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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
r.
Map Parcel` ZJ - ! Application
Health Division Date Issued -1 l 5
Conservation,Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH Preservation/ Hyannis
Project Street Address
Village
Owner Address
Telephone gra �I �-
Permit Request
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation y U 0 Construction Type
Lot Size Grandfathered: ❑Yes ❑'No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) , Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
'Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑exi f sting O.;new: size_
( C�
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: a
LD
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ �
Commercial ❑Yes ❑ No If yes, site plan review# °
Current Use Proposed Use _
z-
V� �
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
s1-7s
` Name Telephone Number
Address r License#
t'l L y Home Improvement Contractor#
Worker's Compensation #
T
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE 6 \ DATE till 612
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED
MAP/PARCEL NO.
ADDRESS I i VILLAGE N
;l OWNER
I 1
.:DATE OF INSPECTION: '
FOUNDATION
ti. FRAME
INSULATION .
c
YFIREPLACE
2
ELECTRICAL: ROUGH FINAL
i PLUMBING: ROUGH FINAL y
GAS: ROUGH f FINAL
"FINAL BUILDING
I
DATE CLOSED OUT F
ASSOCIATION PLAN. NO.
T Town of Barnstable
Regulatory.Services
HAS& ` Thomas F.Geiler,Director
;� n a6'`9, � Building Division'
rEG�
Thomas Perry, CBO,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
'Office: 508-862-4038 Fax: 508-790-6230
PLAN REVIEW
/g
Map/Parcel: y a Q
Owner: S�L
Project Address y � /��/�2r/ Builder: ✓
^Opt."
The following items were noted on reviewing:
Reviewed by:
—
Date:
Q:Fonns:Plnrvw
i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers
A licant Information Please Print Le 'bl
Name(Business/Orkmdmtion/Individual):
A � �Address:
�--f City/State/Zip: 11at
Are you an employer? Check the appropriate bog: Type of project(required):
J1.❑ I am a employer with 4. I am a general contractor and I
. employees(full and/or part-time).
* have hired the sub-contractors 6. ❑New construction
2.❑ I am a•sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g. Demolition
working for me in any capacity. employees and have workers' 9 Building addition
[No workers' comp.-insuiance comp•insurance
required.]___---- ----—- "-5._0 We are a corporation and its 10.❑Electrical repairs or additions
P'1—am a_homeowner doin all work - - officers have exercised their 11.0 Plumbing repairs or additions
( myself"[No workers' comp. _% right of exemption per MGL 12.❑Roof repairs
i sun nce 1eguired.]"t -_ c. 152, §1(4), and we have no 13.0 Other
employees. [No workers
comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tcontractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the subcontractors 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:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirial penalties of a
fine tip 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
Investizations of the DIA for insurance coverage verification.
I do hereby certify under the pains•andpenalties ofperjury that the information provided above is true and correct
"�--- Si "afore:.. . .
1) Date: �00 a
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):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to.provide workers'compensation for their employees:
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more
of the foregomg.engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,.or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced-acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificates)of
insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Towu Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/liceuse applications in any given year,need only submit one affidavit indicating current
policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the aff davit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for-future permits or licenses. A new affidavit.must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Department's address,telephone-and fax number.
The C6mmonwath of Massachusetts
Department of Industrial Accidents
Office of Investigatians
fiat}Washington Street
Boston, MA 02111
Tel. #617-727-490.0 ext 4.06 or 1-977-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.mass.gov/dia
ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR
ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00)
Applicant Name: Site Address:
print
Town:
Applicant Phone:
Applicant Signature: Date of Application:
NEW CONSTRUCTION: choose ONE of the following two options)
780 CMR TABLE 6107.1
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR
NEW ONE- AND TWO-FAMILY BUILDINGS
MAXIMUM MINIMUM
Ceiling or Slab
Option 1: Basement
Fenestration exposed Wall Floor Perimeter
U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER
R-Value
R-Value and Depth
National Appliance Energy
R-10, Conservation Act(NAECA)of
.35 R-38 R-19 RA 9 R-10 4 ft. 1987 as amended,minimums or
eater as applicable
Note: This form is not required if you choose either of the two versions of REScheck as listed below.
❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed
(780 CMR 6107.3.2)
REScheck—Web which can be accessed at htti)://www.energycodes.gov/rescheck/
ADDITIONS:OR`ALTERATIONS:TO EXISTING BUILDINGS.OVERS YEARS OLD*
*Buildings under 5 years old must use option#1 or#2 in New Construction section above.
Complete the following formula to determine the % of glazing:
(a) Gross Wall & Ceiling Area equals Formula: (100 x b _ a)
SF
100 x - _ % of glazing
(b) Glazing area equals SF b a
If glazing is<-40%.use the chart below.. If glazing is> 40%proceed to "SUNROOM" section
780 CMR TABLE 6101.3
PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING
LOW-RISE RESIDENTIAL BJJLDILSIGS
MAXIMUM
Ceiling and Slab Perimeter
❑ Fenestration Wa Floor Base ent Wall
U-factor Exposed floors R-V lue R-value R- alue R-Value
R-Value and Depth
.39 R-3 7 a R 13 R-19 -10 R-10, 4 feet
a R-30 ceiling insulation may be used in place of R-37 if the insu tion achieves the full - ie over the entire ceiling
area(i.e.not compressed over exterior walls, and including any ac
SUNROOM—An addition or alteration to an existing building/dwelling unit where the total
❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the
addition.
