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0045 SEAPUIT ROAD
yea _�o ' -T � M Town of Barnstableuldin .. M Post'This Carii So That itis'°V'.isible From the Street=App'rovedPlans Must beRetained"on;Job anilith'is Card Must:b�e Kept Posted Until Finalln ��Has Been�M�`ade. � s erm�t ea: " Where a Certifica"te of•Occupaney is Requ ed,such BuildingsshallyNotbe Occupied until"a Final Inspection has been made. Permit NO. B-18-1314 Applicant Name:. Craig Bishop Approvals - S ructure DateIssu Curren Permit Type: Building-Insulation-Residential' Expiration Date: 11/21/2018 Foundation'. Location: '45 SEAPUIT ROAD,OSTERVILLE Map/Lot: 118-124 005 Zoning District: SPLIT Sheathing:. Owner on Record: WYSOCKI,MARY P TR Confractor�Name Craig P Bishop Framing: 1 Address: 45 SEAPUIT ROAD �� Con10 tractor License: CS 109777 ' OSTERVILLE; MA 02655 eEstN�PJt Cost: $6,756.00 Chimney: Description: " Air Sealing&Weatherization Permit#Fee: $85.00 �<m Insulation: S 85.00 - Project Review Req' r u .� a Final: : $ ,Date 5/21/2018 �idks(M Plumbing/Gas Rough Plumbing: . Bungffice ildi O � il Final Plumbing: - , This permit shall be deemed abandoned and invalid unless the work authonzefty this permit is commenced within sWrnonths a after-'issuance.. Rough Gas: � � ,, �` r All work authorized by this permit shall conform to the approved application and.the approved construction documents for whichp is permit has been granted. a° Final Gas: All construction,alterations and changes of use of any building and structur6§fshall3be incompliance with the local zornng by,laws and codes. �,M_ � -This permit shall be displayed in a location clearly visible from access street-or,road?and shall be maintained open fgDpublic=mspetttion for the entire duration of the work until the completion of the same. Electrical OF 4 A 0 Service: The Certificate of Occupancy will not be issued until all applicable signaturesxbythe Bu�I ngiand Fire Ol ials aretprovida- on_�this permit. Minimum of Five Call Inspections Required for All Construction Work` r . R 1.Foundation or Footing - - Rough: 2.Sheathing Inspection Finale 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed ;Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage,Rough: 5.Prior to Covering Structural Members(Frame Inspection) ; 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health- Where applicable;.separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final:, "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department ° Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT—ISSUED RECIPIENT 4 LAW OFFICES OF MICHAEL D. FORD ATTORNEYS AT LAW 72 MAIN STREET, P.O. BOX 485 WEST HARWICH, MA 02671 TEL. (508)430-1900 FAX (508)430-9979 mdfesql@verizon.net MICHAEL D.FORD JEFFREY M.FORD March 20, 2012 Robin C. Anderson Zoning Enforcement Officer Building Division 200 Main Street Hyannis, MA 02601 Re: SRC Sales, Inc. — Enforcement Letter Dear Robin: As you are aware, I represent SRC Sales, Inc. with respect to the Cease and Desist Order you issued on November 2011 for the use of property at 45 Seapuit Road, Osterville, MA. (copy attached) I write now to confirm that I have been keeping you advised over the last couple of months of my clients' efforts to find a new location to move their business, rather than apply for a special permit for a home occupation or a variance from the home occupation provisions of the Ordinance. As I reported to you previously, they have indeed found a new location in Osterville, which they have purchased, but were unable to occupy until the end of April 2012. 1 appreciate the Town's cooperation and assistance with permitting the time for my clients to come into conformity with the Ordinance. Please call me if you have any questions regarding this matter. Very truly yours, Michael D. Ford MDF/sfm Enclosure Cc: clients 11/00011 14: 30 5084205353 RWYSOCKI PAGE 02/03 Kegultatury services Thomas F.Geller,Director Building Division 3 •ruwsreetc. 1 Tom Perry,Building Commissioner i6jq. a1� 200 Main Street, 14yann.is,MA 02601 Office: 508-862.4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violations) and Order to Cease, Desist and Abate: Raymonds J. Wysocki, Jr, Christine McCartney, Mary P Wysocki, Trs &SRC Sales, Inc. and all persons having notice of this order. As owner/occupant of the premises/structure located at 45 Seapuit Road,Osterville,MA Map 118 Parcel 124-005,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,Nov. 2,.2011 , to, I.. CEASE AND DESIST,TIV ME,DTATELY, all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances! Chapter 240 Section 13 (A) 1 RF Residential Zone 2. COMMENCE immediately, action to abate this violation. SUMMARY OF ACTION TO ABATE: Operation of SRC Sales, Inc. and any other business or derivative and any and all activities including the storage and distribution of all associated products, storage of equipment, receiving clients and employees on site and employee parking at 45 Seapuit Road, Osterville, MA.. And, if aggrieved by.this tiotice,'and order,'to.show,cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). if,at the expiration of the time allowed,action to abate this violation has not commenced, further action as the law requires will be taken. der, Robin C. Anderson Zoning Enforcement Officer Q/PORMS/vio7tonct i 11/07 'N11 14: 30 5084205353 RWYSOCKI PAGE 03/03 Town of Barnstable,MA Tuesday,November 1, 2011 §24043.RC, RD, RF-1 and RCS Residential Districts. A. Principal permitted uses. 1'lte following uses arc permitted in the RC, RD, RI'-1 and RG Districts: (1) Single-family residential dwelling (detached). D. Accessory uses. The following uses are permitted as accessory uses in the RC, .RD, RF-1 and RG Districts: ()),Keeping, stabling and maintenance of horses subject to the provisions of§ 240-11B(2) herein. C. Conditional uses. The following uses are permitted as conditional uses in the RC, RD, RF-I and RG Districts, provided a special permit is first obtained from the Zoning Board of Appeals subject to the provisions of§ 240-125C herein and subject to the specific standards for such conditional.uses as required in this section: (1) Public or private regulation golf courses subject to the provisions of§ 240-11C(2) herein. (2) Keeping, stabling and maintenance of horses in excess of the density provisions of§ 240- 11B(2)(b) herein, either on the same or adjacent lot as the principal building to which such use is accessory. (3) (Reserved) Editor's Nate;.Former Subsecriori C(4), regarding family apartments, was repealed 11-18.2004 by Order No. 2005-026. See now§ 240-47.1. (4) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but only as an accessory use. D. Special permit uses. The following uses are permitted as special permit uses in the RC, RD, RF-1 and RG Districts, provided a special permit is first obtained from the Planning Board- (1) Open space residential developments subject to the.provisions of§ 240-17-herein. E. Bulk regulations. Minimum Yard Setbacks Minimum Minimum Minimum Maximum Lot Area Lot Lot Building Zoning (square Frontage Width Front Side Rear Height Districts feet) (feet) (feet) (feet) (feet) (feet) (feet) RC 43,5602 20 100 . 203 10 10 30' RD 43,560' 20 125 303 15 15 30' http://www.ecode360.cone/printBA2043/form?guid=6558248 1 l/1/2011 LAW OFFICE OF". • ATTORNEYS AT LAW ��a'� ,• j Y 72 'MAIN STREET - P.O. BOX 485 W. HARWICH,MASSACHUSETTS 02671 Robin C. Anderson Zoning Enforcement Officer Building Division 200'Main Street Hyannis, MA 02801 'ii'I,, =,1;-i, i,tii:I,lJ,ii,i,.ii.il.t,i1,�,:��i�i ��.��,���� .e� �w�. �������w.. , . � �}ƒ r. � � . . . � ( � � � i . : . � { � � � � � � � \ . : . � � � � ) ( , . y � � >�� � yz : \ � ` . \ { . \ : }� � \ � � � � p > 2 ! . © . ) / � � < . f ^/�^ ' � { . <� � � ' \ � � \ � � \ . ( � 2} . � . i �` �\/ . � / . . \ \ � � « . . ):\ \ ��\ � � �\ [ < � | . � . { � � . : j . . \ � ` � � � � � � ) k� � d� � � � j i � . . ) / / � � � � � � 4 \ � � � � * � ! ` \ [ : � � � � . - 6 � : � \ . � _ / � 1 < � . _ . /z \�{ � _ . \�j � _ � � � . . � — � �\� � . � � / » » :� z � , \ [ � \ � _ \ �k & �� � . . : %2��v � � � / }�, � �% . { »� . � . .���, - : \ / � � ������ � � / � � � � � D , � . . . . . � C � » . , � ) �( \\ . � \f � �2 � . _ � \ � � » } . ) � `'/ \ � . } © � � � } \{ \ � � � � . _ ® / � \ \�\ , � . � : . . ��\ . \ ' ' ) � � � � \ ( � \\` ~ ~� � � �__ \ [ § � � � ' . } LAW OFFICES OF MI:C.HAEL D. FORD ATTORNEYS AT LA W 72 MAIN STREET,.P.O. BOX 485 WEST HARWICH, MA 02671 TEL. (508)430-1900 FAX (508)430-9979 MICE•IAFI.D.FORD mdfesq 1 @verizon.net JEFFREY M.FORD March 20, 2012 Robin C. Anderson Zoning Enforcement Officer Building Division 200 Main Street Hyannis, MA 02601 Re: SRC Sa.les, Inc.— I nforcement Letter Dear Robin: As you are aware, I represent SRC Sales, Inca with respect to the Cease and Desist Order you issued on November 2011 for the use of property at 45 Seapuit Road, Osterville, MA. (copy attached) 1 write now to confirm that I have been keeping you advised over the last couple of months of my clients' efforts to land a.new location to move their business, rather than apply for a special permit for a home occupation or a,variance from the home occupation provisions of the Ordinance. As I reported to you previously, they have indeed found a new location in Osterville, which they have purchased, but were unable to occupy until the end of April 2012.. I appreciate the Town's cooperation and assistance with permitting the time for my clients to come into conformity with the Ordinance. Please call me if'you have any questions.regarding this matter. Very truly yours, i Michael D. ford MD F/sfm Enclosure Cc: clients i 11/07/2011 14: 30 5084205353 RWYSOCKI PAGE 02/'03 .Kegulatory aervlces dP Thomas F.Geller,Director Building Division 3 g Tom Perry,Building Commissloner 070. 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desisrand Abate: Raymonds J. Wysocki, Jr, Christine McCartney, Mary P Wysocki, Trs &SRC Sales, Inc. and all persons having notice of this order. As owner/occupant of the premises/structure located at 45 Seapuit Road,Osterville,MA Map 118 Parcel 124-005i you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORD1✓RED this date,Nov. 2,,2011 , to: 1. CEASE AND DESTST,11fJMEDTATELX,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 13 (A) I RF Residential Zone 2. COMMENCE immediately,action to abate this violation. SUMi MARY OF ACTION TO ABATE: Operation of SRC Sales, Inc, and any other business or derivative and any and all activities including the storage and distribution of all associated products, storage of equipment, receiving clients and employees on site and employee parking at 45 Seapuit Road, Osterville,MA.. And, if aggrieved by this notice and order,to show cause as to why you should'not be required to do.so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground therrof) within thirty(30)days of the roceipt of this order(in accordance with Chapter 40A Soction 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. der, Robin C. Anderson Zoning Enforcement Officer Q/PORMS/rtozonct „ 11/07/2011 14:30 5084205353 RWYSOCKI PAGE 03/03, Town of Barnstable,MA Tuesday,November 1,2011 §240-13.RC,RD,RF-1 and RG Residential Districts. A. Principal permitted uses. The following uses are permitted in the RC, RD, U-1 and RG Districts: (1) Single-family residential dwelling (detached). D. Accessory uses. The following uses are permitted as accessory uses in the RC,RD,RF-I and RG Districts: (1) Keeping, stabling and maintenance of horses subject to the provisions.of§ 240-11B(2) herein. C. Conditional uses. The following uses are permitted as conditional uses in the RC, RD,RF-1 and RG Districts, provided a special permit is first obtained from the zoning Board of Appeals subject to the provisions of§ 240-125C herein and subject to the specific standards for such conditional•uses as required in this section: (1) Public or private regulation golf COMM subject to the provisions of§ 240-11C(2) herein. (2) Keeping, stabling and maintenance of horses in excess of the density provisions of§ 240- 1)B(2)(b) herein, either on the same or adjacent lot as the principal building to which such use is accessory. (3) (Reserved)EtlJtor:t.Note: Former Subsecrion C(4), ragording fans fly aportmentt, was repeoled 11-18-2004 by Order No, 2005-026. See now,f 240-47.1. (4) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but only as an accessory use. D. Special permit uses. The following uses are permitted as special permit uses in the RC, RD, RFA and RG Districts, provided a special permit is first obtained from the Planning Board: (1) Open space residential developments subject to-the•provisions of§ 240-17,herein. E. Bulk regulations. Minimum Yard Setbacks Minimum Minimum Minimum Maximum Lot Area Lot Lot Building Zoning (square Frontage Width Front Side Rear Height Districts feet) (feet) (feet) (feet) (feet) (feet) (feet) RC 43,5602 20 100 203 10 10 30' RD 43,5602 20 125 303 15 1.5 30' http://www.ecode360-com/printBA2043/form?guid=6558248 11/1/2011 il3% on c� cYcLba S / Is J of Barnstable latory Services - s F. Geiler, Director Health Division s McKean, Director eet, Hyannis, MA 02601 Fax: 508-790-6304 I ialid after December 31, 2004. FEE $200.00 U.S. Postal Service-r. CERTIFIEn M-A--IL,,, RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) For delivery information visit our website at www.usps.coma OFF I C I lLn Postage w ru I Certified ::rq Total Postage&Fees M (End Return Receipt Fee M Restricted Deliver Fee I I_FS Form 3800.August 2001, _� See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®., ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Retum Receipt Requested".To receive a fee waiver for ' a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the. endorsement"Restricted Delivery". ■ It a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Form 3600,August 2006(Reverse)PSN 7530-02-000-9047 o Complete items 1,2,and 3.Also complete nature item 4 if Restri d Delivery is desired. ,\ ❑Agent to Print your name and address on the reverse e i �w `El Address so that we can return the card to ybu. ived by( 'n d Name) G. D to of elivery , o Attach this card to the back of the mailpiece, ; ,�';t... I l el1 or on'fhe front if space permits. 1 Ds IS delivery adO ''different from item 1? ❑Yes i 1. Article Addressed to: r K t° t 11 +' If YES,enter dlivery address below: ❑ No Al I;y 1�Y1 G1L 1 3. Service Type ❑certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑GO.D. 4. Restricted Delivery?(Extra Fee) ❑Yes a, 2. Article Number, l i i t�t t i i 7 0111 0 4 7 0 0 0 011 '•4-,2 4° !7'.4 4 (transfer from service labeq'l „ 6 A R e 1 1 , 1 , t o t t i S l i t i PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 s UNITED STATES POSTAL S 5XVCV 4 i ,,••_ • Sender: Please print your name, address, and ZIP+4 in this box • y� I Eat+11111 a1 Jill Town of Barnstable ' Regulatory Services I �fNE� Thomas F.Geiler,Director Building Division BARNnABM ' Tom Perry,Building Commissioner MASS. FO,39. ��� 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violations) and Order to Cease, Desist and Abate: Raymonds J. Wysocki, Jr, Christine McCartney, Mary P Wysocki, Trs &SRC Sales, Inc. and all persons having notice of this order. As owner/occupant of the premises/structure located at 45 Seapuit Road, Osterville,MA Map 118 Parcel 124-005,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,Nov. 2,2011 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Chapter 240 Section 13 (A) 1 RF Residential Zone 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: Operation of SRC Sales, Inc. and any other business or derivative and any and all activities including the storage and distribution of all associated products, storage of equipment, receiving clients and employees on site and employee parking at 45 Seapuit Road, Osterville, MA.. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced, further action as the law requires will be taken. der, Robin C.Anderson Zoning Enforcement Officer QRORMS/viozonel J ! Message Page 1 of 1 Anderson, Robin From: Anderson, Robin Sent: Monday, January 30, 2012 4:13 PM To: mdfesg1@verizon.net Subject: 45 Seapuit Rd Hi Mike, I got another complaint about the Wysockis and the business venture they installed in the lower level of their home at 45 Seapuit Road. When I spoke to you around the holidays you had indicated that they were looking to relocate about the first of the year. I will be required to address this matter again and that may result in citations if I am unable to determine a relocation time and place. Specifically, I am now hearing the employees are still reporting to work at this address although the deliveries have slowed down. Please advise. Thank you. &bin Robin C. Anderson Zoning Enforcement Officer Tbwn of Barnstable 200 Main Street Hyannis, NA 02601 5o8-862-4027 i 1/30/2012 i Town of Barnstable 1"HE'�'�i•� Regulatory Services 3 = Thomas F.Geiler,Director • ELUM MM � MASS. Building Division pA039. �� FG Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 COMPLAINT N UIR REPORT Date: I 1 - 11 Rec'd by: Complaint Name: -R!Nl $?14T W v CoC--i Map/Parcel Location Address: RoA.0 c,Tj-K V LL 2, W,4 O,�_(0S�- Originator Name: A)99 v-T I A i-"?W0 WY&000tt i Street: Village:Q S[(e' V-0 1 LLLState: k4 Zip: 0a 6 Telephone: I0 k Complaint Description:IS ttQ- k(p ovg- a_PSA"4- { C t� -7 l 2&V%Sj . SA4-4 or PAA- FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: 3 Additional Info.Attach 1 � { 41L Q:forms:complaint SRC SALES, INC OSTERVILLE company profile, news, and business information I Hig... Page 1 of 2 Welcome,Robert. Your account Log out HIGHBEAAM PREPARED _ f ® ARRIVE SRC sales BUSINESS t COmpanlBS Submit Que Company profiles Industry reports Business articles Research Center i Business information>Company profiles>Wholesale Trade ___... ... 5lrare Like 0 Q _.............................................................................._...................................._................................................................................ SRC SALES, INC I Revenue(USD): Address: Phone: i 1.58M 45 SEAPUIT RD (508)420-1700 Employees: OSTERVILLE,MA 02655-1818 j 7 United States 1 Yearfounded: Map ' i 2003 Competitors ._.............__._......_....._............._..................----.................._..............__..._....__.._... Use industry classification to find related companies and competitors: 423990-Companies in Other Miscellaneous Durable Goods Merchant Wholesalers i..._.............................._.................................... Company description ................................................................._..................................................................................__................................................................................................._..........................._.................................._.. Selling Fresh Wild Maine Blueberries,Genuine Maine Lobster and books News and information about SRC SALES,INC ..............__..............................................................._......_......................................................_..._...............................................................I_...................................................._...__................................ ......... High streets still looking deserted as sales figures disappoint Newspaper The Scotsman;July 20,2011;613 words...deeply disappointing"by David McCorquodale,head of retail in Scotland at accountancy giant KPMG,which sponsors the SRC sales monitor."This is just the latest set of unseasonable results for retailers and,as the economy finds its feet,it is difficult... Stop Bugging Me!(Rocasuba Inc.) #� Chain Drug Review;June 27,2011;215 words...prone and-infested areas.2011 will be the worst year ever for bedbugs--carry the most cost-effective product created 'M solely to fight this pandemic.Key Sales Contact:Christine McCartney Tel.:(508)420- i','. 1700 Booth#1123 SRC Sales Stop Bugging Me!offers bedbug solution.(Marketplace 2011/Corporate Profiles) i L ". Chain Drug Review;June 27,2011;659 words...a huge brand/product launch," noted Ray Wysocki,principal of Rocasuba's mass and chain drug distribution partner, I'V b SRC Sales and Marketing.Robert Trow,chief executive officer of Rocasuba,which is also behind the highly successful RapidLash... +;m RapidLash Eyelash Enhancing Serum.(Rocasuba Inc.) Chain Drug Review;June 27,2011;214 words...effective,RapidLash provides high margins,impressive sell-through rates and guaranteed repeat business. ' [ILLUSTRATION OMITTED]Key Sales Contact:Christine McCartney Tel.:(508)420- 1700 www.rapidlash.com Booth#1123 SRC Sales Stop Bugging Mel(Marketplace'11 Showcase) Mass Market Retailers;June 20,2011;216 words...bedbug-prone and-infested areas.2011 will be the worst ever for bedbugs—carry the most cost-effective product created solely to fight this pandemic.Key Sales Contact:Christine McCartney Tel:: (508)420-1700 Booth#1123 SRC Sales RapidLash eyelash enhancing serum.(Marketplace'l1 Showcase) MPM Mass Market Retailers;June 20,2011;214 words...just one tube.Safe,affordable and always effective,RapidLash provides high margins,impressive sell-through rates and guaranteed repeat business.Key Sales Contact:Christine McCartney Tel.:(508) 420-1700 Booth#1123 SRC Sales Foundation dinner.(News) Chain Drug Review;December 6,2010;535 words...Juiliano,Energizer's Lou Martire and pharmacy student Melissa Palchak.[ILLUSTRATION OMITTED]Coca- Co la's Mike Cinque,SRC Sales'Ray Wysocki,CVS Caremark's Mike Bloom and_.....,._ q Coca-Cola's Mike Rosicki.[ILLUSTRATION OMITTED)Physicians Formula... Daii�AHtail http:/Ibusiness.highbeam.com/company-profiles/info/c2389450/src-sales-inc 9/22/2011 � Y t. "•r 1'a -�a y♦ r• ai 1p � t f" ! r. • , �a,�r�•• _ ! �u �� ~�l"^ l..a�.✓ 11,�4�'�,��,(�d a,!�y!�J��iT:r�� t o�y•,�; I �•' .b js ,.s^+'a •+• �,�a j..� �,1�t�v •� � s 1 j': � '�J• 1,1�l . i a,� _s+ .O �t ' •- f.�• eve n .%� s'� `S : V.ILI J� ` •'h' a. e'> 1 K r.I'�O. , i I "+j. yr. N �f ` v IL .+. »-i . '`� �t r. 1 �„I r�A.T• t>-. y I ' r d �'+/ (' R � •eW � � � ... .� 1 a i�, �a r .s� , , may, �t„ ,�'� .• I, � (,may Ie ":Q9+;"r (1 1, .�� �• � ��1•!•• �.�•: y'��.�. � a ri :'� •: ,�1 • �h~ r �' . Cyr' a,,aa• �.� a\ iI. �� �j rr ,+1'���I ' 1r �` � s ,`.��.sy�\:•��,`'lY .�� .: r �`. ��i yv� `•�r, 1 •` w a • i .• c f P P CI OI ©1 01 OI o 0 0 a •a Pa C ! P \ f P P 0 0 0 0 o O ^ Q O O O C2= Town of Barnstable, MA Page 1 of 1 Town of Bamstable,MA Tuesday,November 1, 2011 §240-13. RC, RD, RF-1 and RG Residential Districts. A. Principal permitted uses. The following uses are permitted in the RC, RD, RF-1 and RG Districts: (1) Single-family residential dwelling (detached). B. Accessory uses. The following uses are permitted as accessory uses in the RC, RD, RF-1 and RG Districts: (1) Keeping, stabling and maintenance of horses subject to the provisions of§ 240-11B(2) herein. C. Conditional uses. The following uses are permitted as conditional uses in the RC, RD, RF-1 and RG Districts., provided a special permit is first obtained from the Zoning Board of Appeals subject to the provisions of§ 240-125C herein and subject to the specific standards for such conditional.uses as required in this section: (1) Public or private regulation golf courses subject to the provisions of§ 240-11C(2) herein. (2) Keeping, stabling and maintenance of horses in excess of the density provisions of§ 240- 11B(2)(b) herein, either on the same or adjacent lot as the principal building to which such use is accessory. (3) (Reserved)Editor's Note:Former Subsection C(4), regarding family apartments, was repealed 11-18-2004 by Order No. 2005-026. See now§240-47.1. (4) Windmills and other devices for the conversion of wind energy to electrical or mechanical energy, but-only as an accessory use. D. Special permit uses. The following uses are permitted as special permit uses in the RC, RD, RF-1 and RG Districts, provided a special permit is first obtained from the Planning Board: (1) Open space residential developments subject to the provisions of§ 240-17 herein. E. Bulk regulations. Minimum Yard Setbacks Minimum Minimum Minimum Maximum Lot Area Lot Lot Building Zoning (square Frontage Width Front " Side Rear Height Districts feet) (feet) (feet) (feet) (feet) (feet) (feet) RC 43,560' 20 100 203 10 10 30' RD 43,560' 20 125 303 15 15 30' http://www.ecode360.com/printBA2043/form?guid=6558248 11/1/2011 Official Website of The Town of Barnstable - Property Lookup Page 1 of 3 Assessing Division Property Lookup Results 367 Mein Street,Hyannis,MA.02601 <<BACK TO SEARCH<< APrint Friendly Owner Information-Map/Block/Lot:118/124/005-Use Code:1010 Owner Owner Name WYSOCKI,MARY P TR Co-Owner Name MARY P WYSOCKI LIV TRUST Property Address Owner Mailing Address 45 SEAPUIT ROAD 45 SEAPUIT ROAD OSTERVILLE,MA.02655 Map/Block/Lot 118/124/005 Assessed Values 2011 -Map/Block/Lot:118/124/005-Use Code:1010 2011 Appraised Value 2011 Assessed Value Past Comparisons Building Value: $506,300 $506,300 Year Total Assessed Value Extra Features: $62,500 $62,500 2010-$2,073.900 Outbuildings: $37,800 $37,800 2009-$1,769.300 Land Value: $1,093,500 $1,093.500 2008-$1,747,900 2007-$1,702.600 2011 Totals $1,700,100 $1,700,100 2006-$1.581.100 Residential Exemption Received=$90,000 Tax Information 2011 -Map/Block/Lot:118/124/005-Use Code:1010 Taxes Fire District Rates Town Residential C.O.M.M.FD Tax(Residential) $2,261.13 Barn FD-All Classes $2.31 $8.05 Community Preservation Act Tax$388.84 C.O.M.M-All Classes $1.33 Town Commercial Town Tax(Residential) $12,961.31 Cotuit FD-All Classes $1.68 $7 28 $15,611.28 Hyannis-Residential $2.04 Hyannis-Commercial $3.24 W Barnstable-Residential $2.65 W Barnstable-Commercial $2.34 Sales History-Map/Block/Lot: 118/124/005-Use Code:1010 History: Owner: Sale Date Book/Page: Sale Price: WYSOCKI,MARY P TRS Jun 17 2009 12:OOAM C188818 $1 WYSOCKI,RAYMOND J&MARY PATRICIAApr 1 2009 12:OOAM C188246 $1 WYSOCKI,MARY P Jun 20 2006 12:OOAM C180383 $1 WYSOCKI,RAYMOND J JR& Nov 15 2002 12:OOAM C167301 $1.315,000 BECKER,LAWRENCE W&GRACE Z Jul 28 1998 12:OOAM C149503 $250,000 CARLTON,ROBERT T ET AL TRS Jul 7 1997 12:OOAM C145092 $270,000 CROCKER.JAMES H JR Mar 29 1996 12:OOAM C140163 $8.000 SEAPUIT INC Jul 20 1964 12:OOAM C33134 $0 Sketches-Map/Block/Lot:118/124/005-Use Code:1010 ell AS AS T 2 As Burt Cards:Click card#toview:Cafd#1 1 Constructions Details-Map/Block/Lot: 118/124/005-Use Code:1010 Outbuildings&Extra Features-Map/Block/Lot:118/124/005-Use Code:1010 http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen.asp?searchparce1=118... 11/1/2011 Official Website of The Town of Barnstable - Property Lookup Page 2 of 3 Building Details Land Building value $506,300 Bedrooms 4 Bedrooms USE CODE 1010 Total Improvements Value $516.671 Bathrooms 4 Full+2H Lot Size(Acres) 1.36 Model Residential Total Rooms 9 Rooms Appraised Value $1,093.500 Style Cape Cod Heat Fuel Gas Assessed Value $1,093,500 Grade Custom Minus Heat Type Hot Air Year Built 2000 AC Type Central Effective depreciation 2 Interior Floors Hardwood Stories 1 3/4 Stories Interior Walls Plastered Living Area sq/ft 4.217 Exterior Walls Wood Shingle Gross Area sglft 8,515 Roof Structure Gable/Hip Roof Cover Asph/F GIs/Cmp Code Description Units/SQ ft Appraised Value Assessed Value FPLG Gas Fireplace-Direct 2 $3,200 $3,200 Vent BLA1 Bsmt Liv-Good 2050 $59,300 $59,300 SPL3 Pool Gunite 800 $37,800 $37,800 Sketch Legend Property Sketch Legend AOF Office,(Average) FTS Third Story Living Area(Finished) SFB Base,Semi-Finished BAS First Floor,Living Area FUS Second Story Living Area(Finished) TQS Three Quarters Story(Finished) BMT Basement Area(Unfinished) GAR Garage UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) CAN Canopy MZ1 Mezzanine,Unfinished UST Utility Area(Unfinished) FAT Attic Area(Finished) MZ2 Mezzanine,Semi-finished UTQ Three Quarters Story(Unfinished) FBM Finished Basement MZ3 Mezzanine,finished UUA Unfinished Utility Attic FCP Carport PAT Patio Outbuilding Listed UUS Full Upper 2nd Story(Unfinished) FEP Enclosed Porch PTO Patio WDK Wood Deck FHS Half Story(Finished) REF Reference Only WKO Wood Deck Outbuilding Listed FOP Open or Screened in Porch SDA Store Display Area Print Friendly '42Z 038 viet+S since 4.4.11 �- Contact i Director of Assessing oJeffrey Rudziak 6P 508-862-4022 fF 508-862-4722 8:30a.m.to 4:30p.m. !Helpful Links to Downloads Abatements Department of Revenue Exemptions Parcel Consolidation Questions about values Town Land Use Codes Helpful Maps All Town Maps Flood Insurance Maps Property Maps Assessing Division lNews&Updates n/a iRelated Boards Board of Assessors - http://www.town.bamstable.ma.us/Assessing/propertydisplayscreen.asp?searchparcel=118... 11/1/2011 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 1 The Commonwealth of Massachusetts William Francis Galvin Secretary of the Commonwealth, Corporations Division One Ashburton Place, 17th floor , Boston, MA 02108-1512 Telephone: (617) 727-9640 Public Browse and Search - Entity Results 0 Help with this form 1 Records Matched Your Begins With Search for Entity Name: src (Page 1 of sales, inc 1) Identification Old Principal Office Entity Name Number Identification Address, City, State,Zip, Country Number SRC SALES. INC. 000854731 45 SEAPUIT ROAD, OSTERVILLE, MA 02655 USA New Search. ©2001 -2011 Commonwealth of Massachusetts All Rights Reserved I I http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchEntityList.asp?ReadFromDB=True... 11/1/2011 The Commonwealth of Massachusetts William Francis Galvin- Public Browse and Search Page 1 of 2 The Commonwealth of Massachusetts William Francis Galvin t y Secretary of the Commonwealth,Corporations Division One Ashburton Place, 17th floor '.,,r��`�•,-f`��`�1�, 512 Telephone: 102719640 x, P ) SRC SALES, INC. Summary Screen ?' Help with this form WE Re 737i a;Ceit51-77e I The exact name of the Domestic Profit Corporation: SRC SALES,INC. Entity Type: Domestic Profit Corporation Identification Number: 000854731 Date of Organization in Massachusetts: 11/24/2003 Current Fiscal Month/Day: 12/31 The location of its principal office: No. and Street: 45 SEAPUIT ROAD City or Town: OSTERVILLE State: MA Zip: 02655 Country: USA If the business entity is organized wholly to do business outside Massachusetts,the location of that office: No. and Street: City or Town: State: Zip: Country: Name and address of the Registered Agent: Name: RAYMOND J. WYSOCKI,JR. No. and Street: 45 SEAPUIT RD. City or Town: OSTERVILLE State: MA Zip: 02655 Country: USA The officers and all of the directors of the corporation: Title Individual Name Address(no PO Box) Expiration First,Middle,Last,Suffix Address,City or Town,State,Zip Code of Term PRESIDENT RAYMOND J.WYSOCKI JR. 45 SEAPUIT ROAD OSTERVILLE,MA 02655 USA TREASURER CHRISTINE MCCARTNEY 9802 ASCOT DRIVE OMAHA,NE 68114 USA SECRETARY CHRISTINE MCCARTNEY 9802 ASCOT DRIVE OMAHA,NE 68114 USA DIRECTOR CHRISTINE MCCARTNEY 9802 ASCOT DRIVE OMAHA,NE 68114 USA DIRECTOR RAYMOND J.WYSOCKI JR. 45 SEAPUIT ROAD OSTERVILLE,MA 02655 USA http://corp.sec.state.ma.us/corp/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 11/1/2011 Src Sales, Inc. 401K Retirement Plan I Form 5500 by BrightScope Page 1 of 2 Login I Register I About BrightScope fBrightkopeo Data. Diligence. Decisions" Home > Src Sales,Inc.401K Retirement Plan > Form 5500 BrightScope Rating Form 5500 Data Plan Dashboard Basic Info(Short Form) Form 5500 Year: 12010 10 Company: Src Sales, Inc. Plan: Src Sales, Inc. 401 K Retirement Plan Plan Information Plan Sponsor Information Plan Year 01/01/2010—12/31/2010 Address 45 Seapuit Rd Effective Date of Plan 01/01/2006 Osterville,MA 02655 Net Assets as of 12131/2010 $338,395 Telephone (508)420-1700 Plan Number 1 EIN 20-0783865 Plan Type Single Employer Industry Code 425120 Did the plan file for an extension of time Yes Named Administrator Joseph Giglio or the DFVC Program? Plan Administrator Information Participant Information as of 12/31/2010 Administrator Name Src Sales,Inc. Total 9 Address 45 Seapuit Rd Total number of participants as of 01/01/2010 5 Osterville,MA 02655 Number of participants with account balances 7 Telephone (508)420-1700 Administrator EIN 20-0783865 Financial Information as of 12/31/2010 Total Assets(EOY) $338,395 Total Liabilities(EOY) $0 Net Assets(EOY) $338,395 Financial Information as of 01/01/2010 Total Assets(BOY) $227,735 Total Liabilities(BOY) $0 Net Assets(BOY) $227,735 Income Cash from Employers $69,042 Cash from Participants $42,746 Others(including rollovers) $0 Other Income $266 Total Income $112,054 Net Income $110,660 Expenses Total Benefit Payments $0 Corrective Distributions $0 Administrative Service Providers $0 Other Expenses $1,394 Total Expenses $1,394 Total Transfers $0 Benefits Provided Under the Plan Code Benefit Description 2A Age/Service Weighted or New Comparability or Age/Service Weighted Plan:Allocations are based on age,service,or age and service.New Similar Plan Comparability or Similar Plan:Allocations are based on participant classifications and a classification(s) consists entirely or predominantly.of highly compensated employees;or the plan provides an additional http://www.brightscope.com/fonn-5500/basic-info/71565/Src-Sales-Inc/72692/Src-Sales-R... 11/1/2011 Src Sales, Inc. 401K Retirement Plan I Form 5500 by BrightScope Page 2 of 2 Benefits Provided Under the Plan allocation rate on compensation above a specified threshold,and the threshold or additional rate allowed under the permitted disparity rules of section 401(1) 2E Profit-sharing A defined contribution plan that allows employer discretionary contributions.These plans often contain a 401(k)feature. 2F ERISA section 404(c)Plan This plan,or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1. 2G Total participant-directed account plan Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts,regardless of whether 29 CFR 2550.404c-1 is intended to be met. 2.1 Code section 401(k)feature A cash or deferred arrangement described in Code section 401(k)that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash. 2K Code section 401(m)arrangement Employee contributions are allocated to separate accounts under the plan or employer contributions are based,in whole or in part,on employee deferrals or contributions to the plan.Not applicable if plan is 401(k)plan with only QNECs and/or QMACs.Also not applicable if Code section 403(b)(1),403(b)(7)or 408 arrangements/accounts/annuities. 2T Participant-directed Account Total or partial participant-directed account plan-plan uses default investment account for participants who fail to direct assets in their account. 3D Master plan A pension plan that is made available by a sponsor for adoption by employers;that is the subject of a favorable opinion letter;and for which a single funding medium(for example,a trust or custodial account)is established for the joint use of all adopting employers. Question Answer Amount 1. During the plan year did the employer fail to transmit to the plan any participant contributions within the time No period described in 29 CFT 2510.3-102? 2. Were there any nonexempt transactions with any party-in-interest? No 3. Was this plan covered by a fidelity bond? Yes $30,000 4. Did the plan have a loss,whether or not reimbursed by the plan's fidelity bond,that was caused by fraud or No dishonesty? 5. Were all the plan assets either distributed to participants or beneficiaries,transferred to another plan,or brought No under the control of the PBGC? 6. Has the plan failed to provide any benefit when due under the plan? No 7. If this is an individual account plan,was there a blackout period? No 8. If there was a blackout period,have you either provided the required notice or one of the exceptions to providing the notice applied under 29 CFR 2520.101-3? Site Links: Home I Ratings Directory I BrightScope Slog I FAQ I Plan Dashboard I Beacon I Spyglass Company Information: About BrightScope I Newsroom I Careers I Contact Information is provided'as is'and solely for informational purposes•not for investment purposes or advice. BrightScope is not a fiduciary under ERISA.BrightScope is not endorsed by or affiliated with FINRA. Copyright©2008-2011,BrightScope Inc.All Rights Reserved.Your use of this service is subject to our Terms of Use and Privacy Policy http://www.brightscope.com/form-5500/basic-info/71565/Src-Sales-Inc/72692/Src-Sales-R... 11/1/2011 The Commonwealth of Massachusetts William Francis Galvin - Public Browse and Search Page 2 of 2 business entity stock is publicly traded: The total number of shares and par value,if any,of each class of stock which the business entity is authorized to issuer Par Value Per Share Total Authorized by Articles Total Issued Class of Stock Enter 0 if no Par of Organization or Amendments and Outstanding Num of Shares Total Par Value Num of Shares CNP $0.00000 20,000 $0.00 0 _ Consent _ Manufacturer _ Confidential Data _ Does Not Require Annual Report Partnership _ Resident Agent _ For Profit _ Merger Allowed Select a type of filing from below to view this business entity filings: ALL FILINGS T Administrative Dissolution Annual Report Application For Revival Articles of Amendment O View�Filings I NewwSearch Comments O 2001-2011 Commonwealth of Massachusetts 0 All Rights Reserved Help http://corp.sec.state.ma.us/core/corpsearch/CorpSearchSummary.asp?ReadFromDB=True... 11/1/2011 ��� �omutonYv�alt� o� �i.as�achug�tt� !i Examiner Willimtn Francis Galvin Secretary of the Commonwealth One Ashburton Place,Boston, Massachusetts 02108-1512 ARTICLES OF ORGANIZATION (General Laws,Chapter 156B) Name Approved ARTICLE I The exact name of the corporation is: SRC Sales, Inc. ARTICLE II The purpose of the corporation is to engage in the following business activities: 1. To broker sales and marketing. See continutatio`n sheet attached hereto C P M Y-jRA. Note:If the space provided under any article or Item on tbis form is tnsuyf7clen4 additions shall be set forth on one side only of separate 8112 x 11 sheets q f paper with a left margin of at least I inch.Additions to more than one article may be P.C. made on a singly sheet so long as each article requiring each addition is clearly indicated 168bart M2 ARTICLE III State the total number of shares and par value,if any,of each class of stock which the corporation is authorized to issue. WITHOUT PAR VALUE WITH PAR VALUE TYPE NUMBER OF SHARES TYPE NUMBER OF SHARES PAR VALUE Common: 20,000 Conunon: Preferred: Preferred: ARTICLE IV If more than one class of stock is authorized,state a distinguishing designation for each class.Prior to the issuance of any shares of a class,if shares of another class are outstanding,the corporation must provide a description of the preferences, voting powers,qualifications,and special or relative rights or privileges of that class and of each other class of which shares are outstanding and of each series then established within any class. ARTICLE V The restrictions,if any,imposed by the Articles of Organization upon the transfer of shares of stock of any class are: See addendum attached hereto ARTICLE VI "Other lawful provisions,if any,for the conduct and regulation of the business and affairs of the corporation,for its voluntary dissolution,or for limiting,defining,or regulating the powers of the corporation, or of its directors or stockholders,or of any class of stockholders: See addendum attached hereto *"If there are no provisions state'None'. Note:The preceding six(6)articles are considered to be permanent and may ONLY be changed by filing appropriate Articles of Amendment ARTICLE II (Continued) 2. To carry on a general mercantile business in any state or territory of the United States and any foreign country. 