_000 ILi.t:aVIT,I_Ir.n n%I;WS r ! I --— — -- -- AUI QM1krfiII1 E I.InVIL ITY i (Es ace00m)ItJC:E LIId{T `S r._...._ 4 pimI ([eaccaont) I "' I 000n r INJUP:Y I (Pu:�3f50i,) b I 1 li r•ut:;5 I I ! I GO'JILY INJURY -�3 ,11i,tF j I 'PF,0C'EI' Y D AIAAGE 5 ( �•-•- •-•�. AUTOUNLY.EAAG•,IG�'NT 5 iCARA,X I I f I 01 HER 11'AN CAAGC S _AUTIO ONLY ------- ANYAU 10 _...A•�c a__... L•kt'L:,IIJ J.tI IYlELIAlln lllll'!'Y i EP.CF!'JCC,U:KRENCE-_--, �� I (7Ci:Lli I I C'.Aitd!i MARL 'A(iGRECAYE IN_.....,s.._.—.......... .I..-_........• _�,• -�. •' �V��Fi�iT�l'�'T� W,riKG`iG C(!pt 5A 110.4 Al;D —� X r.IarL.0Y11t:IJnI;ILIry I WCd394273 I 8J0 6 08 02 07 I E L [nceACcl;Jrrr �-_ 3100000 At.F'P!;t:'rl!:u)I;n rJ?TNL(!:lX.CUt1VC 1 r G_.t:DISEAS E_•EA.t:.K.W.-LC Y['E S�1.0 0000 OI'II:F K:M J6LI1 EYLLLIIIE E.L GI"Gr!iF-POI:ICYL,!+I'f 50 0000 -- Si•I_ IAL l'IiU'di�'Grt3t��iu.,N �^—�� '•----�I--" "---� . 'i slftiti,'1• j 17 �(:IUf'iIrJNOfQI•LIjP.iIt)N S I LOCAIIIQIM IVEHICL'cC:IF,ttCLL'SIONSADDED51INOORSEfAEhTJ&PECIALPNOVIStON3 _ CANCELLATION CEl7.lti'IC'ATr�.1•IUI_DE,� - -. -' 'T' TOWNBAR $I10UL0 ANY Of THE ABOVE 0[SCITI6E0 PO:-:CIE:BE CANCELLED WO913 THE EXP!NAT!ON DAME THEREOF,T I SSUINQ INSURE-R WILL ENOCAVOR TO MAl4 030_ DAYS VJRJTTE4 NOTICE 1'D THE CEFiTIFICATE DIOLDER NA'A0 TO THE I,Vr,BUT'AII.Ukl:-r0 DO$0$HALL Of fvve n5 tab lea IMPO%NO OBLIGATION OR 1.1AAH.11Y OF ANY I(INC UPON THH INSURER,ITS AGENTS OR 2.0c) 44a).T, 3Y'CC:t HEPRE$kHTATIVES. _ 11Y:if12',],w t`y1 O.2CiO1 ___ AUFA.'.EOkL•D TA•r, ._...._� . .,-_- ..,-...._._,,.........._.__......._. __._.._.,_......�_..--__.......-�...., UACJRD CORPORATION 198E b ,,TM�>, TOWN OF BARNSTABLE Permit No. ..: 2 55..... BUILDING DEPARTMENT I Cash TOWN OFFICE BUILDING HYANNIS,MASS.02601 Bond N/A CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #109, 41 Tanbark Road Marstons Mills . Mass_ USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID,'AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS,AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 14 June20, 19....89........,.......................... ....... .Buil... ns.. .... ........... BUILDING �' I�'11�� TOWNI-OF BARNSTABLE, MASSACHUSETTS A=99-53-51 ; DATE May 11 19 39 PERMIT NO. Q ► APPLICANT Gree3nbriur Cor-01 . ADDRESS__.L,sted Below 0013.97 (NO.) (STREET) (CONTR'S LICEN;;E) OF PERMIT TO Build IiCJC1ll:1C( (�) STORY Single �'azttlly DWE`lllll�WELLUMBEING UNITS ' (TYPE OF IMPROVEMENT) NO., y (PROPOSED USE) Lot #109 41 Tanb'A'rk poEiCi It�'r::itc-)n!3 Mill ZONING:: 'RF AT'(LOCATION) �• DISTRICT_ (NO.) �, (STREET) J lt: I .BETWEEN • AND (CROSS STREET) (CROSSISTREETJ LOT SUBDIVISION LOT BLOCK SI74 BUILDING IS TO BE FT. WIDE BY FT. LONG BY ¢ FT. IN .HEIGHT AND SHALL CONFORM,.IN.CONSTRUCTION_. �_:•� TO TYPE USE GROUP BASEMENT WALLS OR'-POUNDATION (TYPE);.. .. _ REMARKS: Sew ige #86-75u + - AREA OR 768 s +� ESTIMATED COST yf 45,000..00 FEEMI,T.$'' t VOLUME 61,,5'0. (CUBIC/SO UARE FEET) _ • OWNER Greenbrier- Corp. ADDRESS P• U• boo. 510 , Cc2ntcrvi11C, BUILDING DEPT. BY I t .... ..>.-..:.;:,:. ....f,- ,.:.. �. ,.i:.+ • ,. .: ..,..:�:..- ..?..�i ...,>,,., F�L .•,,.,1'i .IxiJM��`.s'yn.r..