Note: Owner to fill out Consumer Information Form (found in Appendix 120.P
Town of Barnstable
�pF SHE Tp��
Regulatory Services
swxrrsrwet a Thomas F.Geiler,Director
MASS. $
03ig. A Building Division
DIED µA't
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
�rJQBFLOCATION: 7 � y ��/��1�N >��'/� ��•
number street village
HOMEOWNF—MAhI �f� �y Y��'�����
name L home phone# work phone#
C�NTEMAII�ING�ADDRESS: �S��- ,Ly�T�}"t"L•�//,L��T A y �S
J�J}�nstd�vs M i W_jr A-. G C P r
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such,
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requyjme n_; '
� n
"wSignature of Ho�mr,Y fjer,
Ap�=ofiBuildi g Officials
Note: Three-family dwellings containing 35,000 cubic feet or larger-will be required to comply with the
State Building Code Section 127.0 Constriction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1..1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
oFtHE►�,,,, Town of Barnstable
Regulatory Services
BAMSTABiE Thomas F.Geiler, Director
'0r16
w � 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
operty Owner Must
Comple e and Sign This Section
If sing A Builder'
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorize y this buil g permit application for:
ddress of Job)
Signature of Owne Date
Print Name
I Property Owner is applying for permit please complete the
-Horneowners License
Exemption Form on,the reverse side. -
� 1
77
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel S i Permit# 3
L Health,Divisio"n �! 7 Date Issued
��Z �l e7t
Conservation Division , Application e
Tax Collector M I M Permit Fee -
Treasurer r(N-M &�PTlC S�'.�s : :T
INSTALLED IN GOMPLIr,6e�,_
Planning Dept. WIM TITLE 5
Date Definitive Plan Approved by Planning Board ENVIROMWENTAL CODE ANL
Historic-OKH Preservation/Hyannis TOM REGULA,*IONS
Project Street Address y IU —T„-;-; =5L
Village
Owner h L S 14 it- Address
Telephone
Permit Request
Square feet: 1st floor: existing proposed 01VO 2nd floor: existing proposed Total new
Zoning District R P Flood Plain C_ Groundwater Overlay
Project Valuation ItI5010 Construction Type
Lot Size X_'y a Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family Cl Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing ° new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name—.1-1,AIK 2 1,/L Ey Telephone Number
Address _ P, License#
M i9 ksZ2 Fps al /k k S Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE f/ y -p2
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS ' VILLAGE
OWNER;' ;a'
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
3�3 '
ELECTRICAL: ROUGH_ _ : FINAL
PLUMBING: ROUGH.•-. .. FINAL
GAS: ROUGH, "-' FINAL
} _ 4 y -j •
FINAL BUILDING, `
Z 4 •�
DATE CLOSED OUT/-
ASSOCIATION PLAN NO.
EEII
! L I- -1
SMOKE DETECTORS
S7
BARNSTABLE BUILDING D P
'2. L �UrJR
ss
FRONT ELEVATION
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°pZME*°, Town of Barnstable
Regulatory Services
BARNSTABLE, ' Thomas F.Geiler,Director
9 MASS.
E639n `0 Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion,
improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: Estimated Cost
XAi f.
_ Address of Work: �j /f(/ _
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
QWork excluded by law
❑Job Under$1,000
[L] iik�g 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:
Date Contractor Name Registration No.
OR
A/0 P�w m5g, Q D-
Date Owner's Name
v
Q:forms:homeaffidav,
y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Mapolt.a Parcel�3 JS„ SEPTIC SYSTEM MUST 99rmit# A10 9 q6
Health Division ��—��1 ( INSTALLED IN COMPLIANFaE
WITH TITLE w r y a e Issued
Conservation Division S ENY MENTAL /1
Tax Collector a . r t WN. REGULATIONS
n OWN REGULA', ��.I
oaf' t f
Treasurer l
Planning Dept.
Date Definitive Plan Approved by Planning Board
ese
Historic-OKH Preservation/ annis
Project Street Address 565Q &0A4 i�*� �=t4��� i/�/vim- �FY LoT �fo�
Village m�12sry ti Max s
Owner IYAgg j4,LI-7 _ = r,cRAn,Address V /'ig /sn i_ es,iwc t;- 0.7(75J',
sc i2 w ruro !U
Telephone eoE — ya8- xis It/ 6'oB -�9y-e2.�'Si3
Permit Request rtvo _cTo,e v siru6:1.60" =N"Ik y clyn6r
Square feet: 1st floor: existing proposed 1336_ 2nd floor: existing proposed 80 b Total new 4/3�0
// 7p e'O
Estimated Project Cost%yl ee 6r6o Zoning District '. Flood Plain C. Groundwater Overlay
)Construction Type
l Lot Size X/7 9 Grandfathered: ❑Yes ❑No If yes,attach supporting documentation.
Dwelling Type: Single Family �Y' Two Family ❑ Multi-Family(#units)
Age of Existing Structure V,,140 Historic House: ❑Yes U-No On Old King's Highway: ❑Yes 19-1<0
Basement Type: @<II ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 6
Number of Baths: Full: existing new Half:existing new i
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new_� First Floor Room Count �5✓
Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other
Central Air: ❑Yes VN0 Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes ®-N16-
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing Vew size Z6 Shed:❑existing ❑new size Other:
C1 i1 i,41 q p�
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes klo If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION �..
i
Name O Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE q DATE
iko
FOR OFFICIAL USE ONLY
MIT NO.
DATE ISSUED
MAP/PARCEL NO. _
ADDRESS VILLAGE
s _
OWNER
lilt
DATE OF INSPECTION:•
FOUND 'tii'ION V [ r ?'� ( �'
FRAM
INSUL49;I6N• E
M �l lb3
FIREP ►'CEO r
ELECTRICt\L: `IMUGH FINAL
PLUMBING; ROUGH FINAL
B►e
GAS: ROUGH FINAL
FINAL BUILDING ��► ? I,(T/7 �'l b�
DATE CLOSED OUT
rj
ASSOCIATION PLAN NO.
7
The Town of Barnstable
Regulatory Services
Thomas F. Geiler, Director
Building Division
Tom Perry, Building Commissioner
200 Main Street,Hyannis MA 02601
Office: 508-8624038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: ;96=Z /IAaP S 7`e9g A5 H 1,&15
number street village
"HOMEOWNER
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellin_s of six units or
less and to allow homeowners to engage an individual for hire who does not possess a license,provided that
the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is
intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or
farm structures. A person who constructs more than one home in a two-year period shall not be considered
a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the
Building Official,that he/she shall be responsible for all such work performed under the building permit.
(Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
procedures and requirements.
�1L2
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a
person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see
Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in
serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the
unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit
application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
form currently used by several towns. You may care t amend and adopt such a fomr/certification for use in your community.
Q:FORMS:EXEMPTN
SHEDS (greater than 120 sq. ft.)
If located in OKH or Hyannis Historic District- Certificate of Appropriateness is needed
�ap/parcel number Q b a-D
gn-offs from:
Health
Conservation
s Tax Collector
VTre asurer
Owner's name & address
Shed Mmensions
sated Cost G U
] omplete dwelling information for the Assessor's dept.