3. To act for others as agent,broker,factor,manager or in any other lawful manner and to join with others in any enterprise. 4. To subscribe for, buy,acquire,hold,sell,assign,transfer, mortgage,pledge,or otherwise dispose of,and to deal in stocks,bonds,notes,obligations and securities of any corporation,joint stock company,trust,association, fum or person and the bonds and securities of the United States, and of any state thereof,and of any county, district or municipality and of any agency of any of the foregoing and of any foreign government or agency,and as owner thereof to exercise all rights,powers and privileges of ownership, including,without limitation,the right to vote. 5. To acquire the good will and property of any corporation,joint stock company,trust, association,firm or person and to undertake,guarantee,endorse or assume the whole or any part of the obligations or liability thereof,including,without limitation, leases and contracts. 6. To borrow money and to make and issue bonds,debentures,notes and evidence of indebtedness of the corporation and to secure the same by the mortgage,pledge,or other transfer of all or any part of its properties. 7. To lend money or credit to,to guarantee the performance of any contract or obligation,and to aid in any other manner,corporations,joint stock companies,trusts, associations,firms and persons,any obligation of which or any interest in which is held by the corporation,or in the affairs of prosperity of which this corporation has an interest;and to secure any such undertaking made by it by the mortgage,pledge or other transfer of all or part of its properties. 8. To acquire,hold,use sell,assign,grant licenses in respect of, mortgage or otherwise dispose of,any and all trade marks,trade names,formulae, secret processes,franchises,and any and all inventions,improvements, letters,patents,or copyrights of the United States or of any other country. 9. To purchase or otherwise acquire,and to hold, sell,assign transfer,mortgage,pledge,or otherwise dispose of and deal in,the stock of the corporation. 10. To be a general or a limited partner in any partnership or a joint venturer in any joint venture provided that the business of such partnership or of such joint venture is a business in which this corporation has the power to engage. a Doc:IvI16s666 06-17-2009 2:39 Ct f T: 188818 BARNSTABLE LAND COURT REGISTRY DEED We, RAYMOND J. WYSOCKI, also known as RAYMOND J. WYSOCKI, JR., and MARY PATRICIA WYSOCKI, also known as MARY P. WYSOCKI, both of 45 Seapuit Road, Osterville,MA 02655, for consideration of ONE($1.00) Dollar, grant to MARY P. WYSOCKI, of 45 Seapuit Road, Osterville, MA 02655, as she is trustee of THE MARY P. WYSOCKI LIVING TRUST AGREEMENT DATED June 16 , 2009, with respect to which an Abstract of Trust under Massachusetts General Laws'Chapter 184, Section 35 is recorded herewith, AF> 'Pec.. I , 1 1 6 with QUITCLAIM covenants, the land at 45 Seapuit Road, Barnstable(Osterville),Barnstable County, Massachusetts,being: LOT 12 LAND COURT PLAN 15055-I Subject to and together with all matters of record insofar as in effect. THE GRANTOR, MARY P. WYSOCKI, HEREBY RESERVES HER ESTATE OF HOMESTEAD CREATED BY A DECLARATION OF HOMESTEAD RECORDED WITH THE BARNSTABLE COUNTY LAND REGISTRY DISTRICT AS DOCUMENT NO. l . 64 For our title see Certificate of Title No. 188246. 44741001 1 EXECUTED as a sealed instrument on June 16 ,2009. i qRay�on6y ysock' r. . l,J Mary P. ysocki COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss June 16 , 2009 Then personally appeared Mary P. Wysocki, before me, the undersigned notary, who proved to me through satisfactory evidence of identification, which was my personal knowledge of her identity, to be the person whose name is signed on the preceding document, and acknowledged to me that she signed it voluntarily for its stated purposes. Notary Public LAWRENCE 0. SPAULDING, JR. Notary Public COMMONWEALTH OF MASSACHUSETTS My GOmmhiton ExP1101 SBPtOmbel 70.2011 BARNSTABLE REGISTRY OF DEEDS 44741001 2 f Doc:900� 2l0 01-03-2003 3:35 BARNSTABLE LAND COURT REGISTRY W MWAS,Raymond J. Wysocki,Jr. and Mary Patricia Wysocki,of 45 Seapuit Lane,Ostenik Massachusetts.Barnstable CW*are the resider*ownen of 45 Seapuit Lane,OsftniUa,Massachusetts QwreinaR referred to as the"lot')and being shown as Lot 12 an Land Court Plan 15055-L WHEREAS,Raymond J.Wysocki,Jr. and May Patricia Wysocki,as the owners of said lot have weed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a precondition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State EwAroamental Code.True V,Nlinimum Requirements fnr the Subsurface Disposal of Sanitary Sewerage; 1i BMAS,the Town of Barnstable Board of Health,as a pre-condition to granting a disposal works ooristrsu . permit for a septic system in compliance with 310 CMR 15.000 State E nvironmenW Code, Title V,1Vfmimum Requirements for the Subsurface Disposal of Sanitary Sewerage,and authorizing the issuance of a building permit for the construction of an addition to a single family home on this property,is requiring that the agreement for the restriction on the number of bedrooms in any house co®structed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. NOW,TMMUORE,Raymond L Wysocki,Jr. and Mary Patricia Wysocki,do hereby plea the following restriction on their above-referenced land m accordance with their agreement with the Town of Barnstable Board of Health,which restriction shell rum with the land and be binding upon all successors in title. 1. 45 Seapuit Lane,Osterville, Massachusetts may have constructed upon the lot a house containing no more than four(4)bedrooms. Raymond 1.Wysocki,Jr.and Mary Patricia Wysocki agree that this shall be a permanent deed restriction affecting the lot located at 45 Sespuit Lane, Ostervrille, Massachusetts,and being shown as Lit 12 on Land Coast Plan 15055-1 For title of Raymond 1.Wysocki,Jr.arid Mary Patricia Wysocki see Barnstable band Court Registry Certificate of Tide Number 167301,Document 893,832. Execaved as a ssAad instrument an this day of January,2003. 1 J. ',Jr. r Mary Patricia Wysocki Barnstable,ss Them personalty appeared the above-named Raymond J. Wysocki,Jr. and Mary Patricia Wysocda,known 10 me to be the persons who executed the foregoing instrument and acknowledged the same to be their free act and deed,before the undersigned auttwrity,this✓ day of January,2003. I oo�niski�;eot�itres guy��f z��`'��s "J BARVAM REMMY OF DEEDS Z0 39Vd dQ1Qd - 460ZLZZ4T9 TZ:E0 666T/90/00 l Doc= 1s11Os224 04-01-2009 1 : 10 Ctf-:188246 BARNSTABLE LAND COURT REGISTRY Quitclaim Deed I Mary Patricia'Wysocki of 45 Seapuit Roadi;.P$erville, MA 02655 in consideration of$1.00, grant to Raymond J. Wysocki and MAry. Patricia Wysocki, husband and wife as tenants by the entirety, of 45 Seapuit`Road, Osterville, MA, 02655 with QUITCLAIM COVENANTS Property Address: 45 Seapuit Road,in Osterville,Barnstable County,Massachusetts. 02655 The land with the buildings thereon situate in Osterville,Barnstable County,Massachusetts, described as follows: Being shown as Lot 12 on Plan No.15055-I I Subject to Deed Restriction recorded with said Deeds as document number 900,210. 1. For title le see deed Document No. 1037038 and/or Certificate of Title No.180383. Executed as a sealed instrument this March 27,2009. Mary Pa icia Wysocki Commonwealth of Massachusetts County:Barnstable On this 3/27/2009 before me, the undersigned notary public, personally appeared Mary Patricia W socki, and proved to me through satisfactory evidence of identification, which were ( , to be the person whose name is signed on the preceding or atta hed document,and acknowledged to me that he/she/they signed it voluntarily for its stated purpose. (official signature an vs\! s 0. � Zs S A 4!BSACtN.�r� 4���i�eC1C q�q/IIIUINM BARNSTASLE REGISTRY OF DEEDS Article 11 Continued: 11. To do any or all of the things herein set forth to the same extent as natural persons might or could do in any part of the world as principals,agents,or otherwise,and either alone or with others,and to do every act and thing necessary,convenient or proper for the accomplishment of any of the purposes or the attainment of any of the objects herein enumerated,or incidental to any of the powers herein stated,provided the same be not inconsistent with the laws of the Commonwealth of Massachusetts applicable to business transactions. 12. The foregoing clauses shall be construed both as objects and powers,and it is expressly intended that no specific enumeration shall restrict in any way any general language,that none of the purposes set forth in any of the above clauses shall be limited or restricted in any way by the terms of any other clause,that each purpose may be pursued independently of any other purpose from time to time and wherever deemed desirable,and that the corporation shall have and possess all the rights,privileges and powers now or hereafter conferred by the laws of the Commonwealth of Massachusetts upon business corporations organized under such laws. I i ARTICLE V All shares of the capital stock of this corporation shall be subject to the following restrictions controlling the assignment and transfer thereof: Any stockholder of this corporation(which expression shall whenever used in these ' restrictions,be deemed to include the executor, administrator or other representative of any deceased stockholder,and a mortgagee or pledgee and a receiver, assignee or trustee in bankruptcy of any stockholder,and the purchaser or assignee of any shares called upon execution)who may desire to have transferred any shares,whether by way of sale,mortgage, pledge or otherwise,to any person,firm or corporation other than a than existing stockholder,or his spouse or issue,or the legal representative of any trust or estate in which such stockholder, his spouse or issue have the principal beneficial interest,shall deliver to the Clerk of the Corporation a notice in writing setting forth his intention to make such transfer,the number and class of shares involved, the name and address of the proposed transferee and the price at which he is willing to sell his shares or other consideration for such transfer. The Corporation,acting through its Board of Directors,shall have the exclusive option,for a period of thirty(30)days after receipt of such notice,to purchase said shares(i)at the price set forth in such notice,.or(ii)at the book value of said shares as determined by the independent accountant then representing the Corporation,or if none,by a certified public accountant appointed by the Board of Directors for that purpose. If the Corporation shall not exercise its option to purchase said shares and tender payment thereof to the stockholder within the time herein prescribed,the Corporation's rights shall be deemed to be waived and the stockholder shall be free to transfer said shares upon the terms specified in such notice and to the transferee named therein,but to none other,provided, however,that if such transfer is not completed within ninety(90)days from the date the original notice was received by the Corporation from the stockholder,said shares shall again be subject to these restrictions. No shares of stock shall be sold or transferred on the books of the Corporation until these provisions have been complied with;provided however,that these provisions shall not apply to a transfer to a then existing stockholder of the corporation, or to the spouse or issue cf a then existing stockholder,or to the legal representative of any trust or estate in which a then existing stockholder,his spouse or issue shall have the principal beneficial interest,or to the assignor of any lease to which the corporation shall be the assignee; and provided further that the Board of Directors may in any particular instance waive compliance with these provisions by written notice to the transferring stockholder. I I ARTICLE VI Other Lawful provisions for the conduct and regulation of the business and affairs of the corporation,for its voluntary dissolution,or for limiting,defining or regulating the powers of the corporation, or its directors stockholders,or any class of stockholders: (a) The directors may make, amend or repeal the By-Laws in whole or in part part, except with respect to any provision thereof which by law or the By-Laws requires action by the stockholders. (b) Meetings of the stockholders may be held anywhere in the United states. (c) The corporation may be a partner in any business enterprise it would have power to conduct by itself. (d) The Directors shall have the power to fix from time to time their compensation. No person shall be disqualified from holding any office by reason of any interest,provided said person makes full disclosure of the interest to the directors prior to acceptance of the office. In the absence of fraud and after full disclosure to the Directors,any director, officer or stockholder of this corporation individually,or any individual having any interest in any concern which is a stockholder of this corporation,or any concern in which-any such directors,officers, stockholders or individuals have any interest,may be a party to,or may be pecuniary or otherwise interested in,any contract,transaction or other act of this corporation,and (1) such contract,transaction.or act shall not be in any way invalidated or otherwise affected by that fact; (2) any such director of the Corporation shall be liable to this Corporation or its stockholders for monetary damages for breach of fiduciary duty as a director,except to the extent that such exculpation from liability is not permitted by the Massachusetts Business Corporation Law as the same exists or may be amended from time to time. No amendment to or repeal of this provision shall apply to or have any effect on the Liability of any Director for or with respect to any acts or omissions of such Director occurring prior to.such amendment or repeal;and (3)any such director of this corporation may be counted in determining the existence of a quorum at any meeting of the directors or of any committee thereof which shall authorize any such contract,transaction or act,and may vote to authorize the same. For purpose of this paragraph(d),the term"interest"shall mean personal interest and interest as a director,officer, stockholder, shareholder,employee,trustee,member or beneficiary of any concern; and the term"concern"shall mean any corporation,association,trust,partnership,firm, person or other entity other than this corporation I ARTICLE VII The effective date of organisation of the corporation shall be the date approved and Sled by the Secretary of the Commonwealth. If a later effective date is desired,specify such date which shall not be more than thirty days after the date of filing. ARTICLE VIII The information contained in Article VM Is not a permanent part of the Articles of Organization. a.The street address(post office boxes are not acceptable)of the principal office of the corporation in Massachusetts is: 45 Seapuit Road, Osterville, MA 02655 b.The name,residential address and post office address of each director and officer of the corporation is as follows: NAME RESIDENTIAL ADDRESS POST OFFICE ADDRESS President: Raymond J. Wysocki, Jr. 45 Seapuit Road same Osterville, MA 02655 Treasurer: Christine McCartney 9802 Ascot Drive same Clerk: Omaha, NE 68114 Christine McCartney Directors: Raymond J. Wysocki, Jr. Christine McCartney c.The fiscal year(i.e.,tax year)of the corporation shall end on the last day of the month of: d.The name annggslness address of the resident agent,if any,of the corporation is: q 1rwt ND J•W 1 A 4S5EAPUj T 2 y y0/�- ARTICLE IX O JTE �/1�'1' � 1 +i-1 02]OSS By-laws of the corporation have been duly adopted and the president,treasurer,clerk and directors whose names are set forth above,have been duly elected. IN WITNESS WHEREOF AND UNDER THE PAINS AND PENALTIES OF PERJURY,Vwe,whose signature(s)appear below as into orators)and whose name(s)and business or residential address(es)are clearly typed or printed beneath each signature do by associate with the intention of forming this corporation under the provisions of General Laws,Chapter 156B and d eby s' ese Arti les of Organization as incorporator(s)this m_ day of ocro gii✓r ice— 20Q3-- , Note.(f an existing corporation is acting as incorporator,type in the exact name of the corporation,the state or other jurisdiction wbere it was incorporated,the name of the person signing on bebalf of said corporation and the title be/sbe bolds or otber autborlty by wbicb sucb action is taken I Z2�5 THE COMMONWEALTH OF MASSACHUSETTS ARTICLES OF ORGANIZATION (General laws,Chapter 156B) I hereby certify that, upon examination of these Articles of Organiza- tion,duly submitted to me,it appears that the provisions of the General Laws relative to the organization of corporations have been complied with,a�n1d I hereby approve said articles;and the filing fee In the amount of$Z-75 havin beeup=paid,said articles are eemc to have ek en filed with me this , day of 20 Effective date. WILLIAM FRANCIS GALVIN Secretary of the Commonwealtb FMING FEE:One tenth of one percent of the total authorized capital _ stock, but not less than $275.00. For the purpose of filing, shares of -' r•; stock with a par value less than$1.00,or no par stock,shall be deemed 7:`'. to have a par value of$1.00 per share. TO BE FILLED IN BY CORPORATION Contact informatiom Steven J. Pizzuti, Esq. + 336 South Street Hyannis- ILA 02601 Telephone: (508) 771-1911 Bmall: closing@pizzutilaw.com A copy this filing will be available on-line at www.state.ma.us/scc/cor once the document Is filed. From: Ron<ron@kendallandwelch.com> Subject: Fwd:Wysocki Wall ties. Date: August 3, 2010 1:51:17 PM EDT To: Damon Kendall<damon@kendallandwelch.com>, chuck@osterville.com 2 Attachments, 352 KB Ron Begin forwarded message: From: "Joe Botelho"<info@jbhomedesigns.com> Date: August 3, 2010 1:38:27 PM EDT To: "Ron Welch"<Ron@Kendallandwelch.com> Subject: Wysocki Wall ties. RIDGE VENT 2XI2 RIDGE 2X10 RAF TER S a 16" O.G. ' 2 I/2" PLY. SHEATHING 4 n 150 ASPHALT PAPER �� 4 p PHALT SHINGLES 2X O's C.J. @ ICs O.C. R39 INSUL. n 1X3 STRAPPING 1/2" WALLBOARD r BEROOM 04 2XIO RAFTERS a 16" O.G. 1/2" PLY. SHEATHING 3/4" T/G PLY. 150 ASPHALT PAPER NAILED 4 GLUED. ASPHALT SHINGLES ENG. I JOIST PER MANUF. 1X3 STRAPPING TYP. BLOCKING 1/2" WALLBOARD NEW 1/2" WALLBOARD FAMILY 2X6's o 16" O.C. z RIS INSULATION m ROOM 1/2" PLY. SHEATHING TYVEK WRAP OR EQUAL EXIST NG FLOOR LEVEL - SIDING •------ .............