�A.;.Yj�+ t " V°Jt ESDOES T IONS OF ANY APPLICABLE SUBDIVVISI11ON'`RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE e INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY. IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS O • 2 -II,,---- v�n Orl far 2 !- / q - $5 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER 2 3 D VYl a L6 Y 9(9 - BOARD OF HEALT�i;( WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W;L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. i �: I LOT 108 I K R0 AD i � O � i S0 ! 32, I T 0 \ \ N \\ LOT 109 0 \ 20,934 SF LOT 110 \ U` \\ 66 6 0 THIS PLAN IS NEITHER INTENDED FOR, NOR SHALL IT BE USED FOR MORTGAGE LOAN PURPOSES. 1 4 28 89 INITIAL•ISSUE CF NO. DATE DESCRIPTION BY AS—BUILT FOUNDATION PLAN—LOT 109 MARSTONS MILLS WOODLANDS BARNSTABLE, MASSACHUSETTS tH o r N� . FOR OODLANDS ASSOCIATES REALTY TRUST PAUL A. •IJY SCALE: t" = 50' JOB NO. 1338/13- x l I CERTIFY THAT THE FOUNDATION ` �z LEVY - SHOWN 0. HI LA-N S ,CATED 0 No. 10617 1 i°I 0 50 100 ;I ON THE OMND .A I DI ATED. LEVY, EUREDGE do WAGNER ASSOCIATES INC. DATE REGISTERED LAND SL)R YOR 0WIM 1AMM RUM 1A1mMTO>is 889 WEST MAIN STREET CENTERVIILE MA 02632 14 Assessor's office (1st floor): �_,DD YY S CZnnLh 0`TMET� Assessor's map and lot numberUj�...�.�...... f�7.�. �f, EPTIC SYSTEI4lI MUST B lllIIIJJJJJJ_ Board of Health (3rd floor): �j �j t `' Sewage Permit number .f��..L.�� ....fl.! .... '"' dd peprr��� ' l u 7 i.6: .�', Z BASl9TSDLE. i Engineering Department (3rd floor): , / ,(1 , Eire ;;'u MA0' ♦� House number ... . .. . . . �7 NTAL C ,;.: i639' 9 ..`....p.... TOWN REGULATIONS '°�a M a� Definitive Plan Approved by Planning Board _________ 19 __ . 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 ......�dAJ.5 -�...................................................................................................... TYPE OF CONSTRUCTION ........SI✓✓IrLF f�y (AJQ"0� /Z/✓M� / ...............!-a..........................19... �� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... LQ9............. /JAl13/ 4K...:......ed/J/� �-�(/��eSTUn/S �tLCs .......... . .. .............................. ................................................ ProposedUse ......5...�...�....�.. C�F .. M .................................................................................................................. .....................................Fire District .............. ...District ................ .. . �0. S.:.l.. ......................... Name of Owner GC 6En/l3Xt. 0lZQ:.......................Address Q . ...!�X....Sl4........�ENIEIZVI L(t .............. �..... .I ........... ... Name of Builder ..............�� rA .......I...........................Address �•6^-f . Nameof Architect ..................................................................Address ..............,..........................:........................................... I Number of Rooms .........................................................:........Foundation ...ow.t)........NA(CzETC ...................................... Exterior .. .�.AP..:/ 5�....................�... . .� .........Roofing .......... .. ...................................................... Floors n KQ /V_1j L ...`./!A...l••.•.......... ....V.1...........6•.......................................Interior .....��.