11 Applicant's telephone number
] ✓ Plot Plan
] 1,,,4wo sets of plans with cross section
] LV0,1kman's Comp. form
] ome Improvement Contractor's Affidavit
Construction Super's License AND Home rovement Specialist's License
OR
] 1/omeowner's License Exemption form.
] Check expiratio ate on license(s)
Check expiration date on license
] Fee
OTES:
ffEDS 120 sq.ft. or less - (RESIDENTIAL AND COMMERCIAL), do not require a Building
;rmit BUT Registration form and Plot Plan are required.
] If located in OKH or Hyannis Historic District- Certificate of Appropriateness is needed
LASTIC,FREE-STANDING GREENHOUSES DO NOT REQUIRE BUILDING PERMITS.
brrmpermits 1
02/09/00
a
PROPERTY ADDRESS I I ZONING I DISTRICT CODE SP -DISTS.I DATE PRINTED I CSTATE PARCEL LASS I PCS I NBHD -1 1 I KEY NO.
0015 • RC1i ' 400 07HY . 07/0919 10 i00 [
LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS TY UNITADJ'D. UNIT
Land By/Date SizeFF--Depth/Acres
Dimension ACRES/UNITS VALUE Description M F N D O ZA. C H R I S T O P H E R. 9 ' J O H N MAP-
[CD. De th/Acres E
LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE #LAND 1 28,,900 CARDS IN ACCOUNT -
L 10 18LOG.SI'T 1 . X ' .44 =100 r 164 39999.99 65599.99 .44 28900 .#BLDG (S)-CARD-1 1 68j-000 - 01 OF 51
A 4PL 3 GUY - LANE HY OST 96900
N BATHS .2.0 U 1 ,x° C= , 100 7000.00 7000.00 1 .00 7000 9 ##DL LOT 1 1ARKET 19600 i
D #RR 2120 INCOME
#4SR STRAIGHTWAY NORTH SE
A PPRAISED VALUE
D D 96,900
A U ARCEL SUMMARY
T AND 28900
A T " LDGS 68000
-IMPS
M OTAL 96900
F E �,, CNST
E N DEED REFERENCE Ty, DATE Recorded R I O R YEAR ' VALUE
V A L U E
A
T Book Peg e Inst. MO. Yr. D Sales Prig AND 28900
T S 8965/272UT112 /9.3 L 82.500 PLDGS 68000
U 89651270: I� 2/9.3 B . 1 TOTAL 96900
R 8794'.247: 10/93 L 85500
E BUILDING PERMIT
S Number Date Type Amount
LAND LAND-ADJ .' INCOME SE SP-BLDS FEATURES SLD-ADDS UNITS
28900 7000 333122 8189 ND 4.5000
Class Const. Total Base Rate Adj.Rate r B ilt Age Norm. Obsv. CND Loc 4b R.G Repl Cost New Ad, Rep, Value Stories Height Rooms P.ms B.Ihe M Fiz. P.Ay..II Fec.
Units Units A I Depr. Cond.
02C 000 100, 100 66.10 66.10 89 89 5 96 90. 86 79085 • 68000 . 1 ..5 7 4 2.0 8.0
Description Rate Square Feet Rapt.Cost MKT.INDEX: 1 .00 IMP. BY/DATE: ML ' 5/92 SCALE: 1 /01 -00 ELEMENTS CODE CONSTRUCTION DETAIL
S BAS 100 66.10 768 .5076.5 f3 I(U:S 5 AREA 1556 TWO - FAMILY DWELLINGCAST GP.00
T
815 42 2776 768 21320 . -----a_e___---_32-------------- STYLE 04 ' APE COD 0.0
R ! _ B1 ! " £SIGTd ADJ 1T_ UO ------------------ CF_
0
9 R.WALLS TG C LIV-95?-S- ZNGLE D.O
U ! iEATfAC TYPE f3A_S WA991 AIR---- 0.0
C -NTER.FIN.TSH 04)RYlii+ALL ---------- 0.0
T ! , NT-Elf _1AY60T- T2 4 VIE R.7NO MAL --- .0
U ! ! NTI=R.t�UAa 7Y £T2 ANTE AS E91t-W--T.-
R 24 : BASE . 24 - LflR .ST4?11 CT i12 :J JOISTjPE A I - n.0
A W ! ' c i�t7R-CJV -- t74 AQPET- ----------�.0
L D 768 : "
E Total Areas Aux = ease = O O F--.T��,�____ -r�q-T AYE 1.E=A S P N_ 7��.0
BUILDING DIMENSIONS 'I.A L (3T V E R A G E u.CY
T BAS W32 N24 E32 S24 -. . 815 • N24 ! ! FOU-N- ATID-N---- OJT 5 D ITED-C(TNC-----9���
AW32 S24 - E32 .. ! ! -------------- - --- ----------------------
.. -----WE.Iv-KETORNUIJIS 3V9C-HYgNNT9--------
L 32--------------X '
LAND TOTAL MARKET
PARCEL 28900 96900
AREA 40.34 {.
VARIANCE +0 +2302
STANDARD .. 25
i
Daniel E.Braman,P.E.
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189 Harbor Point Rd.
Cummaquid,MA 02637-0361
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Licensed to: Dan Braman, P.E.
Job: Ashley Residence, Marstons Mil Steel Code: AISC 9th Ed.
SPAN INFORMATION: t
Beam Size (Optimum) = W16X31 Fy = 36. 0 ksi
Total Beam Length (ft) = 28 . 00
Top Flange Braced By Decking
LOADS: Self Weight = 0 . 031 k/ft
Line Loads (k/ft) :
Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2
0 . 00 28 . 00 0.210 0.210 0. 000 0 . 000 0 . 560 0 . 560
SHEAR: Max V (kips) = 11 .21 fv (ksi) = 2 . 57 Fv = 14 . 40
MOMENTS:
Span Cond Moment @ Lb Cb Tension Flange Comp Flange
kip-ft ft ft fb Fb fb Fb
Center Max + 78 . 5 14 . 0 0. 0 " 1 . 00 19. 96 24 . 00 19. 96 24 . 00
Controlling 78 . 5 14 . 0 0 . 0 1 . 00 19 . 96 24 . 00 --- ---
REACTIONS (kips) : Left Right
DL reaction 3 . 37 3 . 37
Max + LL reaction 7 . 84 7 . 84
Max + total reaction 11 .21 11 . 21
DEFLECTIONS:
Dead load (in) at 14 . 00 ft = -0 . 307 L/D = 1096
Live load (in) at 14 . 00 ft = -0. 712 L/D = 472
Total load (in) at 14 . 00 ft = -1 . 019 L/D = 330
RAMSBEAM V2 . 0 - Gravity Beam Design
" "t,icensed to: Dan Braman, P.E.