•----... .3/4"-?/Cs �?LY.-•--- _� --------- NAILED t GLUED. — — ENG. I JOIST PER MANUF. 34X18 GIRDER Rig INSUL. Q 1 3-1/2" CONC. FILLED / v LOLLY COLUMN. 4" CONC. SLAB / CROSS SECTION DETAILS TYP.RIM -- - - - - -- - - -- -- -- -- - -- -- - -- - -- -- -- -- -- -- -- -- - -- -- -- -- -- TYP.H6 FASTENER TYP.DC6 WALL ABOVP ==_;;;;;_::::::; STUD TO JOIST. e 4 y i <—II-T/S°ENG.1 JOIST— PER MANUF. ti } TYP.N6 FASTENER 8' { STUD TO JOIST. fff>6 WALL ABOVE F a--- --- =-y--��--'�--- a SECOND FLOOR ° FRAMING PLAN a TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION �' 2Ot v Map f Parcel. Application # Health-Division `' Date Issued Conservation Division ';,Application Fee '(J Planning.Dept: `Permit Fee. Date Definitive.Plan Approved by Planning Board lam• 04- Historic -.OKH Preservation /Hyannis � Project Street Addresses Village �7��✓�LLB Owner �9�.,►�o•�� Gr/ s'�e.�� • Address clS�S��sd��T�h2G�'j Telephone "- �j 3 Permit Request T E"XT'12✓b Square feet: 1 st floor: existing;&:proposed VW 2nd floor: existing)SZK�proposed q' ,v2 Total new S 'CO Zoning District Flood Plain Flo Groundwater,Overlay Project Valuation���O�i• Construction Type-� �/�' `,`67 Lot Size y9-3 S4: Grandfathered: �4s ❑ No If yes, attach,supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family # units ' Age of Existing Structure Z4� s Historic House: ❑Yes ANo On Old King's Highway:❑Yes )(No Basement Type: ❑ Full Crawl ❑Walkout ❑ Other _ Basement Finished Area(sq.ft.). DSO Basement Unfinished Area (sq.ft), Number of Baths: Full: existing_ new _� Half: existing I new D Number of Bedrooms: existing L2 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: W.56's ❑ Oil ❑ Electric ❑ Other Central Air: dP<es ❑ 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: fisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes— ❑ No If yes, site plan review# Current Use es .1P�. Proposed Use L? ��t��-7., APPLICANT INFORMATION (BUILDER OR HOMEOWNER) 00 Name Telephone Number S��—Va_q mod Address �iY �/ License # D© Home Improvement Contractor# _12 'P`05 Worker's Compensation # C, y 2-kS 5-12 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CZL.t !� Tom. �N.�G'c� .�i�►'T� �� GQr�!f SIGNATURE ! DATE ��-/ L�C(� FOR OFFICIAL USE ONLY APPLICATION# 3� DATE ISSUED MAP/PARCEL N0. ADDRESS T VILLAGE'. j' OWNER- DATE OF INSPECTION: Ile, ' FOUNDATION SIIZ.b o (` i " FRAME k 912r 1 o 14L— INSULATION Y � FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL E; FINAL BUILDING I I /V :•- e �•Y DATE CLOSED OUT + 1 ASSOCIATION PLAN NO: i 3x 4 The Commonwealth of Afassachusetts .Department of Industrial Accidents _ Office of Investigations' 600 Washington Street Boston, MA 02111 wwlv.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Applicant Information �[ / Please Print Leib1V Name (Business/Organization/Individual): l` Address: PO. 1119 City/State/Zip: ;F;ge`[/1��Pf� Phone.#: v Are you an employer? Check the appropriate box: Type of project(required): 1.� I am a employer with _ 4. l�am a general contractor and 1 6 New construction employees (:Cull and/or part-tim.e).* have hired the sub-contractors listed on the'attached sheet. T. 0 Remodeling Z.Q I am a sole proprietor or'partrler-' These sub-contractors have 8. 'Q Demolition ship and have no employees working for me in any capacity. employees and Have workers'comp. insurance.$ 9. 0 Building addition [No workers 1.comp. insurance 110.0 Electrical repairs or additions requixed] - S. � We are a corporation and its 3.❑ I a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right 6f exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.E] Other - employees. [No workers' comp. insurance require(L) J. "Any applicant.that checks box#1 must also fin out the section below showing their workers'compensation policy information. davit indicating such. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affi (Contractors that check this box must attached an'additional sheet showing the name of the sub�ontnctors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. l � Insurance Company Name- Y Policy#or Self-ins. Lic.M C Lf625 l6�2 xpiration Date: 2� ` Job Site Address: 5. Y&i P'ef��tl �' City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure fo 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 DLA for insurance coverage verification. I do hereby under the pains and penalties1oJ& erjury that the information provided above is true and correct. Si afore: Date: Phone#: Offxcial 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 577bing spector 6. Other r information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as ,..:every person in the service of another under any contract of hire, express or implied, oral or written.,, An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or tiustee 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 appurtenant thereto shall not because of such employment be deemed to be an employer." o'r on the grounds or building 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 e coverage required." with the insurance Additionally,MGL chapter 152, §25C(� 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 compliznce��th 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-conti actor(s)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 nfirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should Accidents for co be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials .Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to.fln in the permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under`Job Site Address" the applicant should write"all locations in (city or town),".A copy of the affidavit,that has been officially stamped or marked by the city or town maybe 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 fo 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Iavestigatians. 600 Washington Street Boston, MA 02111 Tel. #617-727-490.0 ext 406 or 1-8774 AS.SAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia V i\ Town of Barnstable Regulatory Services SARNMULE, Thomas' . Geiler,Dfrector 039. �`�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.barastable'.ma.us Office: 508-862-4038 Fax: 508-790-623( Property Owner Must Complete and Sign This Section If Usin A Builder '- , as Owner of the subject property hereby authorize ��,�/�„�� d-�„F 1 �_�'�n/ to act on my behalf, in all matters relative to work authorized by this building permit application for. (Ad re�so ) �, igna e of er ate rint ame If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Town of Barnstable THE rpm o Regulatory Services Thomas F. GeiJer,Director iAriNgrABL6, 1HAM 09- Building Division AlfD nwt A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: village number street .,HOMEOWNER": e work hone N name home,phone# p CURRENT MAILING ADDRESS: 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 requirements. 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." re that they are assuming the responsibilities of a supervisor(see Appendix Q. Many homeowners who use this exemption are unawa tion 2.15) This lack of awareness unlicensed results serious problems,particularly Rules&Regulations for Licensing Construction Supervisors,Sec ed against the unli when the homeowner hires unlicensed persons. In this case,our Board cannot procecensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. lly aware of his/her responsibilities,many communities require,as part of the permit application, To ensure that the homeowner is fa lities of a Supervisor. On the last page of this issue is a form currently used by that the homeowner certify that he/she understands the responsibi several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FO R.MS\homeexempt.DOC Nlassachu,ctts- Dchar'tntcnt of Public jiafct', Board of Building Re(-- lations and Standar(l> Construction Supervisor License License: CS 70086 Restricted to: 00 i DAMON L KENDALL _ 48 KOMPASS DR FALMOUTH, MA 02536 Expiration: 1 1/21 1201 0 (',mmi"iunct Tr#: 6479 -� Boar o urding an =an5ar One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Registration: 128405 ' Type: Partnership s Expiration: 4/5/2011 Tr# 282001 KENDALL & WELCH CONSTRUCTION DAMON KENDALL P.O. BOX 490 OSTERVILLE, MA 02655 a Update Address and return card.Mark reason for change. Address 0 Renewal ❑ Employment Lost Card DPS-CAI is 40M-08/08•DBSLIFORMCA108212008 6 ,�25/ 10 9 : 35 : 47 AM 4130 ® 02 /02 ,aco CERTIFICATE OF LIABILITY INSURANCE 6/25/2o10Y' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) 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 . PRODUCER CONTACT NAME: Suzanne Harrington 'Murray & MacDonald Insurance Services, Inc. AICNNo EXt: (508)540-2400 (A No: (508)289-9111 IL 550 MacArthur Blvd. DRE EMSS:sharringtonpmmisi.com PRODUCER 00014460 CUSTOMER ID p' Bourne MA 02532 INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A:FiremanI s Fund Ins Co INSURERB:Safety Indenmity 33618 Kendall & Welch Construction Inc INSURERC-ace Property & Casualty Ins 874 Main Street INSURERD: PO BOX 490 INSURERE: Osterville MA 02655 j1 INSURER F: COVERAGES CERTIFICATE NUMBER:10-11 Master GL 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. �7R TYPE OF INSURANCEINSR, POLICY NUMBER MMI�DIYYYY MMIODIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED X COMMCRCIAL GCNCRAL LIADILITY PRE occurrence) $ 50,000 A X1 CLAIMS-MADE OCCUR LHB10000343 6/13/2010 6/13/2011 MED EXP(Airy uiie peisuii) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B ALL OWNED AUTOS 6207210 /4/2009 /4/2010 BODILY INJURY(Per accident) $ X SCHEDULED AUTOS X PROPERTY DAMAGE $ HIRED AUTOS (Per accident) X NON-OWNED AUTOS PIP-Basic $ 8,000 Underinsured motorist BI split $ 250,000 JE MBRELLA,LIAB OCCUR EACH OCCURRENCE $ XCESS LIAR CLAIMS-MADE AGGREGATE $ EDUCTIBLE $ ETENTION $ $ C WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? NIA 46252512 /6/2010 /6/2011 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 r DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) CERTIFICATE HOLDER CANCELLATION (508)428—4907 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sandwich Building Dept ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Suzanne Harrington, CIC ACORD 25(2009/09) O 1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909). The ACORD name and logo are registered marks of ACORD 7488 vjr "/ 4V1V wzu 17: « FAX 508 564 5531 Bouchie Insurance 12001/001 ACORDTN CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/YYYY) 03/31/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Robert E. Bouchie Jr. Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1352 Rt 28A HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, PO Box 400 I i Cataumet, MA 02534-0400 'INSURERS AFFORDING COVERAGE NAIC# INSURED Tom Costa Building&Framing i INsuREgn_ PATRONSMUTUAL.INS CO OF_CT...._-._...__.-..;,_,..,_ -. ... ........ 29 Lady Slipper Lane INSURER B. HARTFORD UNDERWRITERS,INS CO ,• ............ ..... .._.._....._ Mashpee, MA 02649 :INsuRERc: t.__...- --- -....._....._..__�._..............._... --.._...........__.._._....... _........,....._..__..._..._.._.......... INSURER D: I f 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. r--............. - ............._.......................- -.._._..,....._..__....— --._....._.......__._. _..............._... Y _ .. _._..........._....._..__.._......._._._.........._..__...—......_..... .._......_.._._...._....._..._........ __._........ .. ILTR NSR ADD'L� IC EFF6 TIVE POLICDATBY EXPIRATION,i LIMITS 1 POLICY NUMBER A PA GENERAL LIABILITY CTR0000478 08/26/09 08/26/10 EACH OCCURRENCE i$, _ __�.QQD 00I ' X.COMMERCIAL GENERAL LIABILITY ----- --ENTED ""-'• _ _ .. 1 ...., ............. ;CLAIMS MADE •..X?OCCUR i MED EXP„(Any one person) L.$ 5,00( .......... .. ._.. ;-PERSONAL&ADV INJURY $ 1,000,00( ........._........................... >......._.........................._.._................................... GENERAL AGGREGATE .......1..g..—_. Z OOO OOI GEN'L AGGREGATE LIMIT APPLIES PER: I ` ...... ;. ... i ;PRO UT ! PA._._ .. . 2,000,00( ? ;-POLICY : : PRO. G..,..... . JECT i LOC ' AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT !$ ANY AUTO (Ea accident) i ALL OWNED AUTOS _._......._......_.._...._...__.... _.._... BODILY INJURY `$ E SCHEOULEDAUTOS (Per person) HIREDAUTOS i ' _._....... ..._..._.... ....._...._._........:...._.....-..........._................._......._ - BODILY INJURY j$ NON-OWNED AUTOS I (Per accident) i ;....._; ..... ....... i........ ...... ... . .. ,..._...... ......._.__..... ............_......................._ PROPERTY DAMAGE - ! `.(Par accident) 1$ s GARAGE LIABILITY AUTO-ONLY-EA ACCIDENT I$ ;....tAUTO ......._..____.__..._...---_. . ,_..__..... ... ......................... ANY AUTO THERTHAN , ........ACC ...... AUTO ONLY: qGG $ EXCESS/UMBRELLA LIABILITY - EACH OCCURRENCE i$ IOCCUR 'CLAIMS MADE ' i .... .......... ....._...i ........................ ...............--......... DEDUCTIBLE S ......................._.. RETENTION $ is WC STATU. ; g WORKERS COMPENSATION AND 6S60UB8118A409 09/21/09 09/21/10 X..:..T Rx l M TS.'....._i...ER..OTH-i.i.._.__... . ...._ _._. EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNERlEXECUTIVE 1 I E.L.EACH ACCIDENT !$ 1 OO,OOI, OFFICERWEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ If yes.describe under .1.Of),0O( ,—.__......_..._....____.._...._.._..__.._....,_----. i SPECIAL PROVISIONS below i E.L.DISEASE-POLICY LIMIT ?$ 500,00( OTHER i I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Kendall 8t Welch Construction Co. DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10.__ DAYS WRITTEN P.O. BOX 490 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 874 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS 01; REPRESENTATIVES. Osterville, MA 02655 AUTHORIZED REPRESENTATIVE Fax: 508-428-4907 G`. &"-4.�• ACORD 25(2001/08) ©ACORD CORPORATION 1981 ` Act® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY1� L� 2/s/zolo PRODUCER '(508)540-2400 FAX: (508)289-4111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION -- Murray & MacDonald Insurance Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 550 MacArthur Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Bourne MA 02532 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Arbella Protection Insurance 41360 Colony Insulation Inc. INSURERB:First Cardinal Corp. 28 Jonathan Bourne Road INSURERC: INSURER D: Pocassett MA 02559 INSURERE: 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 OFSUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADUL POLICYEFFECTIVE POLICY EXPIRATION POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTEL) X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS MADE ❑X OCCUR 8500028928 8/18/2009 8/18/2010 MED EXP(Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 ANY AUTO (Ea accident) A ALL OWNED AUTOS 49692400002 8/18/2009 8/18/2010 BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 31000,000 OCCUR CLAIMS MADE AGGREGATE $ A DEDUCTIBLE 4600028929 8/18/2009 8/18/2010 $ [XRETENTION $ 10,000 $ B WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITYTORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE —] E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NEW WC 1/26/2010 1/26/2011 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONSADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate holder is named as additional insured/contractor on Commercial General Laibility per CG2010. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Kendall & Welch Construction Inc DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN PO BOX 1478 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL North Falmouth, MA 02556 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Gloria Smith, CIC/GMS ACORD-25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200901) The ACORD name and logo are registered marks of ACORD L V-3/.sV/ &VIU 1'UE 13: 33 FAX 15087901677 FAIR INS 0001/002 ,ACORD, DATE(MMfOD/YYYY)M CERTIFICATE OF LIABILITY INSURANCE F03/30/2010 PRODUCER 508.77S.3131 FAX S08.790.1677 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Fair Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . Box 430 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR '' Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Centerville, MA 02632 INSURERS AFFORDING COVERAGE NAIC# _. ____ -- -_- ------ -- - ---- _ _— — —__--- ._ . ............... -_.._.. _---...._..._..__......_..._........ ____ ....-.--......... ...INSURED JOHN C AALTO CONSTRUCTION INSURERA: National Grange Mutual Ins. Co 14788 POBOX 339 —_._.--.--.._---_.__._....._....__ _—_._..----...._.. INSURERS: Safety Insurance Co. 394S4 MARSTONS MILLS, MA 02648 ._._._...._.__.... - - - --...... - INSURER C: AIM 26158 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 DD'9* POUCYEFFECTIVE-"POCICY"Exi5i ATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY DATE MM/DD/YYYY LIMITS GENERAL LIABILITY MPI70531 10/02/2009 10/02/2010 _EACH OCCURRENCE $ 11000,000 COMMERCIAL GENERAL LIABILITY DAMAGE l O REN rr - PREMISES Ea occurrence $ 500,000 A X 7 CLAIMS MADE OCCUR MED EXP(Any one person) $ 10,000 .—_..._ ...... PERSONAL 8_ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 21000,000 POLICY PRO- --------._.— -----.--._. JECT — LOC AUTOMOBILE LIABILITY 1900808 12/01/2009 12/01/2010 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ - 100000 ALL OWNED AUTOS �- BODILY INJURY B X SCHEDULED AUTOS (Per person) $ _ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) 100,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ! 1 ANYAUTO EA ACC $ — OTHER THAN AUTO ONLY: AGG S EXCESS/UMBRELLA_LIABILITY EACH OCCURRENCE $ —1 OCCUR U CLAIMS MADE AGGREGATE — $ --— —--- DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AWC701IS79012010 01 01 / / ._._ WC SY MITS.T ER AND EMPLOYERS'LIABILITY Y/N / /2010 01 01 2011 ANY PROPRIETOR/PARTNER/EXECUTIVEF—] E.L.EACH ACCIDENT $ 10O,OO C OFFICERIMEMBER EXCLUDED? ---------•---•-- —__ __ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE It es,describe under S ECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ S00,00 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Kendall & Welch REPRESENTATIVES. PO BOX 490 AUTHORIZED REPRESENTATIVE Os erville, MA 02655 fKathy Silvia/FAI]S2 k-.JRD 25(2009101) FAX: 508.428.4907 ©1988-2009 ACORD CORPORATION. All rights reserved. r CREScheck Software Version 4.3.1 NJ( Compliance Certificate Energy Code: 2009 IECC Location: Osterville, Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6137 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: Ray Wysocki Damon Kendall 45 Seapuit Road P.O.Box 490 Osterville,MA 02655 Osterville,MA 02655 Compliance: Compliance:3.2%Better Than Code Maximum UA:154 Your UA:149 The%Better or Worse Than Code index reflects how dose to compliance the house is based on code tradeoff rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Gross Cavity Cont. Glazing UA Assembly Area or R-Value R-Value or Door Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss 528 38.0 0.0 16 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 480 30.0 0.0 16 Gable wall:Wood Frame,16"o.c. 288 21.0 0.0 15 Andreson Double Hung Low e:Wood Frame:Double Pane with 13 0.320 4 Low-E 2 Fixed Awning Windows:Wood Frame:Double Pane with Low-E 8 0.320 3 Rear Elevation Wall:Wood Frame, 16"D.C. 272 21.0 0.0 11 4 Rear Anderson Double Hungs:Wood Frame:Double Pane with 50 0.320 16 Low-E Rear Anderson slider:Glass 33 0.320 11 Front Elevation Wall:Wood Frame,16"D.C. 300 21.0 0.0 12 5 Anderson Double Hung:Wood Frame:Double Pane with Low-E 63 0.320 20 Front Anderson Slide:Glass 33 0.320 11 Crawl 1:Solid Concrete or Masonry 256 0.0 10.0 14 Wall height:4.0' Depth below grade:3.2' Insulation depth:4.0'. Inside below-grade depth:0.8' Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2009 IECC requirements in REScheck Version 4.3.