�1�../Zb.q.4..................................................... e Heating .1W/m.........P�`y.........(I- . ................................Plumbing .....L....... 441 Fireplace .........................Approximate Cost ... ! `=b Area .......,/ .(?..................... Diagram of Lot and Building with Dimensions Fee ............z� '..J..L/.... , s S A S $1C 3a u aAl C' 6, vN 1,�1 N� vf s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I herebya to conform to all the Rules and Regulations of the Town of Barnstable regarding the above agree g g eg construction. Name . . ......... .. .:....:......... .................:................. ` Construction Supervisor's License 9� t �, `GREENBRIER CORP . a u: 4� No JU5.5... Permit for ....BTNID„DWELLING .............. :Location -L0.t...U9.4....!U.J.anb.AxA...Ra...... ..............: ...M l l.S........................... Owner ..Greenbrier, Co,r.P........................ i Type of Construction" ..Woo!L.Fr;AMP.............. ..... . ............................................................. Plot ....................t....... LoY ............................... Permit Gran'ed-.....May...1......................19 89 Date'of Inspection ......./......................{....19 Date Completed ........e!...-... ....19 x -r h t ISt n11 >.�.wS�.lt4�AeL'a.."'.Yr�'w� r�, _�� r_ }l� � Kr• �o ro +,,�;;;i,!�S r o• r'^ � .�1 x ��.:!.., � .o-,--'Y�.�. .--.. ..,.._-.• uJ� .:'i'�;iv ���h..w•�i:� t�"�',s.'•yy�(-.yr:r�;.�.k� �".�3,,/}'�71'WN/V.'_Jv+i`�:sv ci.' � _. �'. Assessor's office. (1st floor):' _,9 V `TME , Assessor's map.and lot number'.X... .�.......519- �"-57-.a.�s Board of Health (3rd floor): ♦ fO�Q ��//`� �%/� �l. l Sewage Permit number .<,.........1...:.> ..............�.. � >; 323aHa9TSDLE, t Engineering Department (3rd, floor): / FJJ oo rb 9. Housenumber' ................:.......:`.................................... ......... �F0MAYd• Definitive Plan Approved by Planning Board _________� 9____._._..__19 APPLICATIONS PROCESSED 8:30 9:30 A.M. .and 1:00-2:00.P.M. only: TOWN OF BARNSTABLE BUILDING INSPECTOR ....:...:.:......... :.:::.... �:......�.. ('0.0.�r ��C>, w c 'J APPLICATION FOR PERMIT TO .................... � II TYPE OF CONSTRUCTION ........S....N(�.. ...................................... )/. .............../.... ............................ .................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....:h:.G.�....I0........... .4"!.�....°.!..��..........�UR... ....!j:.�..... 1Y�/VS ................ ............................................. Proposed Use 5/M(rC6 ...............................................................................................I................. ZoningDistrict ........................................................................Fire District .............................................................................. n p Name of Owner �✓:.'eFt^✓!'�t[C�' l G!Z/ Q: l)X 5/6 ��n�9c`7Z V1 L << Address .... . ................................................. i S ( ,. Name of Builder '��.......`.