Job: Ashley Residence, Marstons Mil Steel Code: AISC 9th Ed.
SPAN INFORMATION:
Beam Size (User Selected) = W16X26 Fy = 36. 0 ksi
Total Beam Length (ft) = 6. 00
Top Flange Braced By Decking
LOADS: Self Weight = 0. 026 k/ft
Point Loads (kips) : Flange Bracing
Dist DL Pre DL LL Top Bottom
3 . 00 3 . 37 0 . 00 7 . 84 No No
SHEAR: Max V (kips) = 5. 68 fv (ksi) = 1 . 45 Fv = 14 . 40
MOMENTS:
Span Cond Moment @ Lb Cb Tension Flange Comp Flange
kip-ft ft ft fb Fb fb Fb
Center Max + 16. 9 3 . 0 0 . 0 1 . 00 5.29 24 . 00 5.29 24 . 00
Controlling 16. 9 3 . 0 0 . 0 1 . 00 5.29 24 . 00 --- ---
REACTIONS (kips) : Left Right
DL reaction 1 . 76 1 . 76
Max + LL reaction 3 . 92 3 . 92
Max + total reaction 5. 68 5. 68
DEFLECTIONS:
Dead load (in) at 3 . 00 ft = -0 . 003 L/D = 23306
Live load (in) at 3 . 00 ft = -0. 007 L/D = 10309
Total load (in) at 3 . 00 ft = -0 . 010 L/D = 7148
I
The Corrimonwealth of Massachusetts
,Department of Industrial Accidents
0lfice o!lnyesti9,111 s . -
600 Washington Street
Boston,Mass. 02111
Workers' compensation Insurance Affidavit
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Failure to secure coverage v required ender Section 25A bf MGL 152 canlead to the imposition of criminal.penalties of a Su-up to S 1,500.00 and/or
one yearn'imprisonment weII as duff penalties in the form of a STOP wORK ORDER and a fine of$100.00 a day against me. I mmde fans that a'
copy of this s{aterneatmay be forwarded to the Office of Investigations of the DIA for coverage veriilcatiom :-
I da k'ereby-eertifyunderthepains and penalties-of-perjury thid-the-information-proaude�Labn�e_isscu acid corlecd - ..
Date )w Ir` J Q
#
Print name
amcial use only do not write in this area to be completed by city or town official
permithicense# C3Buflding Department
city or town: ❑Licensing Board
(,]Sel-ctm&s Office
contact person: r
.Information and Instructions
Massachusetts General Laws chapter�152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from toe `law , an employee is.defined as every person in the service of another under any contract
of hire, express or implied,.oral or written.
partnership, corporation or other legal entity, or any two or more of
An employer is defined as an individual, Ij hip _
the foregoing engaged in a joint enterprise,-and including the Legal representatives of a deceased employer, or the receiver or
trustee of an individual,partaership3 association or other legal entity, employing employees. However the owner.of a ...
and who xesides therein;•or the occupant of the dwelling house of
dwelling house having not more than three apartments
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
b g appurtenant theretd shall not because of such employment be deemed to be an employer. t
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance br renewal
of a license or pe:-mit.to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of eompliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the perfoanance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
%Applicants
Please fill in the workers' compensation affidavit completely,by checking the box of that applies as to
affida maybe
supplying company names, address and phone numbers clang with a certificate _ _ _.
strial Accidents for confirmation of insurance coverage. Also be sure to sign and
submitted to the Departrnent.of Indu
d to the city or town that the application for the permit or license is
date the affidavit. The-affidavit should'be retume
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law",o �ifyQu
lease ci11.`'the D aitEEa afihe number-listed below:.
.aie required,to 0 tain.a workers' compensating policy,p eP
City or.Towns •.
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o�`te
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Plese+
be sure.to fill the•permrtll%cense niiRibei wliicliwilLbe'used as a reference num�ei. The:affidavits may�i'e'rCtq,.
�ti `aiaiT or FAX unless other arrangements have been made: ^~ .
the Department „., ,,.. Y
Investigations would like to thank you in advance for you cooperation and should you have an estions. .
The Office of _ ..., ., . • .. •... ... _r _. .... - .. ..
..,.s. , y ,y
please do not hesitate to give:us a call.
The Departrnent's address,telephone and fax number.
:.,,...
: The Commonwealth Of Massachusetts
_Department of Industrial Accidents
amce of lnilestigatf ons
600 Washington Street
Boston,Ma. 02111 ,
fan#: (617) 727-7749
:: : plione #: (617) 727-4900 ext. 406, 409 or 375 -
Department of Industrial Accidents
==��• Office ofl�estlgatiaos
600 Washington Street
Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit
name:
location: 14 /V/ '
Cih, Dhone#
❑ I am a homeowner performing all work myself.
❑ I am a sole proprietor and have no one working in anv capadty
I am an employer providing wo 'compensation for my employees working on this job.
con any name.._. .
a dces
D
CI -
: ::.::::::::.:::::..:::.;....:.;:.;:.:...::... >:;>;:.;:.;:.. . ..:..:.::.:..
Olicv#..i
' I am a sole proprietor,general contractor, or homeowner cle one)and have hired the contractors listed below who
have
the following workers' compensation polices:
company n
a
a d re
`'>tiltitin
...........................................................................................
....................................................................................................::................................
...........................................................................................................................................................................................................
.................:..........................................................................................................................................................................................
:......................:.::.........................................................:::...,..:....:
.:..t...... ......................... ....
any : « ::<: _ .... ..
:#---
ad fires
s.
one
cite
M.
.........,Lv
ivaren
oli
Faffare to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae to$1,500.00 and/or
one years'imprisonment as well m civil penalties in the form of a STOP WORK ORDER and a 9ne of S100.00 a day against me. I understand that it
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verincation.