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Damon Kendall, Partner Name-Title Signature Date Project Title: Report date: 07/20/10 Data filename: H:\My Documents\REScheck\Wysocki Res Check.rck Page 1 of 5 It REScheck Software Version 4.3.1 CNJ( Inspection Checklist Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments- Above-Grade Walls: ❑ Gable wall:Wood Frame, 16"o.c.,R-21.0 cavity insulation Comments: ❑ Rear Elevation Wall:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: ❑ Front Elevation Wall:Wood Frame,16"o.c.,R-21.0 cavity insulation Comments: Windows: ❑ Andreson Double Hung Low e:Wood Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ 2 Fixed Awning Windows:Wood Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ 4 Rear Anderson Double Hungs:Wood Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ 5 Anderson Double Hung:Wood Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: Cl Rear Anderson slider:Glass,U-factor:0.320 Comments: ❑ Front Anderson Slide:Glass,U-factor:0.320 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Crawl Space Walls: ❑ Crawl 1:Solid Concrete or Masonry,4.0'ht/3.2'bg/4.0'ext.insul/0.8'inside bg depth,R-10.0 continuous insulation Comments: Exposed earth in unvented crawl space foundations is covered with a continuous vapor retarder(less than or equal to 0.1 perm).All joints of the vapor retarder are overlapped by 6 inches and are sealed or taped with edges extending at least 6 inches up the stem wall and securely attached. Project Title: Report date: 07/20/10 Data filename: H:\My Documents\REScheck\Wysocki Res Check.rck Page 2 of 5 i Air Leakage: ❑ Joints(including rim joist junctions),attic access openings,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed with caulk,gasketed,weatherstripped or otherwise sealed with an air barrier material,suitable film or solid material. Cl Air barrier and sealing exists on common walls between dwelling units,on exterior walls behind tubs/showers,and in openings between window/doorjambs and framing. C] Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. Wood-burning fireplaces have gasketed doors and outdoor combustion air. Air Sealing and Insulation: Building envelope air tightness and insulation installation complies by either 1)a post rough-in blower door test result of less than 7 ACH at 33.5 psf OR 2)the following items have been satisfied: (a)Air barriers and thermal barrier:Installed on outside of air-permeable insulation and breaks or joints in the air barrier are filled or repaired. (b)Ceiling/attic:Air barrier in any dropped ceiling/soffit is substantially aligned with insulation and any gaps are sealed. (c)Above-grade walls:Insulation is installed in substantial contact and continuous alignment with the building envelope air barrier. (d)Floors:Air barrier is installed at any exposed edge of insulation. (e)Plumbing and wiring:Insulation is placed between outside and pipes.Batt insulation is cut to fit around wiring and plumbing,or sprayed/blown insulation extends behind piping and wiring. (f) Comers,headers,narrow framing cavities,and rim joists are insulated. (9)Shower/tub on exterior wall:Insulation exists between showers/tubs and exterior wall. Sunrooms: Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification and Installation: Materials and equipment are installed in accordance with the manufacturer's installation instructions. Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction and Testing: Building framing cavities are not used as supply ducts. All joints and seams of air ducts,air handlers,filter boxes,and building cavities used as return ducts are substantially airtight by means of tapes,mastics,liquid sealants,gasketing or other approved closure systems.Tapes,mastics,and fasteners are rated UL 181A or UL 181 B and are labeled according to the duct construction.Metal duct connections with equipment and/or fittings are mechanically fastened.Crimp joints for round metal ducts have a contact lap of at least 1 1/2 inches and are fastened with a minimum of three equally spaced sheet-metal screws. Exceptions: Joint and seams covered with spray polyurethane foam. Where a partially inaccessible duct connection exists,mechanical fasteners can be equally spaced on the exposed portion of the joint so as to prevent a hinge effect. Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). Duct tightness test has been performed and meets one of the following test criteria: Project Title: Report date: 07/20/10 Data filename: H:\My Documents\REScheck\Wysocki Res Check.rck Page 3 of 5 0)Postconstruction leakage to outdoors test:Less than or equal to 8 cfm per 100 ft2 of conditioned floor area. (2)Postconstruction total leakage test(including air handler enclosure):Less than or equal to 12 cfm per 100 ft2 pressure differential of 0.1 inches w.g. (3)Rough-in total leakage test with air handler installed:Less than or equal to 6 cfm per 100 ft2 of conditioned floor area when tested at a pressure differential of 0.1 inches w.g. (4)Rough-in total leakage test without air handler installed:Less than or equal to 4 cfm per 100 ft2 of conditioned floor area. Temperature Controls: At least one programmable thermostat is installed to control the primary heating system and has set-points initialized at 70 degree F for the heating cycle and 78 degree F for the cooling cycle. Heating and Cooling Equipment Sizing: Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2009 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-3. Swimming Pools: Heated swimming pools have an on/off heater switch. Pool heaters operating on natural gas or LPG have an electronic pilot light. Timer switches on pool heaters and pumps are present. Exceptions: Where public health standards require continuous pump operation. Where pumps operate within solar-and/or waste-heat-recovery systems. ❑ Heated swimming pools have a cover on or at the water surface.For pools heated over 90 degrees F(32 degrees C)the cover has a minimum insulation value of R-12. Exceptions: Covers are not required when 60%of the heating energy is from site-recovered energy or solar energy source. Lighting Requirements: A minimum of 50 percent of the lamps in permanently installed lighting fixtures can be categorized as one of the following: (a)Compact fluorescent (b)T-8 or smaller diameter linear fluorescent (c)40 lumens per watt for lamp wattage—15 (d)50 lumens per watt for lamp wattage>15 and—40 (a)60 lumens per watt for lamp wattage>40 Other Requirements: Li Snow-and ice-melting systems with energy supplied from the service to a building shall include automatic controls capable of shutting off the system when a)the pavement temperature is above 50 degrees F,b)no precipitation is falling,and c)the outdoor temperature is above 40 degrees F(a manual shutoff control is also permitted to satisfy requirement V). Certificate: l] A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Report date: 07/20/10 Data filename: H:\My Documents\REScheck\Wysocki Res Check.rck Page 4 of 5 I V I Project Title: Report date: 07/20/10 Data filename: H:\My Documents\REScheck\Wysocki Res Check.rck Page 5 of 5 r 2009 IECC Energy Efficiency Certificate Insulation Rating R-Value Ceiling/Roof 38.00 Wall 21.00 Floor/Foundation 30.00 Ductwork(unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.32 Door 0.32 NA-- Heating& Cooling Heating System: Cooling System: Water Heater: Name: Date: Comments: i ...•.�rti.«-.tir-...-..f..{.;:.I'v-%r^ -�i u -"'-'.+w,..,,r-,:-r.-+.,r-V++►:s-}'+;:�•'n.�+l- ....... .. tio--.-....-.'L-,3v-:,...ys._n,•-y r„ ,, «, -.. Y A J The Town of Barnstable 4 BARNSTABLE.� Department of Health Safety and Environmental Services , MASS r f6jq. `0 �Fu�►•+> Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice_ Type of Inspection ,a Location '�O a-P-k i Permit Number U p Owner Builder if 4-v One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: ' l ( ) ro t A L4(AA 1 1)-1 C , r ' Please call: 5 -790-6227 O.T,re-inspection. �^ Inspected by fi ,� ` ������ Date .y '.^'^..-.-..r •.,Jyy,-••- •.-�---�• y .. e r r .J 'y„r r ,r,., k' ..+M' �%.n�-rX.�i�r-r ��i�` .. ., -._. .� .. ..,,.�,. tHEtpy_o� The Town, of Ba..rnskible BARNSTARIX. Department of Health Safety and Environmental Services MASS g 0119. �0 Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice ,z,, � Type of Inspection r, >r P 2 Location P,4 r 'i Permit Number Owner Builder �0'" �0 02� (;GQ r ii T L One notice to remain.on jobsite, one notice on file in Building Department. The following items need correcting: ellO '4--- (.3 O �o J ( U :aL -P it r r i Please call: 508-790-6227 f re-inspection. Inspected by Date '` / i MRY-07-1999 15:17 GURRIN0!S%5S3 19796679553 P.01 South Shore Gunite Pool & Spa, Inc. Quality Pools And Spas Since 7975 FACSIMILE COVER SHEET SEND TO: FROM: 1�R. ?err 4;z. �tkets F1`4z9tr�1� FAX NUMBER DATE SOS-140- 6.13 0 Totai pages, including this cover sheet.�— lovrk R`[` T proce. � 12 Hadley Street - N. Billerica, MA 01962 •'(978) 667-0629 • (800) 649.8080 • Fax: (978) 667-955 I MAY-07-1999 15:17 GURRINO'S/SSG 19786679559 P.02 TIMOTHY HY WALKER CONSULTING ENGINEER ucEN9� 19 W0066mg AVE, a•Nt FAitQA<AL ENGINE&p Wcamritt,CT bl 880 (2O3)464.4370 May 7, 3999 Mr. R(.ObPrt-, rtlaV11710, prpsident COUCH S;17Cfr" (,,mite K101 61111 Spa 12 Hadley st - Re: Becker pool No.. Si13.erica MA 0J R62 Dear Mr, ruArino: As described tv me on the Phone, you have d's9cover-ed a problem with the 8erke:r poni in Osterville, MA. Icy understanding is that when digging thn pool you found a lalrar or nrUaenir marP1'ial tturied belgw ground where you are placing the pool . However, the urttatable layer is noL as deep as r)1A rvnr,l rwravarinn F;o the DiAtOM or t176 P991 S"s o» solid uridistur'bed earth. 7 further understand that the steel reinforcing hats been ccnnrrleLad d,id Llu: tv"rb & t i.1% 1t14ee Ar,sumi.ng that the above is accurate, 49 1 Have not had a chance to verity tbQ actual rield corlaitions, then the rnujor problem to be faced is that the pool deck will be sitting on highly unstable ground and will probably settle substantially in the ricxL several years. quntte peal walla are utxonq enoutlli oa that oomplotilig consatructiol1 or the pool at this time will not be a problem. However, to P.nvutC that the deck i.s stable, I would _h;Lrunyly recommend excavar-ing the deck aroa pl.u. phrhap4 ri.vP tear additional and replacing the organic material with properly compacted sand arul gravel. This Gbou3d not be done until the pool shell has cured for at Least. 10 days anci hat; been kept iaviSL Cox this period of time. Considerable oars must be uacd when oxczl1t4tiug 'I'd bmc:kii1lil29 Lv iueure t"a �l 'fully scmp�Gt::9 illIPUT-ily of ItIP piti wrlll r rip rArQ to provide a stable base fOr the pcao.l deck. it you nave any further questions; please call Me aL 203-454-4376. Sincerely yours, Tilt ot:Uy wrt].kyr, PTi r 5 5 �� -r e- TOTAL P.02 rlEnai „b � , � Map 1 1 8' Parcel �^v`Permit# House# �� Date Issued �-� —f Board of Health(3rd floor)(8:15 -9:30/1:00- 64/°" �34: Fee 2t,�'?7-2-0 Conservation Office(4th floor)(8:30-9:30/1:00-2:00) ZZ �! �� ;�` SYP �tl"w3 i Planning Dept. (1st floor/School Admin. Bldg.) IN M I IANIr Definitive Plan Approved by Planning Board Q- 19 VIFt� N R E AND ' NS TOWN OF BARNSTABLE Building PermitApplication Project Street dress LoT f2 y S .SLAPU IT �A� Village AA q� ^ A� Owner 1 j�(�® �C... U12 I C;�/ IR OA l.'1—"r f�TAddress /�/'M � Telephone- , Permit Request �(' �.�/1/ ���/✓���(J/1 �� Ile,x, Rick, 6e;nsOr f��t�?'W ��tldQl� pvaL First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ cG Zoning District Flood Plain Water Protection Lot Size q , 2,� Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Zot 4 O� ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information 1Name &MXeqAffi6-r dUq?,PZ1C_7_-12-W Telephone Number -6-6 9 — '9 2E - 13 Address leoly �f License# d 4711� q 2_0 Home Improvement Contractor# Worker's Compensation# `3 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DEN FOR THE FOLLOWING REASON(S) ' FOR OFFICIAL USE ONLY _ i PERMIT NO. 2.3 L; DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE OWNER a DATE OF;INSPECTION: FOUNDATION cA I FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: °-i ROMH- FINAL FINAL BUILDIN60 DATE CLOSED OUTt',) ASSOCIATION PLAN NO* '� TOWINI GI%,, BARNSTABLE ' CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 094 GEOBASE ID ' ADDRESS 45 SEAPUIT ROAD PHONE (508)771-7410 OSTERVILLE, MA ZIP 02655- � I LOT - 12- -- - . BLOCK " _ LOT SIZE . - DBA DEVELOPMENT DISTRICT I' PERMIT 40208 DESCRIPTION CERTIFICATE OF OCCUPANCY I PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY 1 CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $.00 O� CONSTRUCTION COSTS $:00 101 SINGLE FAM HOME DETACHED 1 PRIVATE Pill "' •+ BARNSPABLE, • MASS. ` i6g9 BUILD �T IVIS 0 BY � DATE ISSUED 08/04/1999 'EXPIRATION DATE y` I?h1441T - PNRCE'L.-ID 000600 094 GEOBASE: i'D ADDRESS 48 /SEAPUI.T ROAD : PHONE (50B�'; :1-?41.0 e - PEHVILLF, MA "' 2I`P 026 BLOCK ?',` �� t LOT SIZE .� DBA I` ' DEVEI3l�MEN`�' DISTRICT PERMIT' 24188 DESCRIPTION NEW''SINGLE FAMILY RESIDENCE SEW-PT#96-663 ,HERMIT r. PE BUILD _ ,TITLE NEW RESIDENTIAL BLD,G PMT CONTRACTORS: STA P FORD, kEl'a Department'of Health, Safety ARCHITECTS: and Environmental Services TOTALfFEhS: $763.22' BOND - $..00 . THE 1 � CONSTRUCTION COSTS $246,200..00 2 '101 SINGLE •FAM HOME DETACHED • 1. PRIVATE P=of?I" * 'BARNSPABM i6 A�� OWNER BROOK VALLEY REALTY TRUST,' 39' ♦ � , ADDRESS 298 MAIN STREET.'.,._ SUITE '5 HYANNIS, MA ` "lam BUILDING DIVISION -BY Y DATE ISSUED 07/03/1997 -EXPIRATION DATE 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 OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF-PUBLIC WORKS.THE ISSUANCE OF THIS 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 M FOR (READY TO LATH). PANCY IS REQUIRED;SUCH BUILDING SHALL NOT BE CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTI15 ROVALS ELECTRICAL INSPECTION APPROVALS V 1 9r 2 2 ,c L l c,•.��-G-2 99 i D fij 3 1 HEAT NG INS ECT O1NAr.OVALS ENGINEERING TMENt 2 O BOARD OF HEALTH Isp (4 ). y q II OTHER: SITE PLAN REVIEW APPROVAL �7 \., � � I WORK SHALL NOT PROCEED UNTIL. PERMIT WILL.BECOME NULL AND VOID IF,CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION 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. ' �A t B I L D I N J P .ERM .IT '1 !¢�2 c re �'/� Lv-Div APPROVED 'OWN OF BARNSTABLE GAS ❑.W: .N;G PLUMBING ❑ B&-J34NG -� APPROVEDC-/�-�-g TOWN OF BARNSTABLE ❑ GAS C9-WIRING PLUMBING ❑ BU LDI G r l TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 094 CEOBASE ID ADDRESS , 45 SEAPUIT ROAD PHONE (508)771-74101 OSTERVILLE, MA ZIP 02655- LOT 12 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 40208 DESCRIPTION CERTIFICATE OF OCCUPANCY PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety AR ITECTS: and Environmental Services TOTAL FEES: NE BOND $.00 � ,r ` CONSTRUCTION COSTS $.00 101 SINGLE FAM HOME DETACHED 1 PRIVATE P; (:1 E * BARNSTABLE, # MASS. � ED MA'S BUILDING DIVISIO BY DATE ISSUED 08/04,/1999---- EXPIRATION DATE 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 OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS 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- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. 1 i BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I I 2 2 2 I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL i I I I 1 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION 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. BUILDING PERMIT JUL-23-1998 15:.37 GUARINO'S/SSG 19706679559 P.02 Hea:lth Care Water Purification Systems The Environmentally Safe State of the Art Etter Treatment System yy 4 WIN* :. ' H E A LT H CA RE PcwfLq Otr air 17 5 .: i MANUFACIUrzEU FY SUPERIOR.AQUA Sir us ' ENTERMISES.INC. The easiest, most automatic SUP ®uA-% environmentally safe way to t _ � enjoy sparkling clOor poo(water. SYSTERRS �- The HEALTHCARE SYSTEM pool water sanitized by, Environmentally, the is the most advanced the HEALTHCARE SYSTEM HEALTHCARE SYSTEM is water purification system has many advantages the right choice. There's available. It combines over chemically treated no need to store the algae and bacteria- water. Along with poisonous and unstable killing effectiveness of freedom from the chemicals harmful to ionization with the constant adjustments of plant and animal life. vxirlazing efifec+iveness tit i-Nca4s.it is mn)4o)dr; The HEAi.WME'11W5WM r•-, ,r,� ,. ..r.�` .,-..-�. Q.. rlr�r�.{^r-,�-rnci �n r-�r�f'+f�� c•c jc �ricily in�iryll�?r'I {71�?C7 c:7n l JI IL-23-1998 15:37 GUAR I NO'S/SSG 197966795se P.03 At the heart of the HEALTHCARE SYSTEM is.a specially sealed chamber housing two electrodes, This is called an "ION CHAMBER". It is here that a safe, low electronic charge produces a mineral ion (electrically charged atom particle) which "attacks" impurities in the pools water. Mother Nature 1 treats water in mush the same way, as water rushes through b mineral deposits lining the beds of rivers and streams, The solid state controller regulates the number of IONS Introduced by the ION CHAMBER. Since the quantity of impurities in the water may vary from time to time, a weekly ion check is recommended. Your HEALTHCARE dealer can demonstrate how quick and easy this is.to do with the turn of a knob on the .controller box. The HEALTHCARE SYSTEM automatically oxidizes the pool with ozone. Ozone is produced.naturally by lightning storms or ultraviolet rays from the sun. Advances in technology have made it possible to combine these two processes into one complete treatment system. The system has been designed to minimize service and j maintenance. D naf/ews^y.r.ss [ 4!+•.{v,{6e..t.1'4err1'!P Ar'l f.L,A C'n r?y p+.eq*emrw 1P t/'+ I JUL-23-1998 15:38 GUAR!► O'S/SSG 1 9 7 OGG 9558 P.04 Your HEALTHCARE SYSTEM was engineered to provide you with maximum automation in the day to day treatment of your swimming pool, to ensure a safe and healthy pool for your use. The HEALTHCARE SYSTEM has joined the benefits of ionization with its long lasting stable residual and ozone,the strongest oxidizer available -for pool use. The HEALTHCARE SYSTEM proven technology is used to sanitize in many different applications. It is used for drinking water; cooling towers, fountains, fish ponds, mamr-nal tanks, zoo features, industrial process water.and, of course, in swimming pools. N.A.S.A. used ionization in the early manned space flights to purify water aboard the spacecraft. Before the HEALTHCARE SYSTEM was introduced for swimming pools, we accepted common problems such as red burning eyes, itchy skin, scum lines; and odors as part of the luxury of owning a pool. We continued to live with the continually increasing cost of operation and sometimes dangerous handling of different pool chemicals. i _TUL-23-1998 15:38 GUAR 1 F10°S/SSG 19786679558 P.05 ,INSTALLATION Model IP1-HC I172-HC FROM POOL Capacity 10.40 K 10-40 K e ° CONTROL Gallons o, Gallons ooa BOX pp��VV e VoltageF145. 