�.n'`......................................................Address .......':Sort P I. Name of Architect Address .......................................................................... UN �ETC s Number of Rooms .............:/..s::...............................................Foundation ............. X.............. C EXlertor . !...5/........................................................Roofing .......... //(l..�L `I Floors .... ... F�...../.V I/V�. ..................................Interior ..... . ...................:........................................: Heating .Plumbing 73AT0 ...."...�.......................................................... Fireplace ......./". ...................................................................Approximate Cost ......../..t.G .'............................................. Area .......................................... Diagram of Lot and Building with Dimensions Fee .: ............................................. 12 f. a � ,v i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name -. Construction Supervisor's License . J ...... .. ................ GREENBRIFR� CORP . A=99-53-51 No ... Permit for DWELLING ...................... S in.gj�!...Fami.1y.. f�.j�.in a ......... .. .......... .. ..... .............. Location !U...... .b....ark Rd .................... ............M.a r.s.t.q.n§....Mllls...............I............ Owner ...G.r..e.e.n.b.r.i.e.r...C.q.r.p........................ Type of Construction ..:FP.P.d...T.K ............... ............................................................................... Plot ............................ Lot ............ ................... Permit,Granted .....k.ay...I......................1989 Date, of Inspection ......................................19 Date Completed ......................................19 y c , Y tMARSTONS SHEET 7 OF 7 At LOT 130 LOT 129 1a003 OF LOCATION MAP lei j,o POP f /' 7p.6 `�j LOT 12a• a►,► �,411r tr 13 G ` LOT 31 1 �1 10.40 bA ♦' f— / ♦ OT is 1 ta�w3v LOT 124 4 105 r �a LOT 128 -Z�T,4 ';e+oo LOT 123 � 'i ( . I ' if 1 _ 4.6 I:I t' y� etr � yM. I T 11� LOT 13 ' w_-�io s i I �:' `may t LOT 149 I L � 11 /1�1 q LOT 136 \� 11.0 or t4'a N ` � i r ' � `�I y i1 .� � ���' �•- � � � LOT 122 uT 34 LQf 133 �• Y j �'' fit' t� J LOT 121 toMiM� I '1 � ' roso s ► w3` -� �LOT 107 LOT 14e � / �� h.4 .3 ♦a T t40' :o I 4 lams111� 11 " �^ faoo� �'''t�R ji "AOT 147 '11 �� y LOT 119 ' y � 'LOT 141 1 ttt 1tt` "on04%5 1r �. o 1LOT�\rl ;areT� it I I 1: \ (( • ''t' '' iw t� Y Q`. 1kw r >bd i1`' ` LOT 120 '+ lam or LOT 117' a ' I�1 ' 1� ' R Y I I t t• 1a� �' Flo'ZLS LO �. • .y �: O ) 'itA i '� •Q� mod' I.Sit 6NlBT 7A or"I hA_ 50+1- v4! MO' R1 /' �' ���''y:/ t •• -►'\ 7 TWUO llM-A -Misr. ROWvrs. 4S y LOT 115 '►d , 4L t.W a-ewer 7 Xi A ew 7 'CA_ �t *ND' LOT 146 /`/rn>fr ���' t�>moo i / LOT 10e ? so�ti..' - L1p 'o r I 1 \ ! \ ( V- LOT 110 V 'tp'?' 4 LOT 11E tw a r tam W M Jr \ w i LOT 11� t LO I �� "I �� '�LO 114 taw 10, t} 6 i p 1a s 11 a �s ,o,r.., 0.1 Rone E 1at�Mnews top r ` p ` j$,Q I • 3 11 29 e9 FINAL BLDG. AND SEPTIC LOCATIONS PAL �� I ►I o T� 1`� I r BUILDINGC TION TIAL ELK NO. 1 O DATE DESCRIPTI By BUILDING LOCATION PLAN MARS TONS S Mims wo LAND 1.1 LOT 110 LOT 109 nr s. BARNSTABLE, MASS CHUSETTS \� � , i OODLANDS ASSOCIATES jmxLmrRusm SCALE: 1" = 50' 1 JOB NO. 1338 430-10 30 a too A. F 1 LOY, EIDMBDGE & WAGNER =Mt YC v® Lo x me eea Alm 1[AIIi 178�f CEMTRV= MA 028M