I do hereby certify undA the pains and penalties o edury that the information provided above is trio and correct
Signature q�— Date
Print name Phone#
OMNI
official use only do not write in this area to be completed by city or town official
City or town. permit/Ilcense# • ❑Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
❑Health Departmentcontact person: phone#, _ ❑fie!
(revved 9/95 P1A)
Information and Instructions
t --e '14
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", an employee is defined as every person in the service of another under any cQ:rLr=
of hire, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or`other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership, association or other legal entity, employing employees. However.the owner of a
dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renews:
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contr mg
authority.
Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and
supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns `
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the peiz�it/license nrmbei which will be used as a reference number. The affidavits maybe rct riR io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of 1nvestloadons
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 eat. 406, 409 or 375
M CUR Appmdk j
- •• 4 Tablt.iS.ZIh
pronipdre Padcases for ace cad Two-Family Rnldeadal Boildlap Seated with Focal Fads .
MAXIMUM NIIlVI14tI1Rt
Wall Floor ��� S1ab H$���8
A K) U valuc= &value &�l &valusj WaII AEta rq m Fffia�
paama,e R.vdae' &valae'
5"1 to 6500 Headaw Delstee BMW
Q E
2Y. 0.40 3E 13 19 10 6 Normal
R 2-A 0.32 30 19 19 10 6 N�
1 12•6A G50 3E 13 19 1 l0 6 UARE
T IS9s 036 3E 13 23 WA N/A NormalU 15% OA6 3E 19 19 10 6 Normal
is %a .... W A 25 AFUE
W 15% 03Z 30 19 19 10 6 U AFUE
X Ir/. 0.3Z 3E 13 23 WA WA Normal
Y 13% 042 3E 19 2S WA WA Normal
Z IVA 0.42 3E 13 19 10 6 90ARM
AA Ir/. 0.30 30 19 19 10 6 90AFEJE
1. ADDRESS OF PROPERTY. Zi'„'1 Lr)4V i K T,C At-ej�; a "U ;1.4 .
A%-ro ti Hi,c,c C M p. va 61 y 7-
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:
3. SQUARE FOOTAGE OF ALL GLAZING: 1 /
4. %GLAZING AREA(#3 DIVIDED BY #2):
S. SELECT PACKAGE(Q —AA-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-form-080303a
780 CMR Appendix J
Footnotes to Table J5.2.1b:
Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors) to the gross wail
area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 fl of glazing area.
=After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table JI.5.3a. U-values are for
whole units: center-of-glass U-values cannot be used.
' The ceiling R values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-3 8
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
- --`laced fo.::on ofthc 0a�
me can diuoned space nuts u,c r an
'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding, structural sheathing,and interior drywall. For example,an R-19'requirement could be met EITHER
by R 19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-flame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements,
or garages).Floors over outside air must meet the ceiling requirements.
`The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
basements must be included with the other glazing. Basement doors must meet the door U-value requirement
described in Note b.
'The R-value requirements•are for unheated slabs.Add an additional R-2 for heated slabs.
If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J5Mla
NOTES:
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table JI.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c) If a ceiling,wall,floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(035 for doors).
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LOT 44 ASSESSOR'S MAP 62 PARCEL 38
LOT 46 HOUSE 452
PLOT PLAN OF LAND
'TO THE BEST OF MY monEDB& THE FOUNDATION LOCA TED IN
SHOW ON THIS PLAN IS AS IT ACTUALLY EXISTS AND BARNSTABLE - MASS.
THAT IT cONFORMS TO THE TO!✓N TA OF BARNSBLE �� Mq�
ZONING RESULA TION$ RESARDIN¢ YARD SETBACKS' , PREPARED FOR
FUCHARD
oA :DEC 2, t 99 S. o FEflREORA00%5 HARRY ASHLEY
No. 313®9 ZA M DECSOFA 2, l99.9 SCALE 1--60 FT.
FLOOD ZONE 'C• (NON-HAZARD) Y ' FERREIRA ASSOCIA TES
D-147 46100CAP 131 SPRING BARS RD. FALMOUTH—MA .
TOWN OF BARNSTABLE
CERTIFICATE OF OCCUPANCY
PARCEL ID 062 038 GEOBASE ID 3518
(ADDRESS 452 WHISTLEBERRY DRIVE ,,•' PHONE
MARSTONS MILLS ZIP -
I
LOT 46 BLOCK LOT SIZE
i'DBA DEVELOPMENT DISTRICT CO
PERMIT 50194 DESCRIPTION SINGLE FAMILY DWELING PERMIT # 40946
PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY
CONTRACTORS: Department'of Health, Safety
ARCHITECTS: and Environmental Services
(TOTAL PEES:
BOND $.00 pk T1"VE
CONSTRUCTION COSTS $.00 '�'
Qi► �
756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P *FE_
* BARNSTABM •
MASS. .
1639.
ED MA'S
BUILDING
BY
DATE ISSUED 11 28 2000 EXPIRATION DATE
, •` TOWN OF BARNSTABLE
BUIL3 NG PERMIT
.PARCEL ID 062 038 .'" GEOSA51k ID --351:
ADDRESS 452 W'HISTLEBERRY DRIVE PHONE
MARSTONS MILLS 'r ZIP -
LOT' 46 BLOCK LOT SIZE I
DBA _., ' DEVHLOP�ENT DISTRICT. CO
PERMIT 40946 DESCRIPTION NEW 3 BDRM SING.FAM.HOME SEWPT#99-541
PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT
CONTRACTORS: PROPERTY OWNER � De p.artment of Health, Safety
ARCHITECTS: , ` and Environmental Services
TOTAL FEES: $364. 19BOND $.00
Y° THE 1
CONSTRUCTION CASTS $11.7,480.00 , Q�
101 SINGLE FAM HOME -DETACHED 1 PRIVATE P_ * STABLE,
4 MASS.
0.39.
� � ED MA'I 1►
BUILDING D CIO
BY
DATE• ISSUED 09/00/1999 EXPIRATION DATE w
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN-
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OFF;,
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OFTHIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE
1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH-
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS.
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE.
4.FINAL INSPECTION BEFORE OCCUPANCY.
POST THIS CARD SO IT IS-VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
3 1 HEATING INSPECTION APP77/,00
ENGINEERING DEPARTMENT
t -cry i k s o
2�, 1 . BOARD OF! 'HEALTH
r�I
OTHER: SITE PLAN REVIEW APPROVAL
&ndluha" //be/
WORK SHALL NOT PROCEED UNTIL RMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVED THE TRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
TION. NOTED ABOVE. TION.