220V 1• TO POOL r. Control 14.5 x E OF Untt t2.25 R Size . x 7.5 PUMP . .o. •o Total 20lbs. 20lbs. Weight BY PASS INJECTION 107: — FILTER Row Cal . 1- 1 mrWW s dooms,. r : .MANUFACTURED FOR 10 YEARS BY SUPERIOR AQUA ENTERPRISES OF U.S.A., INC. 2140 Bispham Road Sarasota, Florida 34231 (941 ) 923-2221 . FAX: (941 ) 925-4509 . 1-800-225.0 a 19 DEALS t r JUL-23-1998 15*39 GURRINO'S/SSG 19786679558 P.06 �111�1.�@`_11111811"all m `3� Wr, u��f 1 F {. ',J)6 ��1�laa IPto?�o.ILS:Si�ai,�w5�r�iu�i.4:�i�S�.s'9Jif+,`^J' �511 ,Hf' W"�� '�:.'.#wC....l �, ..,.�� ..�ai£J'�.1: .��.si ...�., .,i��� .'�'.'�:°': a MODULAR MEDIA The innovative Modular Media version of Syste-iv:3 filtration. A. Systein3filtration is YI unsurpassed in innovative anal fi4ndbrial desi .7 Perfectly matched to Sta-Rite pumps in perfor- mance and dependability, Now,Sla-Rite is proud to expand on the proven Posi-Flo"cartridge design,and bring these ""top-of-the-line" you the product that makes-Ultra Capacity Filtratidn"a reality. No longer simply '.cartridges','advanced technology has brought an entirely new class of filtration filters are truly redefi-ning to the industry. Sta-Rite's Modular Media concept incorporates the latest in media science,perfectly balanced flow,and an integral manifold design to bring you Ultra how pool and spa water Capacity Filtration,This filtration concept puts totally care-free operation within is processed. rF,3ch of today's pool owners, U.S. P3te'?f No.5,190.651. Other patents pending. Feaft(res - Dirt-loading capacities in excess of • Combination of tank and module 50 times more than sand filters in design allows fof rinse-in-place oper- eqWvalent sized tanks!(Ask a Sta-Rite ation.T"top is removed in seconds, representative for details). and Modular Media can be cleaned 0 2 concentrically placed balanced-flow with ease. - modules.Dirt-loading is totally wli- • Patented Posi-Loki tank closure form,using all the media for effective system makes rapid,sale and reliable filtration before cleaning is required, tank access a reality.No other Ares- • Modular element's integrally molded sure vessel has better access to the ports use 0-ring design for positive internal working components, seal over lower manifold assembly. Posi-Lok...nothing safer...notlting This design assures positive sealing Surer. duoughout the life of the filter—in all Profemnlonal i JUL-23-1998 15:40 GUARINn°S/SSG 19786679558 8.07 NEE mom I MMI Feature�'(cont) Outline Dimension • 'Tank construction is of Dura-Glae,the proven material of choice for all water and climatal extremes.Indoor or out- door,cold or hot,no material in the industry has a longer track record of absolutely superior durability in pres- sure applications. • Exclusive Waterford Process"produe- don makes the System:3 tank design possible.Material compounding, molding,assembly and testing are done in-line on a continual basis. D • Sleek lines,low profile and black A silhouette make System:31 filters the easiest to work with for all land- scaping design. • 2"full flow bulkhead fittings provided E with union adapters for standard plumbing connections. • Operating labels are placed ni clear view. Clear and concise,they display recorded start up data for handy reference. g • ' LET 0-ring seals and hand-tightened _ fittings have replaced gaskets and thread sealants at all bulkhead,drain OUTLET 7,612 and gauge port locations. • Top port allows for in-tank chemical treatment of media.Bushing and n-rbig 9.19 design helps prevent tank damage. • Tank base is integrally molded.Incor- porates leveling pads and mounting L 2"STA-RITE UNION holes to facilitate all installations. (ONNE(TIONS • Dramatically oversized drains are oriented far both side and bottom . access.CJ-ring sealing plugs may be used as is or adapted for all piping and valuing applications. E C Area(width) Area(height) Catalog A a Number Needed to Needed to Remove Number Width Height of Clamps Takeoff Clamps Top Hall of Tank Certifications STM120 28.5' 42' 1 36' se• ►• w (W The filter shall be test9d and certified by JI_IL-23-1999 15:40 GI-IARI1,10'S/SSG 19"f866 9558 P.0G. Materials and Design Filter sizing • Tank Catalog Maximum Pool Size Pool Size Port Glass reinforced thermoplastic Number Flow 8 Hr.Rate' - 8 Hr,Rate' Size Dura-Glas.Proprietary blend contains S7M120 100 GPM 35,000-48,000 21.000-36,000 2" carbon black fbr maximum outdoor S8M150 125 GPM 45,000.60,000 33,750 45,000 2" af}ing resistance. • agamp5 Based 011 tecornrnenoeo flow tale reruje 0175`��to 100%of maximum. Plated and polished stainless steel. Designed.with hand secured knob and stud issemblies. Accessory Ordering Information • Piping Connections Catalog Number description Ship Wt.fibs.) Through-tank bulkhead fittings --- -•---.._..._...-............-- ----............ ......-.. ...... feature full 2"diameter clear flow. Pkg.188 Union x 2'Slip Adapter-Pkg.of 2 1 Bulkhead fittings are hand secured Pkg.189 Union x 2'FPT Adapter-Pkg.of 2 1 against O=ring seals and include 77703-0100 Union x 1-12`FPT Adapter-Pkg.of 2 1 2"slip adapters which allow for 77703-0101 Union x 1-1/2'Slip Adapter-Pkg.of 2 1 tunion style piping connections. 25021-0200S 100 sq.It.Inner Replacement Module for S7M120 10 • T'4nk Base 25022-0201S 2W sq,4.Outer Replacement Module for S7M120 to Integrally molded with tank. 25021-0202S 191 sq.R.Inner Replacement Module Ior S8M150 15 Design incorporates mounting holes. 25022.0203S 259 sq.ft.Outer Replacement Module for S8M150 21 • _fir Bleed Contains internal automatic air bleed, as well as top-mounted air bleed at gauge port ass rembly. Engineering specifications for Material and Design • Qf;erating Limits FILTER FILTER AREA Designed for maximum continual . working pressure of 50 psi.Water The System 3 filter(s)specified under • The filter shall have a.total effective temperature maxinnun 105'F. this section shall be of the Modular filtration area of square feet. Media type manufactured by Sta-Rite e When operated at gallons per Industries Inc. minute(CPM.)per squarc foot(Sq.Ft.) • The filter shall consist of an injection- of filtering area,this filter will have a iFilterOrdering Information molded,glass-reinforced thereto capacity of filtering gallons in plastic(Dora-Glas)tank,2"PVC union hours and _minutes. Catalog Titer Ship Wt. Carton Size connections on inlet and outlet ports, Number Area (1As.) L x W x H - a pressure gauge,and an external air FILTER TANK ;-\,120 300 sq.n. 120 28 x 27 x 4i relief valve,all of which shall be • The tank shall be inches in 'YXI 50 450tq,4, 147 31-112 x 31.1/2 x 41 mounted on a base that is integral to diameter,and shall be injection- the lower half of the tank, molded,glass-reinforced thermo- • The filter shall contain filtration mod- plastic(Dura-Glas)in in upper half ules of pleated polyester media which and a lower half with integral base. shall be manually flushed clean in the The tank halves shall be sealed at the lower half of the tank,or be remove- centerline by means of a peripheral able from the tank for pressure spray sealing ring,and secured by means of Eleaning and/or chemical treatment. multiple Posi-Lok clamp segments • The filter sh-ll be tested and Certified each having stainless steel Tabolts to ___ rl_ n"nor+ snrl n h{•rf':�rlarl JUL-23-1995 15:41 GUARINO'S/SSG-, 19786679558 P-09 Engineering Specifications for Material and Design operating on the wedge principle, INTERNAL MEDIA AND upper tank half,and provide means shall compress the tank sealing ring DISTRIBUTION SYSTEM for lifting of the modide from the tank. mid retain the tank halves until all • The piping connections shall be pro- The lower module end caps shall have residual internal tank pressure is vided by means of 2"union-type bulk- integrally molded flow channels to vented. head fittings which seal to the lower engage a distribution manifold having •The tank shall cant'a 50 psi maximum tank half ports with 0-ring seals. 0-ring seals,and shall have self- pressure rating,and have a continuous There shall be a distribution manifold supporting legs to stabilize the maximum m water temp eratt re rating of which collects filtrate from the Fnodule inside the tank and for 105 degrees F. modules and seals by means of external cleaning. • All piping shall be though the side of 0-rings inside the module outlet ports. • There shall be an internal continuous the lower half of the talk,to allow the • There shall be two self-supporting air relief tube connected to a large top half to be removed for internal filter modules concentrically placed capacity strainer screen at the top of access without disassembly of the inlet within the tank,comprised of 4 oz. the tank for effective purging of accu- and outlet piping.The tank shall have spun-bonded polyester filter media, inulated air from witfnin the tank drain ports with nominal 2"threaded uniformly pleated in a'dual sided con- during circulation system operation. drain plugs for both side and bottom figuration supported by a rigid central • The filter unit as outlined herein shall access. core.The media shall have a 20 micron be Sta-Rite Model No. rating.The molded upper end caps of the modules shall have centering tabs which stabilize the module inside the L F try{f�` �`5 " v1�i f f r,'i• Sy a' , tJ .. � , �(, • �•���.��ia .4 T •Ra < t. :i } err . �•;' j^ r S. 1 ,tea s � � , n 1 'h+rq,4��x1,`'�{y - _ - ' � r sv SF _ h' •4, v , ,. `- ice...• �t +� .1 . 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'�� ,t,•. a ;c no d;pa ana]]no a ssassoa o4i 4, r !' �,. _-v fl j� � � (fir h3' i � � x � .`•�`'r~ zY+ Y� �� �_`" ' ` � ' -�• { • saio d � � �• �� .�;-:� F 8•� �,r,,��,.:,ek„ OSinsaAS uIpAUSfl0O EdBdyS OI'ua d0 11011kS 61 fo3 4aiolllaafl 1 y����- •G ,- r� �.3 �-•Y s ` ; �/�' _" .rz 1 �.t•'+�J �t+'a�lT,`'}r �i , eA�• 4i1• j •• —_.. '. `4 c�_;' • a _c�'S i '�r��` `4 S;rr r t "'+�+, 7^� (�,wi { �-`,+a �1.'_ ��`� ri,y$c}&�'+ :'Wr y t• , ,'akt v r c ¢r• .�'�, it a x aA :.+' 7. ti r 4 ' j' .^c' .• j`�.1<, -, sY '+ 1ve-.{. �yd�i1� c•1^ =7� s '. °Erne r� The Town of Barnstable • nAtaysrasM - 9� MAM Department of Health Safety and Environmental Services''OrF&659. #' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only I t I Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION I I 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: __F00 Est. Cost Address of Work: Owner's Name Date of Permit Application: — —�� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit a the agent of the owner: Date Contractor Name Registration No. OR Date / Owner's Name /j _ — The Commonwealth of Massachusetts _= Department of Industrial Accidents o ce of/nyesffoo ons ^_ t 600 Washington Street Y Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: 41),alW r ems' I67?) 'll r T 9*2921I,19 location: a99 &X%N �&ZecT 1 ci A& �� AM hone# J'� `'-2 c// ❑ I am a fiomeowner performing all work myself. I am a sole t have no one in any c ac '///❑//////////%%%%%%/%% %%%/%%%/%%%%%%%%/��%%%%%%/%%% %/%%%%%%%/&/m/////%////m/m/%/%///%%%%%%%%/%%%��%%%�%�%�%%%%/%/%%%%��%%/O%%%%%//, ❑ I am an employer providing workers' compensation for my employees working_on this job. C �2lCGr comaanv name:. _ .. r .. .... .............. 1 address:: . >'>::>'. ;`:>::<>:> :�> ..:...:.::::. shone#.:. X. insurance co. ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have r the following workers' compensation polices: ... .......... company name: :: .::. .::::...::::::::... .. . address: phone#:: ......... >::<:>::<;:::<::><::>:::<:»>«:;:><..........................:,. .................. insarance::co . .... 0 CV :.:.:.. . an name:;'::: >:<: :;;::: 'com v D address: ;..;::.;:: .:. ........:.::...:::.. ::.:::. shone#c tv: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify r the pains gyd penalties of perjury that the information provided above is true and correct Date Signature Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if Immediate response is required ❑Selectmen's Oiflce ❑Health Department contact person: phone q; ❑Other (mised 9/95 PJA) � 1 . Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. i , 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 she 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 agepgS� hall,withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the�insurance\coverage required:`Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a 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 perniitllicense number which will be used as a reference number. The affidavits may be retmmed 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 Me of lovesugadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 TOWN OF BARNOTABLE *BUILDING.;, PF MIT PARCEL ID 118 124 GEOBASE ID 6095 ADDRESS 27 SEAPUIT OAD PHONE '(508)428-755 I' OSTERVILL ZIP LOT BLOCK LOT SIZE DBA - DEVELOPMENT DISTRICT CO PERMIT 66250 CJR PTION FIN. BASEMENT 2050, SQ FT_ . PERMIT TYPE BREMOD TITL R IDENTIAL ALT/CONV . I CONTRACTORS: PEACOCK & CROSQBU RS, INC. Department of ARCHITECTS: Regulatory Services TOTAL FEES: $ . 8 BOND $.00� �E dr tME CONSTRUCTION COSTS_ $196,800.00 434 RESID ADD/A T/CONV 1. _ I 7ATE auwsrnst.E, I BUE�L;DIT D ISION � BY r, DATE ISSUED . 01/07/2003 EXPIRATION DATE i TOWN OF BARNSTABLE '`�'.- =`•• BUILDINGL PERMIT PARCEL ,ID 118 124 .� GEOBASE ID 6095 *- ADDf2ESS 27 SEAPUIT ROAD ' PHONE (508)428-7551 I .•w;, OSTERVILLE ZIP - LOT BLOCK LOT 'SIZE ` DBA " J {DEVELOPMENT DISTRICT CO PERMIT 66250 DESCRIPTION FIN_ BASEMENT 2050 SQ FT. PERMIT TYPE BREMOD TITIE/ RESIDENTIAL ALT/CONV CONTRACTORS: PEACOCK & CR SBY BUILDERS, INC.. Department of ARCHITECTS: U Regulatory Services TOTAL FEES: $ 0.08 BOND ( $ 00 pU CONSTRUCTION COSTS $1 ,800.00 434 RESID AD /A I ATE »InxNsrns>LE, MAss. u BUILDI D ISION BY DATE ISSUED 01/07/200 EXPI ION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALL Y OR SID LK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMI D UNDE HE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR " ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SE WE MAY OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS A 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. jPOST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS f 1 1 1 I' 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL R WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION 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. BUILDING PERMIT El g'peering Dept. (3rd oor) Map Parc Permit# AN House# Z Z�� Date Issued 7/3Iq-7 Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee Conservation Office(4th floor)(8:30-9:30/1:00-2:00)_A1177 Planning Dept.(1st floor/School Admin. Bldg.) r L' �1HE rq, Definitive Plan Approved by Planning Board 19 ������/• �40-7 A 0 d c L /Vo f.2P u C,r pp� !h TOWN OF SBA&STABLE Building Permit Application Project Street Address LDT i2Senpo t a �/ '4N Village 'I Owner �o�-��� �N�� Address 2 f1P �lG���.,�Uia,G i4fpC, om Telephone Permit RequestI A St 0 Toga L S CL,or. I First Floor W�%-) square feet i Second Floor / square feet Construction Type. wo o-1*3 JP2AN J-_ ,Estimated Project Cost $ aq I „ Do Zoning District Flood Plain Water Protection Lot Size 5 1 g2.?v _,r, -9 Grandfathered ❑ No Yes V Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure !.lob€ Historic House ❑Yes U,No On Old King's Highway ❑Yes l9 No Basement Type: N'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 33 Number of Baths: Full: Existing New�_ Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count �p Heat Type and Fuel: ,I,Gas ❑Oil ❑Electric ❑Other ( C Q�h� Central Air AYes ❑No Fireplaces: Existing New _L Existing wood/coal stove ❑Yes gNo A Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) f'Z , 11 Z� �tl ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes icQNo If yes, site plan review# Current Use Proposed Use Builder Information Name QSS Telephone Number t;x Address 2�g [) License Aa.,. #.-j : krf,rj '(-0. O.-(W2_0 11/P$ MCP 5 Home Improvement Contractor# 1XA (52-&0 1 Worker's Compensation#?FRA r;�7z'z.L, zl ( lrgvelor,$) NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE- OWNER •- DATE OF INSPECTION: ' FOUNDATION ,y FRAME INSULATION = FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: NR��_VGH FINAL GAS: ; Y� FINAL FINAL BUILD120', s�► .J { G� - - 1 ` 777"'C$ o' ~ Q DATE CLOSED OUT - 6 ASSOCIATION PLAN NO. .Ji. PAS - o� - f a 'n` �lg� rpm Engineering Dept. (3rd floor) Map I g �` VZJ5 Permit# House# Date Issued Board of Health(3rd floor)(8:15'-9:30/1:00-4:30) Fee Conservation Office (4th floor)(8:30-9:30/1:00-2:00) la4 U( Planning Dept.(1st floor/School Admin. Bldg.) _ �DANCE Definitive Plan Approved by Pla ing Board � 19MOWN OF BARNS sysTELED IN COM Building Permit Application WITH TITLE 5 Project Street Address lZ f� _6S' ®(/ANVIRONMENTAL CODE AND Village O 3%G/V. `le Owner G A0dkUa &V/l.5(,7_ //WSJ Address G�_ -I S/ , A, r Telephone Permit Request First Floor 51 ?6 o square feet Second Floor /e 0 C3 square feet 'Construction Type Estimated Project Cost $ Sid ciC)C/ 6 Zoning District f\C Flood Plain Water Protection �— Lot Size 5 Grandfathered ❑Yes 45�40 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: Oful1 ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Z 7-— .5 Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New 4 Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: 3 ras ❑Oil ❑Electric ❑Other Central Air Yes ❑No Fireplaces: Existing e_New Existing wood/coal stove ❑Yes ❑No a ( Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Z o ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) :` r 0 .w - FOR OFFICIAL USE ONLY PERMIT NO. • G 1 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROU,.GH FINAL PLUMBING: ROUGH. FINAL ,.. FINAL GAS: -ROiUG�-I:�; . FINAL BUILDING ' �g. ` ✓ r , DATE CLOSED OUT ASSOCIATION PLAN NO. f ' i' i gineering Dept.(3 d floor) Map r /� � ...r • �� (Poo �� � \ � ✓ I l Parcel 4,H" Permit# r"House Date Issued Board of Health(3rd floor)(8:15 -9.30/1:00-4:30)�� �1��' � Feet CoI servahon Office(4th floor)(8:30-9,30/1:00-2:00) z�� �.� (�.� Irk `vU, Planning Dept.(1st floor/School Admin. Bldg.) , /O/In THE rp Definitive Plan Approved by Planning Board • - • BARNSTABLE. 059. TOWN O -BARNSTAB LE ' BuildingiPermit Application, Project Street Address ,-0 7` 12 /T t Village 3/t✓`/ Ile Owner I4/t,f J 2 Address AZ u lritiF ,., S/ • M11-1— Telephone Permit Request C(14,. ...P t First Floor A 7o o square feet Second Floor A o c) square feet Construction Type - cc Estimated Project Cost $ Z Sid co Zoning District 1\ Flood Plain -a"' --� Water Protection Lot Size `�-4Z Y` Grandfathered ❑Yes tp',No Dwelling Type, Single Family ❑ Two Family ❑ Multi-Family(#units) ! Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: dFull ❑Crawl ❑Walkout N ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) r— Number of Baths: Full: Existing y New Half: ' Existing New No. of Bedrooms: Existing New 4 Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ®Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) 2 of 4" w ' ❑Attached(size) t ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ { - Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information 1 Name Telephone�Number_+ 4 Address License# R HomeyImprovement-Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - MAP/PARCEL NO. _ ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION . FRAME INSULATION - + � FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL i t , FINAL BUILDING t , DATE CLOSED OUT ASSOCIATION PLAN NO. _ TOWN OF BARNSTABLE y BUILDING PERMIT I` PARCEL ID 118 124 005 GEOBASE ID ADDRESS 45 SEAPUIT RD. PHONE (508)428-690 OSTERVILLE MA ZIP 02655- LOT LOT 12 BLOCK LOT SIZE DBA DEVELOPME DISTR T CO �- PERMIT 66250r DE RIPTI FIN. BA MENT 2050 S FT. PERMIT TYPE BREM TI E SIDENT L ALT/CONV CONTRACTORS: PEA OCK & CR SBY BUILDE INC. Depa tore of ARCHITECTS: Regulato y ervices TOTAL FEES OND 'f . .00 CONSTRUCTION COS $196 800.00 434 RESI ADD/ALT/C 1 PRIVATE * BARNMBLE, • MA.9S. I FD MA'S j i B SION B 1 DATE ISSUED 01/07/2003 EXPIRATION DATE TOWN OF BARNSTABLE BUILDING PERMITj' . 