I 4
•
r
r
L �J
The Town of Barnstabe
� �FTNE t
Department of Health Safety and Environmental Services
Building Division
` BABrrsrnBM ` 367 Main Street,Hyannis MA 02601
Mass.
� 039.
ArFD MA't A
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building.Commissioner
HOMEOWNER LICENSE EXEMPTION
G� Please Print
DATE: T `9 n� /
JOB LOCATION:
number street �^ village
W r
"HOMEONER": 7 2/ C 2 r
name home
?phone# work phone#
CURRENT MAILING ADDRESS: J
d,26 ?
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units
or less and to allow homeowners to engage an individual for hire who does not possess a license,provided
that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is
intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or
farm structures. A person who constructs more than one home in a two-year period shall not be considered
a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the
Building Official,that he/she shall be responsible for all such work performed under the building permit.
(Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
procedures and requireme
Signature of meowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from
the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a
person(s)for hire to do such work,that such Homeowner shall act as supervisor."
. Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see
Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in
serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the
unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit
application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is
a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community.
Q:FORMS:EXEMPTN
Inclusionary Affordable Housing Fee
Property Owner's Name C. AJ
Project Location Z- - Q ��` 0
Project Value Permit Number 0 y�D
Planning Dept. INCLU3IONARY HOUpINDG INCLU3IUSIY HYUS�NGING
pLANNi G DEPARTMENT L I _ V �� D
INITIAI•S l DATE_' 3�� 5 i N}PLANK QF+ DA, B
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I A ,
m / �C(�'J IL
DATA
I .
CURTISS CONSTRUCTION BIM
115A PINE AVE
HYANNIS MASS
Buimi s 7753312
Home Phone 775-4351 HARRY_ASIMEY__
5 WIHs'I�8ttP*,'0,746
1V�AI�.STONS>MiILS
BILLING DATE:
ACCOUNT ID:ASHRES
I
FRAMING LABOR TO'CONSTRUCT HOUSE PER PLAN-
INCLUDING ALL INTERIOR PETITIONS,INSTALLATION OF ALL .TOTAL
DOORS AND WINDOWS AND EXTERIOR TRIM NO ROOFING CONTRACT .COMP
OR SIDING INCLUDED IN CONTRACT
in-VMRKMANS-COMP#7PJUB510X851.Wg
�I
ACORD� CERTIFICATE OF LIABILITY INSURANCE F10-19-99Dm)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Edward A. Grazul Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 337
Marston Mills, MA 02648 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Assurance Company of America
Ail Square Foundation, Inc. INSURERB:
78 Beldan Lane INSURER C:
Centerville, MA 02632 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TR MM D Y RATION
Y
GENERAL LIABILITY EACH OCCURRENCE $1 ppp ppp
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one fire) $EXCluded
CLAIMS MADE OCCUR MED EXP(Any one person) $ 1 0,000
PERSONAL&ADV INJURY $1 ,000 000
GENERAL AGGREGATE s2,000,000
A GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,00O 000
POLICY PRO- SCP 35270231 07-26-99 07-26-00
--]
JECT LOC
AUTOMOBILE LIABILITY
� COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
OTHER THAN
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
TATUWORKERS COMPENSATION AND WC SLIMIT O R
EMPLOYERS'LIABILITY TORY LIMITS ER
E.L.EACH ACCIDENT $
A TCO 55751748 07-26-99, 07-26-00 E.L.DISEASE-EA EMPLOYEE $ 100,000
E.L.DISEASE-POLICY LIMIT $ 5
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
For work being done at: 452 Whistleberry Drive, Marston Mills, MA, for Harry Ashley
CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
230 South Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Hyannis, MA 02601 IMPOSE NO OOBBL-IGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTAT? ES.
AUTHORIZED RE RESENT TIVE
Attention: Building Department
I Ara&
ACORD 25-S(7/97) 0 ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
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).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
,rt r
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ACORD 25-S(7/97)
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AREA PLAN
SCALE: 1 "- 30 ' S YS TEM PROFILE ' .
APPLICATION NO. P-9187 ✓ULY 2. 1999 FINISH GRADE NOT TO SCALE
GLENN HARRINGTON BARNSTABLE HEAL TH DEPT. �••. FINISH GRADE FINISH GRADE
_____ --- C.I ,O "'•r O• CO 'O OVER TANK OVER TRENCHES.
TOP FND
NOTES.' 1�' �' // A• / / �'/�6 �riA �/ .SCH 40 PVC '
1. ELEVA TIONS BASED ON USGS ..' ,
►` OR ,..
2. TOWN WATER ON SITE ,`�: 5 '20 CAST IRON LEES
3. FLOOD ZONE NC At 5'T 9 p . �� •..
BSM'T FL R
6lr 1500 GAL. ,•1 EQUALIZERS 5Z•00
5 3.?, ''' rt REINFORCED I
CONCRETE GAS DIST.BOX
::...;.�•�.:•:..�.•:.:• r• BAFFLE ,ag"'. '::°S._"r' a .�.•:••y.
TO BE INSTALLED ON A ;��::�L:.�..:':�.'::. .�%•:i:..;;. ..:::; "+ •%.s.
LEVEL STABLE BASE
SEPTIC TANK 515.0 TRENCH LENGTH
t•
r..
LINE BEARING DISTANCE TO BE INSTALLED ON A •g2• - 0".
1 N 09.00'00'W 25.00 LEVEL STABLE BASE
f" ;' ,..•: :. 5'MIN.HEIGHT
NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM ABOVE OBSERVED: -
%' / GROUND WA TER
LEACHING INFIL TPA TOR SECTION
E,S&,E,,,, NOT TO SCALE SOIL AND PEPCOLA TI.ON DATA
5
LOT 45 FOR FINISH GRADE APPLICATION NO. P-'9187
SEE SYSTEM PROFILE MIN.2"
r'
: �� J` ; ♦` // %�Yr' y,' ,�,"/ ^//�! s"/tKS< r i(. r/ /�C//.�'/�/R"r/9/F"/�` ,N'r�, F//�;l•�f WASHED STONE PERC. RA TE � 5 MIN11N.
Uo
S' ti (12"MIN.) Z TAKEN BY BRUCE G. MURPHY
J f + /� > ..•/ S � ,•�: ': ..: '-.,;..• WITNESSED BY GLEN HARRI NGTON
• •' . DA TE JUL Y 2. 1998
4"DIA.PIPE �, ,.:. ' ' ;•,' :; TEST PIT ELEV. VARIES
`. :/ ` > ,. ;�• TEST NOLE 1 TEST hIOLE 2 r
NATURAL SOIL -� a��•o '� % EFFECTIVE 0 •qr 'A' , 0;
LOT 46 / y e �•�• ;,� DEPTH B, SANDY LOAN 10YR 4/3 SANDY LOAN' 10Y19 4/3
oB
•� ` i t .o A .1• • t•� 4 Br-
147. B F j 3/4„-1 1/2" � �a,�i�?�',����er.e '��•�, ��., a • r •
WASHED STONE — •.• .r •c S'- •.'a o:•i a' . . •••. :'o,:'' .•:'"-:. •r,' v:' LOAMY SAND 10YR 5/6 LOAMY SAND 1049 5/6
EFFECTIVE WIDTH 30r 30'
r
EXCA VA TED SIDEWAL L t0'-10 __ SAND •10YR 6/4` LERC'D DV 4%f' I
S.• /1. / � 9a. . 4'-0' 4'-0' LESS 2MIN/1N sedium-coarse sand ter"
j } NUMBER OF TRENCHES 1 60' SAND 1049 614
"diuer-coarse sand
\ / SAND JOYR 7/4
i' NUMBER OF INFIL TRA TORS 4 sedlun sand
f •. .i -. �' NO 6R0llNO1VATER
1( I N b j DESIGN DA TA
Q 1 - P°' f 171_ S. F. SIDENAL L AREA . 74 GAL S/SF 126 GAL S. NO.OF BEDROOMS
" ' ® 346 S. F. BOTTOM AREA . 74 GALS/SF 2 6 GALS. DISPOSAL NO
EO `'E Q / EST. TOTAL DAILY EFFLUENT 330 GALS.
517 S. F. TOTAL AREA GALS/SF 382 GALS. SEPTIC TANK t500 GAL.
? ,
t • ly
o '
_ wAMP s��z —— — -- rP / GENERAL NOTES
NOTE.'
------�_� g : 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN
5z'"~ : m T TA TE SA NI TARP CODE
ti �- ACCORDANCE WITH TITLE 5 OF HE S
p EXCAVATE TO ELEV. 51.0 OR LOWER AS REQUIRED
TO REMOVE ALL LOAM AND CLAY CONT4INING DA TED MARCH 1995 AND ANY LOCAL RULES APPLICABLE.
MATERIAL BENEATH THE LEACHING AREA.REPLACE 2. ANY CHANGE IN THIS PLAN MUST BE APPROVED:
t ` : EXCA VA TED MA TERIAL WI TH CL EA N, CL A Y FREE GRA VEL BY THE BOARD, OF HEALTH AND FERREIRA A SSOC.
'sTz�"� MECHANICALLY COMPACTED IN PLACE
TAW
�' 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING
NOTIFY BOARD OF HEAL TH FOR INSPECTION
— 79 't 4. FND. EL EV V. MUST BE CHECKED WHEN COMPL ETED
4 1 , TRaVS LE CHINe LEGEND 5. THESE EL EV. MUS T NO T BE CHANGED WI THOU
t J ! IWIL77U nwS MXry THE BOARD OF HEALTH APPROVAL
/ l s2 Sx 10�10•X'021 6. BOARD OF HEA L TH INSPEC TION REG 'D WHEN .EXCA TED
�. . / :. ..
MEE~zcivEXIST.GROUND ELEV,
FINISH GROUND EL EV.
0) SEWA GE DI SPOSA L S YS TEM PL A N
58•ZO PIPE INVERT ELEV.
ES PI LOCATION RD PREPARED FOR
TT T T
E El =,
mi100 SEPTIC TANK c N 309 HAROLD ASHLEY
173.80 1 .,,?_
N 79.42'36"W o DISTRIBUTION BOX LOT 46 . WHIS TL EBERR Y DRIVE
M 54
•_ \ J c,a 4r C.I.OR SCH 40 PVC .sY �N aF BARNSTABLE -- MASS.
3 SZ MAssf ,
LOT 52 ,++««�«►���� 4"BIT.FIBER PIPE—TIGHT JOINTS
GEORGE
... PROPER i LINES No R45# N DESIGNED: SAP DATE: JUNE e. 1999 FERREIRA ASSOCIA TES '
— ---� SETBACK DISTANCE
62 38 46 452 s r.E� ; DRAWN: HP SCALE•As SHOWN 131 SPRING BARS: ROAD.. '
' FALMOUTH MASS.
NAl.�'�'� CHECKED : GS. DRAWING NO.` 060899
HSE MAP SEC PCL LOT •, ,,
-• 1 . •.. ,, ... .. - . • • - • • ., . ' - . ` . ._ ,
AREA PLAN
sCla L E• 1 ��= 30
S YS TEM PROFILE -
APPLICA TION NO. P-9187 JUL Y 2. 1999 rNrsH GRADE NOT 'TO SCALE
GLENN HARRINGTON BARNSTABLE HEAL TH DEPT. �.;.. FINISH GRADE FINISH, GRADE
C.1 10
.••�, -�, Co a o pVER TANK OVER TRENCHES; O'd'
NOTES. TOP ; ►,• , ,, wy / / / ,�`/ /``° �F `/�• � , y /N/:fi �vV a/Ny M .� `/ha S `/3�/L> + /�/ / / / J'/ /
i , .. /Q F �' � � R ♦Y/ /,�` �,/�, /�,W LAY/� //�•,,� ��` /` ` /,',�/ �, b�, �o/
' SCH 40 PVC -
1. EL EVA TIONS BASED ON USGS ` 40 '
OR
2. TO!✓N WA TER ON SITE 5 •7.�
3. FLOOD ZONE "C" 5'l•90 CAST.IRON LEES 5 7.34
BSM'T FLR !:':
ss 1500 GAL. :! EGUALI7.ERS
REINFORCED ;. DIST.SOX
r; CONCRETE rJ GAS ..
r:.:•:..±.•..., f, , BAFFLE .eg ,t •:: •
• ... ;.,. .•�:�., TO BE INSTALLED ON A :::�=•s=L:�.:•�:•::•:;• •::,:..;.• •::;.?,•::w.;,sy�
} LEVEL STABLE BASE
SEPTIC TANK
515.0
TRENCH . LENGTH
'f °• '''I LINE BEARING DISTANCE TO BE INSTALLED ON A 32• 0«
1 N 09000,00IN 25.00 LEVEL STABLE BASE
5'MIN.HEIGHT
. •
F NO TE. DO NO T RUN HEA V Y EQUIPMENT O VER S YS TEM ABOVE OBSERVED''.