4 PARCEL ID 118 124 005 GEOBASE ID ADDRESS 45 SEAPUIT RD. PHONE (508)428-650 OSTERVILLE MA ZIP 02655- 5 LOT 12 'BLOCK LOT S DBA DEVELOPMENT DIS. CT CO PERMIT 66250 D S RIPTI FIN. BA EMENT 2050 Q FT'_ PERMIT TYPE BRA OD TU$66 IDEN AL ALT/CONV CONTRACTORS: PEA "OCK & C , INC. De rtmen of ARCHITECTS: Regula ry rvices TOTAL FEES: BOND ptr CONSTRUCTION COSS $ 434 RESI ADD/A1 PRIVATE II BAIUVWABLE, Y MASS. "MASS. BI D' SIGN A' Br DATE ISSUED 01/07/2003 EXPIRATION DATE- 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 OR 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- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- ' 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN ANICAL INSTALLATIONS. .MADE. � 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION.APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH i' OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION 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 I I I I . I I I � I I I I I . I I I I I I I I I I I I I I I I I I i I i I I I y I I I I I I I I I I I I I I I ?lie Commonwealth of Massachusetts Department of Industrial Accidents � -- ' .� 011fcrafLQras�patloas � � • _ 600 Washington Sire& -- Boston,Mass 02111 Workers, Campeasation Insurance Affidavit i e: zGle y�,�aAcme rI mallwortsmyself:m a sole 'C=and hava.ao tine is aav igicM oa this 'ob. 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If•• •If...••. • • •• • • 1■. •• 1•r . •• l\1\ • 1 w■1•r .•..• _•• r.1.1\ « f•I •. ••• •r • • .I••f■ • • •1 •1 •. •.• �•••• r.•w.•.• .1 .•1 «...••r • •mow. • r•1�• • • Y.1.1■ •.■ 444 Oil ... •-•.•r. •is• — .••• 0181016 •1•I•• •r •le• 1•f Yw •••Y:•. •1 1. .. ... Ole 0 too 1•1•./■ w•w•Il •1 �.1•et•..•%.. •1. •. .• .• ...Y �.•r _ • 1 •r•.•11 •1 sops .r..• �.•... .�• . / of ' •. .••r•1 .0 fare I ••. «.ru► �I••• • •.1 .. .• . . . .•.. •r _ be w• . .. NOS . •1•..r •1.0•r• ...•11 •• /��jj mom ��jMNI .•.• • uff�• �_� • 1 -•. . •f.�••. . . • • e�• r. • •• •.• • of.. •law • • iii f1be n •. w•1 e• • i■ • • ... •ru•1• •. , , • � . . •rM•tl w• .1•N..r f • as,r61 • ••. • .• • •w • .ee wn rnn •. •�-•• a.= .. •• 1• In • 1 1 •. .•e w01 .e e .. •sell •• n nup•r 1 • . ••■ • • • • • 1 1 1 I I I f l � u t �y BUILDER INFORMATION C s� Name ��� Telephone Number c� t)d � r91 3 Address ) ���4 t �� License# �� ✓e L�� +� O2j�J Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �--� DATE ��3 i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Q� Permit# 6 ?, S' 0 Health Division !%-L 3 I�IUIDS/ �cM 6bRM � � �ESTaIGTIDate Issued ! O 3 Conservation Division �6/cam Application Fee JTD of Tax Collector ) //��P. Permit Fee Treasurer t1 jha��3 SEPTIC SYSTEMI MUIST BE I?S de Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board ENVIRONUENTAL COCE'ANL TOWN REGULATIONS' Historic-OKH Preservation/Hyannis Project Street Address LIS �S-, P� fl> Village r-_-)S�r 1` //L C Owner /94_Le 1A J to,C'�G 1 Address Tom_ XA ,n ILE-L Telephone Permit Request F94144 T Square feet: 1 st floor: existing a Q proposed ® 2nd floor: existing 6 0 proposed Q Total new— Zoning District 9F I Flood Plain Groundwater Overlay "Project Valuation Construction Type Ljbuo Fmk Lot Size 1,16 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) �. Age of Existing Structure 45 Ll As Historic House: ❑Yes dNo On Old King's Highway: ❑Yes VNo Basement Type: Full ❑Crawl ❑Walkout ❑Other cBasement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �,,�'np Number of Baths: Full: existing new ) Half: existing new Number of Bedrooms: existing_ new © 7 Total Room Count(not including baths): existing g new j First Floor Room Count 5- Heat Type and Fuel: [ Gas ❑Oil ❑Electric ❑Other Central Air: 14s ❑ No Fireplaces: Existing 1 New D Existing wood/coal stove: ❑Yes No Detached garage: �❑�existing El 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 Ao If yes, site plan review# Current Use SiA)6LE L.AM 1 Ly Proposed Use BUILDER INFORMATION Name C.OG (d Telephone Number Address License# .� b eD V 1 l�Z� . MA rya .� M Home Improvement Contractor# 3 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .S'7-A SIGNATURE DATE FOR OFFICIAL USE ONLY ' Y PERMIT NO. DATE ISSUED MAP/PARCEL,NO. AD�RESS VILLAGE O LIVER d i` DATE.OF INSPECTION: ' FOUNDATION I ; FRAME l� " G'��.4)3 ' INSULATION b1� C7 -- �U3 FIREPLACE ' r ELECTRICAL: ROUGH., FINAL i PLUMBING: ROUGHi:.; FINAL. GAS: ROUGH o .= f r FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLANNO. The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATIO A number / street village "HOMEOWNER": nana home phone# work phone# CURRENT MAILING ADDRESS: 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 un ersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Depay,ftnent minimum inspection procedures and requirements and that he/she will comply with said pro dunes and a nts. (r �y Signa of Ht�otr 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 form/certification for use in your community. i °FINE 1°� Town of Barnstable ti Regulatory Services SA SAS MAss.LE Thomas F.Geiler,Director MASS 39. `e� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date 31 ' �3 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: �� Q""� Estimated Cost Address of Work: qs A9J Owner's Name: Date of Application: r 3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied weer 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. to Owner's ame Q:forms:homeaffidav r V `f I 7ETP �tao-.crt_awoc.,�•wc sou/.: IML �I.o /rG Fwe...�n.,'�,. ,a.ww..�i•+QOS Ind ... ....... - I I. _ 1 ' ...... . .... REAR ELEVATION — - EFJ FM r�•wn�rwo.m♦ ' Ofl� --_---. .. - = .. =eE•OCTV�. '�ow.+.ecb Nw•E ...M 1/ 1 -♦iJ.. =_ - -- �I I A'+blB YwuN P1L( SAC[. II I --- - FRONT ELEVATlb� � I I j - I -._.... - ._.,. LEFTELEVATION -- _- _-... r •1'. _.. �7��I i - v K:��• EDT _ - I � I _. RIGHTELEVATIO --' DETAIL FR011T FNTRy r F` 20 Q o44 Y .BEDROOM/. �vls5 :1 i i 1 p 1 'iefai- - -Y-c• �— i By R.S I wAeDi o qr u.c tµcew i .1:.+/ecw,eB,+a.'vrtt.eovrN a iF' b� / •� QYISED y...•.�• C)436L ee CafcT--we --d' ;� AMC V FVA we a - _ oe u �Fj`p i. yy :i tE Q BEDROOM) a AmcsroMOE.... S •° -LOFT •J BEDROOM 31 SNDY . V — �i«Hcr.Kf a_a -Y 4�•Y. . use r...•.wrx. ` / � �. --- OKJU.00K BATH \ +• s=6•-_I ate• � '"'• LJ' / �.�`�5• � Oy •sea s.-ems..cc�a � woa.f SECOND FLOOR PLAN L.^ I EGRESS YIIANO6-SUCO FLOW. S - MIBIAI■6--a-NFA• OEB HEIGHTi Q I. 1. _. _. J "A1O•IA�BOVE FINISWHT O OFF OR 'K1" to L �{g Ru.FxrEaoFc.LUM.Cs o,w Nona In�tuiioa�.ua..�: yw} i ram•_ _a.=�. - � „i i-�• . rc mow. 3 cv�x`RRia 7 I asQr s r y ,BEDROOM/. S ' _,.•:M Q I F GAVE r/ulva I Ia •s -I w.LRDco q� vFolsc+;oFaa��-}}'vrlc.ea....n oR.w Rr R.S '• S' •1yo II 2W'P.T' REVISED u.4ye�s:' ATTIC -w RAU �.V" s'•6• �. - - S $. I I Tg try a + O Iq ^''• ':M:-a�..._:.. .. a'-d a's..._.Y•d C\ ,• 1! CsKGT - :a a• 7 ATTIC \ 20 N ; t$BEDROOM S 'raOSET o ArncsroRAGc,... � •° .LOFT _ •J l Autss :q'_w yc' BEDROOM I/MDT wig•w G j OVP.RLOOH: BATV c9 . N 10 b• I i 48 di .j%•O� 4-F/- I �"-C' / !-1' GI LJ ''fi6eNiS' IJ _ � O I eQRo•+•u.+�M1y�4T 11 SECOND FLOOR PLAN L_ I EGRESS RIHD016.SECDBB FLDd1. 77 9 -, RAIREAIR 6•41•HEADER HEIGM y AIR1 A SILL HEIOR OF LESS EHAN 41 I_ -- _, J N•49WE FINISHED FLOOR m RIA.E97e"fe Wm.I.S PXG S in7rwtiut�w+w: ax.} a •C 4 '/ x i �Q. T .._ Ir • Fob ;,� - -� ! ... �' I i J d a ° r. — �: o o IL i 7jeIDcrCntl ,a•t \�Y,' IIY Y J I � i NIW@cfte loses F.;—T G AS=qFS oyrcd LLG �. U y 5M ua 93% R i0 aM w 05ruma m 020 .F�¢Cf_F•.ouQ F2w.Hb rc.�:r...e°o., w..a'rl e•rr p •�1 a .•a•n+ti.a Jr..+�w..w.v...w. c eµ L� HH f n Tj = a — - - -I 1� T'e• �•I � l YI v(@{a'Q.f 1• 0 IN — � � - - g I � sN• 71 Lp Rim w ' e e u jc7 oO t8 v=ro'�w lw l �... 14 f I' IrLrL d! 31 II t 4.'ij - U I ! C? a l jL�- JAI'll• :I nIIIU o� p] ;'' v hill I .�1 lili!I`'Iri! � • .:I'II :. �T..(!IIIII� - i':i r- '•!I j �,; I•II1' { I 1 �I II ,'I,.i:' �'f�'II:Ii � li �:I I� I' I ` II �Iii! � I''L��I�'I:'I:II F.. II M�I;�• - .III ! -�'- I!ii .I G:� R I'.�•! ems; !:11=.�l''' I ii r l I � pp 1 �F�Fgy pjti i l�� 7x1P !:a!AT P I; I ( II L j '�'l�j: • � ti r J LW 02-51 LEFT ELEVATION o. lElf7 Ifl iN 11:3 �A e. 20 G•:cO oftdw_ - 3 I .ALL:Q• FfiDrJS i � .B[DRDOM 1. J 1 1 :rs-: IK MR (' ♦ +�`lY�_3W0vre2-Ti�c+'-BiY Y= I wyl n R.3 II — ::—'I ve6q 1�/uL+wr+a. D.rcea+An a WAAp RpeP� X Gf. M,-4NL6 yy ATnc d •1 T SGIE III�JJY'�" EO• �. B � 50T i'•ns,L � IF' S a� � .� \ R[YISED m � J re f _ p• P: i ll ATM 20 R" D6 dp t it BDDROOMI s5 ��ISC7 Ep f{ J ADTCsroAAG6.... 1 •�� .LOFT....^ FY -J RLLG�1 9=6' Yf: BLDRDOM LSEUDY — 7lll Nr 4T' - s•A -a .Y�3•. 1 0 wsb T-.•.�w a-B i� / i I - � BA,a wac.,. .�• (fir � 8 a••�I R J�/ Gc�.a STY„9.5r. M eo— .o. SECOND FLOOR PLAN L— i ?�` LRRLSS RIIODI6.6ECM FLOOR. MINIAIN S•-9-READER REIRNI •� AND A SILL NEIRRE OF USS TRAM Q AM FINISWO FLDDR X m E rra.Fmk u,.N.r.s oxv ae'=o• I + H I ' n �-•� I_ —•=�M�1 $ a: nr t•:e a..e� � 1i -y' I II rAa•nx anoM.l• �� pP _ j S D A.M II LL,uNkII— r?ranwr� 6 MON L .1 OAR I -A—k-%9 #?� Dcac it l s ^�I• ^ yco• x_owmi. 3 QAPr RY �+• R$. UTTYC ARU. l I �1 nGe• �s .- �•M,..+m Psa'w Solt emcm qJ. K 0 KVISM I .l' 9J•NC10+o I \/J w 1 _ / $ 4,, ".,Vbw G. m•C <f 0 , ,ti a m l .J 9,y W. t c-6 E L ,/ :ca—..•....a.ao.c� .I __.§ ��: I�ys 1. s>v hc-L o>✓-c,aa_,P '• ! �..6.j t u �. 4 •� 2oxa0 ...—_uv_4�C ILN ' j' Ir P _.DUYUY°ROOM. l� l i ew•. Y•t' R. O'ATASTER BEDROOM 1 Jill J N 4 / wARUDHEJ. sa.LO to-1 SDGCVI�( A vaic — _// ::4'6•.. { /, t YAULTT'll Mr, - •�. gip• A nb• I, D EYMYCR ct c C -pT '�/ \ II h'• e�9•I n• sG c-s• :�F �yg� OC y �q+:o• U Stm�•rt� � C 1 � .)�l /••. III S-Y SGe% 3'-fi �3=V O WSJ OeM AWG�C I S ` / IL covERED nvwi�mrroRCR ° e arrrt - 3$ 62 \� FIRST FLOOR PLAN - nM rP1 wIP�wWM v W wlu rasa r+W+rr V o4W .go-.. �warw-w ww r�w�rrww �T+,wn�2e 31�b�' 9Mw;TVM5o t&W9 of b if n WE VCr WG / I 94 - I 0 — — ' — - t$KZa P t I L 1 fM 1 0&�j �— I �o r• , ya �s�F o� 'nary tiA •'•D/ 3 �� {� � aro•a n � 0 JJJ � .I � IxE NN,e:1�•i •i-O.G. '?�� . 1 u+-�.au Ha�X.i'•.. -- ` - __�� 'MGKa a.,D cs4+t1.Cw7 se�9�� 7 jBYAM,3 e7PL^�F a �wn.�v+c`w wit`fA / urc-m•cK +r Z 1y9� 1� II III ,o / I IE Ia I I j I Ln e3 S l �� I j ti 7 � I -- ! " -ew-.y.•�..{r eas:.y I I ra,.< T � v> tro¢ 3 I Ryaoo[n tyvJE I Itwaa I....�., y. 3 { LL LI w C .1. ��-` -..._._-'. I•ti P T w I - _ P:s<n �,..e¢�.,o•....�-.rc.. t3ECTION DETAIL: +I\ Isss Ivwcf+l'ett_ I w r'^" SEMON DEfAFL: B _.I Y-• b'f 1� �,,,. .. W hwt'Cfrt1 I li � G P__ I I - — — � I ...:.crt a+.+,II rows �i w.vsrr,c.a;..®•-. ¢mya�mc�.: j I� I -aAe< afF e+ae ��w¢::w+li oay.s a^ `I I-I � �! y,...✓_r..wl _ L._y....-._ w�'3: T S%aT.iL �-'-- «_e+.�wi �I fit,.•,..... � .i i �—e19't I'+v wi�IL r s:.•:�< �va.envS I; II d s DINE RM MLDG I: SECTION-DETAIL:PtAIN HOUSE A fwc.J I%>itq%f I Spb1S� I _ 1 I - - �'\�4�1�'//' _li T, I.._._. sw-.•lo Pt-a:.Ev:.a e sc• I 1. I \,\'y I '\ t,r yt --r' �� \ I i� C_:uN6 Rhf'CLa RC6�w►sp. ... •/ ! j j j eo�r�wog` I. s I ._!. .i$ cam:csil:nt� . •fcftP tw+�,% I =-IJ.�Jo Rtwtr.>rS � ..fucx.•,. �+•wti W,w: £. ��..., t w..�nb�- - \'fa tit�Ya 3'3d95 VNT_E w jE"'�•��• weirs t SECOND FLOOR FRAMING - L7'*oc�s,a`a.a ,a• ' SEC I IONE$IjEC I ION DETAi D FAAQLY R(`O_A1 3 D:.! I r I ✓7 i BOARD OF BUILDING REGULATIONS _? !License: CONSTRUCTION SUPERVISOR Number'- S, 043556 ! Expirds 1'2/t312004 Tr.no: 4902 Restricfe8: 00: SCOTT E CROSBY _ 62 CROSBY CIR ��: OSTERVILLE, MA 02655 Administrator LIN — 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: 131376 One Ashburton Place Rm 1301 Expiration: 7/13/2004 Boston,Ma.02108 Type: Private Corporation PEACOCK&CROSBY BUILDERS, kOTT CROSBY 1112 MAIN STREET UNIT 7 _� OSTERVILLE, MA 02655 Administrator Not valid without signature �OFIHiE, Town of Barnstable Regulatory Services saxxsTAUX, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-962-4038 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: is S.)-3<-A E:kj� e, bDK��Estimated Cost Address of Work: 1 Owner's Name: U Date of Application: Q I hereby certify that: , Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ]Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: / Date Contractor Name Registration No. OR Date Owner's Name r , p 'I RESIDENTIAL BUILDING PERMIT FEES f APPLICATION FEE New Buildings,Additions $50.00 SQ ^ D Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE o?® -S d square feet x$96/sq. foot= x.0031= d plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE - square feet x$64/sq. foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq. ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq. foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) • . Permit Fee (o ,rO. � projcost V' FROM FAX NO. Jan. 02 2003 09:330M P1 Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code RF..ScheckSoBware Version 3.5.Release 1 Data filename:C:\Program.Files\Cheek\REScheck\43305.rck TITLE:New Finished basement CITY:.Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or-2 Family,Detached UEATI.NG SYSTEM TYPE:Othor(Non-Electric Resistance) DATE..:01/02/03 DATE OF PLANS:08/23/2002 PROJECT INFORMATION: Tho Wysocki Rosidenco 45 Seapuit Road Ostervi.11e,Ma. 02655 COMPANY INFORMATION: Peacock&Crosby Hui ldemINC. 1.1.12 Main Street P.O. Box 1.51 Ostervi.11e,.Ma. 02655 NOTES: MaCheck by Cape Cod Insuintion INC. #3305 COMPLIANCE.Passes Maximum UA=635 Your Nome UA_-590 8.7%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter. R-Valuc. R-Valuo. U-Factor UA Wall 1: Wood-Frame, 16."o c. 2592 1-3.0 0.0 202 Window 1: Wood F.rame;.Double Pane with Low-E 46 0.340 16 Door 1:Solid 80 0.300 24 Floor 1: Slab-On-Grade:Unbeated 324 0.0 338 Insulation-depth:0:0' Furnace 1: Forced Hot Air,97.2 AFIIE COMPLIANCE_STATEMENT: The..pcoposed.building_desigrt.described.here.is eansiment..with_the building plans,specifications, r FROM FAX NO. Jan. 02 2003 08:33AM P2 and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Codo requirements in RBScheckVersinn 3.5 Release I (formerly MECchec4 and to comply with the mandatory requirements listed in tho REScheckinspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions tound in the Code. 71to HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as 9pecift in Sections 790CMR 1310 and J4.4. Builder/AesignLm Date.—)/,;, ILO� f y FROM FAX NO. Jan. 02 2003 08:33AM P3 REScheck Inspection Checklist Massachusetts Energy Code REScheckSoftware Version 3.5 Releaso 1 DATE:01/02103 TITLE:New finished basement Bldg. Dept. Use I Above-Grade Walls: ( J I 1. Wall 1: Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: I Windows: [ ] i I. Window 1: Wood Frame:Double Pane with Low-E,U-factor:0.340 For windows w.ith.out labeled ll-factors,describe features: H.Panes_.Frame Type Thermal Break?[ )Yes[ ]No Comments: -_-- I Doors: [ ) I 1. Door 1:Solid,U-factor:0.300 Comments: I Floors: [ ] I 1. Floor 1:Slab-On-Gradc:Unheated,R-0(uninsulated) Comments: I Heating and Cooling Equipment: [ ) L Furnace 1:Forced Not Air,87.2 AFUE or higher Make and Model Number I Air Leakage: [ ( ,loins,penetrations,and all other such openings in the building envelope that are sources of air leakage must be pealed. ( I Whom installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type 1C rated,manufactured with no penetrations between the inside of the recessed fixturo I and ceiling cavity Emd scaled or gasketed to prevent air leakage into the unconditioned space. 2. Typo iC rated,in accordance with Standard AS'rM E 283,with no more than 2.0 cfin(0.944 Us)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall havo been tested at 75 PA or 1.57 lbs/ft2 pressure difrerence and shall be labeled. I Vapor Retarder: [ ) I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. I Materials Identification: [ ) I Materials and equipment must be identified so that compliance can be determined. [ 1 I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ l I insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct.Insulation: FROM FAX NO. Jan. 02 2003 09:34AM P4 Table l: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sires Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up t0 1)„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 1.00-130 0.5 0.5 0.5 1.0 Table 2: UiNimum Insulation Thickness for HVAC Pipes. Fluid Temp. insulation Thickness in Inches by Pipe Sizes Piping System es Range .F 2"Runouts I"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low 1.'ressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems. Chilled.Water, Rchgetant, 40-55 0.5 0.5 0.75 1..0 and Brine Below 40 1.0 1..0 l.5. 1.5 NOTES TO FIELD (Building Department Use Only) The Commonwealth.of Massachusetts ......�•. 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YIIUYAAlICe:COi':i:::;4:;;%:;^:`•ti:%•`:•':::?•::?ti;+v}}:•:�:}:{•%:.:a:::?::a}:{4::•}:•}:•Y:?{?;{{{•J::4it:v::::::.::v:J>:<t•:•}}:c?{:lv:::.,•.v:.ty..:: ji. Failure to secure coverage as regzdred wider Section 25A of MGL 152 can lead to the imposition of criminal penaltlea o[a Sae np to S1,SOO.QO and/or one yew,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I undastmd that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 da hereby certr under the pares and penalties of perjury that the information provided above is truo and eorred Ido hereby cer�fi5u�nderlhepains andpenaldes Signature Date �� t3 •� - Print name �. phone# C�n g - use onl do not write in this area to be completed by city or town offidal official y . perudt/ncense# ❑��g Department city or town: ❑Lacer-dng Board ❑ ❑5electtnen's Office check if immediate response is ❑Health Department contact person: phone##; ❑Other Orn"d 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments,and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. . MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants ` Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of inc„rance 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 pemait or license is being requested, not the Departm®t 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. 011 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 peimit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. , The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax numbez: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of fnyesugatlons 600 Washington Street Boston,Ma, 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 • ___.-•=-- 77:e Commonwealth of Massachusetts •= Department of Industrial Accidents � r '_ � 0117Gr pfflODs � � • 600 Washington Street - Boston,Mass 02111 Workers, Com etssatina T.w^*a=sr Atlida, rt • i e: - N ` a �Jr-rrt�y � / 0 JJa' one I am a homeav�ner peering all woz3c myself . ' . 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Fh�ea 31 print o't • otIIdal me only do net wstta is this area tob.eoongieteel by CRY or taws . * •�Buadini pepartraLl't city or tows: ` �LW:osat Board ❑Sd"=zn!s OMM ❑rheacifilaaALzu�+P°m8 _ ❑H.IthDep+=eslt eoniad person: PER I ([evr�e 1/93 P1A1 • •• • •. •. • • •« ••• •11LOL•.1 •r. w1u wn1• • n_ Leo• • •• w• U • • • •• • ••= • • o —Oslo • •s w•1 • •�..•••�• .• • ... well• • 1 • • l• • 0 e • . • • • • • • • • / J. • • •s•I• • / • • • • • lose •1ll/le•Is • • •• - • • Il •• 1•er, O•• l•1\ • I r•IO-. •e1s• -•s r•I.1• _ « 1•I •/ •.