GROUND WATER
fr •j. xr . .- f 7� '. it
LEACHING INFIL TRA TOR SECTION ;
NOT TO SCALE SOIL AND PERCOLATION DATA'
LOT 45 FOR FINISH GRADE APPLICATION NO. 'P=•9187
SEE S YS TEM PROFILE
MIN.2 -C g MIN/IN.
Q► j / 5� , �, ^//,�r ,(a is`/�S< i/,�t�,(.•,�// //,c �C'r e"•��/AK•�h� .N~••, /i� ���, wASHEO s roAft= PERC. RA TE
,O f `S so• (92"MIN.) ? TAKEN BY BRUCE S. NURPHY
r �� ter: ;.:r:a•.. .': ::�_1_w.,: , ::: :: ,,., ,: ;; WITNESSED BY GLEN HARRINBTON
/ �� ;.. .•., 3 DA TE JUL Y 2. 1998
;' .. ••. r � VARIES
" i `cam 4"DIA,PIPE ; �� ,;,'•• ••';:•�' ;;` TEST PST ELEV. - .. '
J �,;� �/; • . O, TEST/ROLE t ' TEST MULE 2., 0•;
," • NATURAL SOIL -� `e,••o✓ i^ •i :% EFFECTIVE .A• .A. .
LO 6 �' y i�,�••� :.;• DEPTH e• SANDY LOAN JOYR 4/9 SAVOY LOAN• JOYR 4/3
t a rr � ,�•ii0i1,�••i.�i.i y•, �" 4 .o. .B•84e :
WASHED STONE �.• •• •• ." .'.•: i•, ••• . o;;'' '.'. :: •�.' • LOAMY SAND JOYR 5/6 LOAMY SANG tOYR 5/G
r _ EFFECTIVE WIDTH 90' 90*..
EXCA VA TED SIDEWALL JO'-JO' 'Ct'
PERC'D AT 42"_ SAND JOYR 6/4
/ �'a 4'-0' LESS 2MIN/IN medium-coerse sand
r _ _ U S 0' 6/4
NUMBER OF TRENCHES 1 6 SAND : JOYR
! / .L,2, medJUN40arse sand:
SAND J0YR 7/4
NUMBER OF INFIL TRA TORS 4 medium sand
38.
NO 6R IWVATER
2 ^%; � , �% DESIGN DA TA T
• 171 S. F. SIDENAL L AREA 74 GALS/SF 126 �GALS. B
R ( NO. BEDROOMS
Q a / DISPOSAL NO
a _® 346 S. F. BOTTOM AREA = 74 GALS/SF 256 GALS.
ma-w°znrvE EST. TOTAL DAIL Y EFFLUENT 330 GALS.
j I 5.17 G 5 382 GALS. SEPTIC rANK 1500 GAL..
S. F. TOTAL AREA ALSI F�
i '' o � � � �,/� / - - - •• , ' , ill'
�� I Ta GENERAL
TR S J — — -- NO TES
..; I " � S°• q NOTE:
d 1. ALL S YS TEM COMPONENTS SHALL BE INS.TAL L ED IN
52` . m t?�... ,- ACCORDANCE WI TH TI TLE 5, OF THE STA TE 'SA NITARY' CODE.. ! '
o ► °SOX N p �`• EXCA VA TE TO EL EV V. 51 0 -OR L OWER AS REOUIREO
.. I o �B• To REMovE ALL LOAM AND CLAY canrralNlNG DATED MARCH .1995 AND ANY LOCAL RULES APPLICABLE.
? MATERIAL BENEATH THE LEACHING AREA.REPLACE 2. ANY CHANGE IN THIS -PLAN MUST 'BE APPROVED,
;
t I EXCA VA TED MA TERIAL WI TH CL EA IV, CL A Y FREE GRA VEL
'50° �L MECHAI'JICALL Y COMPACTED IN PLACE BY THE BOARD. OF HEALTH AND FERREIRA ASSOC. -
F _ J 3, WHEN CONSTRUCTION IS COMPLETED; PRIOR TO BACKFILLtNG
/ J ` TAW
NOTIFY BOARD OF HEAL TH FOR INSPECTION '
;
4. FND. ELEV V. BE CHECKED WHEN COMPL E'TED -
;1 Ev LE M Ne 5. �HESE ELEV.MUST NOT BE CHANGED 1✓I•TROUT
4 j LEGEND
1 1wrLMATa�s MXTH THE BOARD OF HEAL TH APPROVAL
tj W. '- ``ol x 2 ° 6. BOARD OF HEAL TH INSPECTION REO 'D WHEN .EXCA VA TED
aJ; _ . CAQ-- . EXIST.GROUND .ELEV.
FINISH GROUND ELEV.
7" S8•zO PIPE INVERT ELEV, 01 SEWA GE DISPOSA L SYS TEM PL A N ..
c 1 I ® TEsr Pr LOCATION ' RD s PREPARED FOR
E El
.•.� 173.80
0- o SEPTIC TANK N 09 HAROLD ASHL EY
N 79.42'36',W 1 a OrsrareurroN {pox T 46 . WHISTLEBERRY DRIVE
54
J ff 4 C.I.OR SCH 40 PVC X: BARNS TABLE MASS.
SZ LOT 52 4'BI r.FIBER PrPE-TIGHT JOINTS ` �� sVc+
GEORGE
...._. PROPERT i LINES No R U TO N DESIGNED: SAP DATE . 1999 =:.
FERREIFRA A5SOCIA TES
SETBACK DISTANCE DRAWN: SCALE.•AS SHOWN 131 'SPRING BARS. ROAD,
. 62 38 46 452 '
IVA�,�.�'G ORAwING NO.• FALMOUTH - MASS.-
.;. CHECKED ; 6S, • 050899
MAP SEC PCL LOT JHSE I