• • It • •Iss1• l • •• Os •• •« �••11 wse wes•. •1 •l\ r•.•••w • •mow• • ws\�• • • r•1.1■ ••• .01801 it /• •• 111. w• ••• -� .IO• •s•Is soslo• •-• •le• IOO rw •o•r•=•• el /1 Ie .•• O/•• 1• •t••I•.•/ • - , ' • •se w•1 •1 ••11 • M•wel•. •1 r•Il•••••er_O• •1• •1 •• •• .•••• e•••-• - 1 me Is �• • �••• �• • ••r. 11 •••t•.•-. sous-•• .••o• •• • .. 1 .. . ... I .. •1.... .-. _. ����OO��%///!//O/ i••. . •I • • :il asses • / l/ •• wll p • i• l I • � , • o w••oI -•• nu\••-1 •• • 1 .••w w•r •l•ul• / i••- so • •• • e w _ • .e••M••w•1\ • •�w1 •lr. -�••.e••lo '•O • • •-•o • • • •.•O r • •• r•••-• •lo•IO - •• •• o • •. • �l •• •• •' •Y.• • J - I ' • •••ws1 •• -+ •l•Is •• ee W some•• •-• 1 1 1 1 1 1 1 1 / • I 1 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATIO -) CJ�A i°u ri— 4. ��� —✓t �-P nu e street village //r "HOMEOWNER": �� [N tj l)d"s ?�-1)oP me home phone# work phone# CURRENT MAILING ADDRESS: � ✓ 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 un signed"homeowner"certifies that he/she understands the Town of Barnstable Building Dep nt minimum inspection procedures and requirements and that he/she will comply with said pro es a ements. 71 igna a of 1H 0 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 forr /certification for use in your community.. � v�L17/N� �m�` ��9 S�1Y11�N�' W Town of Barnstable Regulatory Services 1 MAW Thomas F.Geiler,Director i019. . Building Division Elbert C UlshoeRer,Jr. Building Commtssiooer 367 Main Stmet, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 , NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FKOM PROJECT 1, CC) , Construction Supervisor License #O ,_ , hereby certify that I am no longer the Construction Supervisor listed on the a plicetion for the project under construction as authorized-by building permit issued.to (property address) C�c 71� �U t ul& on b 2003. I also certify that ona� S , 200 , I notified the property owner, that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 2-LICENSE HOLDER ATE q/ronm/newcmv m(mnce R-S 710 CMR v v�L7�J►n/1 �`�� � P SLR ��� Town of Barnstable Regulatory Services LAAMANA Tbomas F.Geiler,Director i6'" . Building Division Elbert C UlshoeRer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508-190-6230 NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL OF LICENSED CONSTRUCTION SUPERVISOR FKOM PROJECT Construction Supervisor License hereby certify that I am no longer the Construction Supervisor listed on the application;for the project under construction as authorized-by building permit issued-to (property address) l7 ��-- I Ste "`V l li 6/S- on 6 , 2003. I also certify that on 1 1200_gj, I notified the property owner, chat the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. S-T-er LICENSE HOLDER ATE ' q/r0ff✓newtonQ ►eRxncc R-S 780 CMR i TOWN OF BARNSTABLEc s BUILDING,VM IT . xr. PARCEL ID 118 124 005 GEOBASE ID ADDRESS 45 SEAPUIT.RD_ PHONE (508)428-690 OSTERVILLE MA ZIP 02655- LOT LOT '12 BLOCK OT ,, DBA g�EVOPME.lT DIS T CO PERMIT 6r3191 D SCRRT S N PORCH TO SUN RM . PERMIT TYPE BREMOD TLEENTIAL ALT/CONV CONTRACTOR PEACOCK & CROSBINC. Depa mento ARCHITECTS:�t Regulatory ices TOTAL FEES:BOND CONSTRUCTION CO TS $15,NON S./ ONHSKP PRIVATE If BAItN3rABI.E, * ► a3� 1639. BUILDINC�'rDAll ION BY DATE ISSUED 01/03/2003 EXPIRATION DATE TOWN�' OF BAR,NST ABLE BUILDING. ERMIT ' PARCEL ID 118 124 005 GEO BASE ID ADDRESS 45 SEAPUIT RD. PHONE (508)428-690 OSTERVILLE MA ZIP 02655- LOT LOT 12 BLOCK T STZE _ } DBA F DEVELOPMENT STkICT CO.. , Y PERMIT 66191 D SCRIP ON CO .VERY S RN PORCH .T SUN .� PERMIT` TYPE ". BHEMOD ITLE RES�DFN7'IA ALT/CONY t CONTRACTORk. PEACOCK. & CROSBY BUILDERS, INC. ; Dep rtment of ARCHITECTS:,�: , fv RegWat ry Servi s TOTAL' FEES: 2..r- BOND •U0 p� . CONSTRUCTION C STS $1.5,136 -00 pc( NOi RES./ ONHSKP\ADD0i�V 1 ' PRI TES V r _ ' * B - STABLE, * I BU ING-q_ SIGN �- BY _' nJ ,. 'DATE ISSUED 01%03/2003 EXPIRATION DATE 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 OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROMTHE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE.OF THIS 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 • OM STREET * BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS � 1 1 ,ft I, 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT r 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL ' WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY ti VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. ` f V 4 I 1 i °FINE�°� Town of Barnstable ti Regulatory Services r + mimsiABLE, + Thomas F.Geiler,Director - D AS& 1639. a Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date 3/ IV,03 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 ) lyo � J Address of Work: �� ���`'�` [ leg, 6 e�`"�"",�f /�w �S � Owner's Name: Date of Application: J �3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied J�30wner 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 ntractor Name Registration No. Date Vwner's e Q:forms1omeaffidav �iEAFV i r QoAr> Cl0 vo M Q i A LIT 1 m Z orJ� IZF-1 144-•4Y, 4so n SIL A \ 99 `l N cE,e7-i�iEo • o�or o�A.v / •�.eT/,cy T.U�IT TNT FovN�/�7-i0&) jsTElz✓�L[- Ar C-5-AIOWN/-1E.e-lso/ yS W122V 5C,A L OATE 7-/-AC-,S"/OE.0/.c/E ANO SETBA Cl- �E'QUi.2EA-/E.t/TS OF Tf•/�' Tow�t/aF F'•C..4�(/ a��•�J sr-A 8�t Ago iS . 4197- .L ar i2 ,�oc�TT�'� �/iT.;i/�C/ T//E .�.LOaaPG4/�f% /_AND •Gov�T /So55 A:55azaes .ui'fn //8 Ax. /z4- OATS= iD'�• 9S (.�,: cf-�(� BAXT,E.2E NYE /NC. Ty/S �,[..9.t//S �t/o7"BASE�O av Apt/ AEG/STE.2E0 L.4•�/O SU.e!/EYa� /NS7,eU���T Stie✓EY 15 T1-1,C— O.�,rS'E'TS Sh�ol✓�Y S.�v� �t/OT 8� APP�/C�/T S� ����°3 �� ��� �� � �� r9 l i � fi � �� b-1 L�,_.�p _�3 '� -+l. Q,y s 0Z. t BUILDER INFORMATION Name V A& Telephone Number S-z)j7- V - Y j/3 Addr s SJ .dgA, 17T License# yJ/e4✓l lle- , 01A— d 2,9bY Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE U3 I + TOWN OF BARNSTABLE BUILDING PERMIT A PeL_ICAT ON Map Parcel �-y o '� - ~ // U $AWSSj,BLE Permit# , CP \ Health Division � Date Issued (?�- �)�, -G,.� Z'n-, Conservation Division Z lqhmi2, b 53 rwWo, Fee J U --� Q, Tax Collector S � 12 Fe q- 7 6 Treasurer 0� -.D1�1� SEPTICSYSTUULWBE INST �KWICE YM Planning Dept. Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANL TOWN REGULA,'.'IONS Historic-OKH Preservation/Hyannis Project Street Address Village 6 S Owner Rw Address Telephone _� - �{ g, 6 C>LOsL Permit Request Q4-rvV'� �' li� Fri Square feet: 1st floor: existing o— proposed P.7> 26d floor: existing proposed Total new Estimated Project Cost . DC 0" Zoning District Flood Plain — Groundwater Overlay Construction Type W04 Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. 1 I Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 0116 - On Old King's Highway: ❑Yes 2-N Basement Type: UrFu-11 ❑Crawl ❑Walkout ❑Over Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) oZSD y 1 Number of Baths: Full: existing — new 0 Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 15_!� new O First Floor Room Count Heat Type and Fuel: UrG'as ❑Oil ❑ Electric ❑Other Central Air: es ❑No Fireplaces: Existing New Q Existing wood/coal stove: ❑Yes No I�e Detached garage:❑existing ❑new- size O Pool: xi sting ❑new size Barn:❑existing ❑new size D Attached garage:Vexisting ❑new size O Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes @'f_ If yes,site plan review# .f�Current Use n�L T)16 e9 u�^-9 Proposed Use BUILDER INFORMATION Q I Name 414,CMLA Telephone Number SD�-qc g^�� Address_� (� '1�t,W� License# o 4 3ss r " Home Improvement Contractor# 0 3 aZ65-s Worker's Compensation# TN %_60Xgig ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I SIGNATU DATE a ' FOR OFFICIAL USE ONLY ' PERMIT NO. _ DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE + ` Y - OWNER 4 - DATE OF INSPECTION: I y FOUNDATION I i FRAME ®' . INSULATION Q 1 _ 4 -ID- FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL' ��tt�� LU GAS: ROUGFV fA i� FINAL - FINAL BUILDING, t :-- f . r, DATE CLOSED'OUT ASSOCIATION PLAN NO. RESIDENTIAL BUILDING PERNIIT FEES ' APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 ��b Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= ' plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE ` 72 4 square feet x$64/sq.foot x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ftt >120 sf-500 sf S 35.00 >500 sf-750 sf 50.00 >150 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$961sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (n-� Deck _x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool . $60.00 Above Ground Swimming Pool $25.00 j Relocation/Moving $150.00 (plus above if applicable) 4 .? Permit Fee r proicost ,nPOF("ErO�~�w The Town of Barnstable . Department of Health Safety and Environmental Services BAR�STABLE. ' 7 MASS. 0p ' �b asq• �0 p�EGMP�a Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: Ii I y Map/Parcel: Project Address: �,i/4 r'u iTropp -1 Tin Builder: R1,45 C-0c,44 a4-0-5 y i The following items were noted on reviewing: & /A I- lPo z 3)gki4 Q', rff i,� `� Oi- Maio�. W 4 s r , r. Reviewed by: . Date: i q:buil ding:forms:review FROM FAX NO. Dec. 31 2002 oe:45AM P1 ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE. RESIDENTIAL NEW CONSTRUCTION and ADDRIONS 780 CM IL Appendix I (effective I/It98) Applicant Name:_ - co�( E C-f'o5�,_ - Site-Address: S- Oak �.oA Applicant Address: 3o k �s! - .—. City/Town. O 5 5 Use Group: O f �S _ Date of.Application: v Appdicaoi Phone: - B-L 70SLApplicant Signature: AI.'TER _ATM-FOR ADDITIONS.ONLY: a.G Wall +Ceiling Area y0 sg1t. b. Glazing Area' ► 6(o sq.ft. c. G_iazieg_%(too-z a-+.a)-�y.38g ADDM06 with Glazing% (e.) up to 40%may use 730 CMR Table h.1.2-3.1 beloar; MAXIMUM MINIMUM Fenestration- Ceiling Wall JFloor TBasement Wall Slab Perimeter- U-Value R-Value R 4alue R-Value R 4alue R-Value and Depth R-47' R 43- R 49- - I R-40- -R-40,4 ft 'R 40 ceing insulation may be used in place of R 47 if the insulation achieves the Hill R- value over the entire-ceft-arew(te. -not-compressed-over exterior walls,and includ`mg any access openings.) —J "SUNROOt1ii"adtUtion(greater than 40% gt=ftg:tci�--ws0 and ceiling gross area) Attach"Consomer formation Fond'tvm 790 CMR Appendix H. MaWsName: O>fficiars Sipanw. Appliealidn AQpcoved Denied Date of Approval/Devial: R a n(s) for DeniaL- (provide additional details as needed on back side) 'Glazing Arm may be eidrar Rough Opus-jag oe Unk daaeasimm seas owtzs 1 1 0 .`, BOARD OF'BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Numb'� 043556 ' ((11iir. Tr.no: 4902 Rel° ,c s ~� SCOTT E CROS j I *; 62 CROSBY OR. OSTERVILLE, MA 26 5"� Administrator PWad.... .. .. -. ... ,:. .. � -- ---✓!e Toammw,coea/�y o�✓�aaoac/u� Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPPRR\VEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration:=131378 ' One Ashburton Place Rm 1301 —:7 j�AExplratlon_-012004 Boston Ma.02108 .R-- ^___ Type—Private Corporation PEACOCK&CRBOY BUILD%ERS, grOTT CROSBY,'\\ 1112 MAIN STREET•UNIT%7 �,, _r—�, ,fir.✓ _ OSTERVILLE,MA 02655 Administrator Not valid without signature H IHE T°y,. : . �,j• The Town of Barnstable • &%RNSraece. • MAM �0 Department of Health Safety and Environmental Services 'tiFaNui° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. (� p6X&A Type.of Work: \grog& t� Estimated Cost Address of Work: . Owner's Name: Date of Application: �•� Z I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit al agent a owner: 17 Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts 11-' -• Department of Industrial Accidents ,; =3 ; o11Jce 911orest/9at/oas --r - 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit QQ C I name 1` _ W location. `� �--•' ,r,� C= ,/city phone# `ice V ' ❑ I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worku in anv achy �� �, . :.......:..:....:..:..... .... ..................... .: ..::}:.::.:: com anv name... �.�' :. . :...: :...;:;. ••:.::.,:;..:.;: :.:...:. .; -':::.}'.: '........ .. . >'> .:.:......:.:...::::::...........::......... ...::.::.;};;:::;..... ............::.:.... ::::::::::::::::: ..:::.....:::.. ............. Z_:� :.::...:.;,.:.:. .........::...:.::.:,.,:.. hone#:.. .. .....::... .........:: .. .. ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have win workers' compensation olives: the following ................... ......:::::::.::::::::.:.::.::::::.::::...:::::::::::.:::::...:.:::::::..::::::::::........:..::.....::....::.:...::::.:::::::::.:::..:::::::::::::::::.::::::::::::::..:::::.::.. 'com $nvnam :::: . ... :. ad - o x. ::.�:.:. e e h ::::s::>::......... r....;w::.}�.}v.v::•.:::..}::.:r....}::.�n;•...ii:: ...:.............:..........::: :.�:::.i}:;4::ti)•ti�i:•.:::v. :^:th::�i:�iiiii.'4::i>�Tii`}:;::?`:^iii:�ii'r}>i}}i}:+�ji`:ti'^.'."`v''viii:, .::::•.:.:::.:{�:}i:4::<}:v}i:';:};;jvv}:Oi:iv:i::i:>....................................... C: : ii1:. X. ....:::;:..... ii:'i'i'(ti:..•.. :.:�::.:..... v.,,v vn:•. ..........:........ env: tam a dd=es .. ::;:: .. ........::::>;>::: ...... ................::::::....... ................:::::..................:::..... ::::::::...:....::::........:.:::::..:..::.::::::.:........:::::..:::::.::......::::. .. ..... oli Failmz to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties o[a fine tip fo 51,500.00 and/or ODe years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against nm I understand that a copy of this statement may be forwarded to the Office of Investigations of the DU for coverage verification. I do hereby certify under the pains and penalties of perjury that theinformation provided above is&W.and coned signature �q Date Print name SC��r / I Cc-� Phone#�������� ���5•— ofHctal use only do not write in this area to be completed by city or town official city or town: permit/license H []Building Department ❑Licensing Board ❑ []Selemnen's Office check if immediate response is required []Health Department phoned; contact person: -' ❑Other (revised 9/95 PIN Information and Instructions i Massachusetts General Laws chapter 152 section 25 requires all empltiyers to,provide workers' compensation for their is defined as every person in the service of another under any contract employees. As quoted from the "law", an employee 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 s 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 repay work o sawn dwelling rn l�house or on the grounds or building appurtenant thereto shall not because of such employment be P y MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. ��irjjj�/ 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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and or town that the application for the permit or license is date the affidavit. The affidavit should be returned to the city � the'law or if you being requested,not the Department of Industrial Accidents. Should you have any questions regarding are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant- Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe retmmed 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 lavestl9atlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 l i 1 W old �1 . � J WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE NCCI Co. No Policy No. 10901 LEGION WC3 -0285395 1. INSURED: ROBERT CARLETON&EDWARD STAFFORD • Renewal of Policy No. DBA ASSURANCE CONSTRUCTION CO. NEW The Insured/Mailing address: EJ 298 MAIN STREET,SUITE#5 Individual ©Partnership HYANNIS, MA 02601 Corporation or Other workplaces not shown above: Insured's I.D.No(s). (if applicable) See WC 00 00 01 F.E.I.N.# 043191438 Risk ID# 2. POLICY PERIOD: The policy period is from 03/10/1998 to 03/10/1999 12:01 A.M.StandardTime, at the Insured's mailing address. 3. COVERAGE: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: Massachusetts B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident$ 100000 each accident Bodily Injury by Disease$ 500000 policy limit Bodily Injury by Disease$ 100000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: D. This policy includes these endorsements and schedules: WCOOOOOOA,WCOOOOOI,WC000414,WC00031 IA,WC200301,WC200302, WC200303,WC200306,WC200601, 4. PREMIUM: The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. All information required below is subject to verification and chage by audit. Code Premium Basis Rate Per Estimated Annual Classifications No Total Estimated $100 of Premium Annual Remuneration Remuneration See WC 00 00 01 If indicatedbelow,interim adjustments of premium Premium for Increased Limits Part Two,if applicable $ shall be made-- Total Premium Subject to the Experience Modification $ Premium Modified to Reflect experience Mod.of $ Semiannually; Ej Quarterly; Monthly $ Total Estimated Standard Premium $ MA - DIA Assessment $12 Premium Discount,if applicable $ Expense Constant Charge $ Total Estimated Annual Premium $ Minimum Premium$ 500.00 FbepositPremium$ 513.001 Total im tedAnnualPremium $ 500.00 NameofProducer: HORGAN JAMES INSURANCE AGENCY INC Servicing Office: MASBU Program Countersigned B 03/19/1998 TWO PARAGON WAY,FREEHOLD,N.J.07728 Authorized Representative Date CtUS BNBQSJIIA[LON PAGE w.1.TH. THE WORKERS COMPENSATION D PLOVERS LIABILITY INSURANCE POLICY AND E'ND'OR'SETTENTS,9E.A.T4N', 955UE79'1'lA {�7V1 ?�9'l�ftA''ArA?L�6?WN_ RO%Rp4?6`E6-01 Xl3f3V$ I 404<@' 9:0 P(9IAGV: e,�.tr,t�r•.t 7 nr rtl r*.n1'1''R1G11T 19117, NATIONAL. COUNCIL ON CODIPENSATION INSURANCE WC 00 00.01 A �\ •� Vam»ra�cuieal� o�v��trata.•�«Jr,(�J Restricted To: 00 ' ° = DEPARTHEIT OF PUBLIC SAFETY 83226 - CONSTRUCTION SUPERVISOR LICENSE 08 - None lluabort Expirest %& - 1 & 2 Fanily Hooes Restricted'Tot 00. Failure.to possess a current edition of the . ; . Raesachusetts State..Building Code EDNARD T STAFFORD is cause for revocation of this license. '298 NAIL ST IS Hy"11S, HA 02601 n�yk> 7�,. 'yk +�}r •. ?h+'�BMINO/fE�u!�LfJM�Q�t/dl�d .f NFL ^ ✓M HOMES IMPROVEMENT,CONTRACTOR Registration: 110190 7YP8`t PARTNERSHIP Expiration "10/69/98 1 y` ASSUMANCE'CONSTRUCTION EDN RD Tr STAFFORD� MAIN ST SUITE 5 ADM:f•ASMAMR HYANNIS MA 02601 1 07/23/1998 M/1��'s�'�/!�1�(� . .:. ,,. ,... <::>::: . :.: . ::<:r.r..,..:::.,,�°:`;`�;;;:�x:;:;.'<';:5ss•>.>r;:::;;::;>:.:.;,:;>;:>x<;:•,a:•...::i i•:r::s.. 4 TwR r PRODUCER (508)77$-5830 FAX (508)775-6688 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION organ-James Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 44 Barnstable Rd. HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY The POLICIES BELOW. PO Box 250 COMPANIES AFFORDING COVERAGE Hyannis, MA 02601 :.................................. ...................................................................... COMPANY Northern Assurance Company of America Attn: Ext: A ................•......................,....................................................•.......................... ....................,..,........................,..,.............................................,................................................ . ...... INSURED COMPANY Legion Insurance Robert Carleton 61 Ed Stafford dba AssuranceConstruction Co. .................................................................................................................................................. 298 Main St. Suite #5 COMPANY Hyannis, MA 02601 C COMPANY :'4k•• >i5'iiI>3i!`.);E<�;;�`fa'%"�?�s::3 i>�'25:itii;'iiiti<•`::`,`:iji .`FiJ?:,<,,,.";:r�P:�`::::;,".?,!:•' IS IS TO C :..:..:.....:..�:.:::•::::,::.>.;.r:,•:•:::>::::::rr:;:::::s;•:;•:::;::.�:..:.:::::.>::;:,::>::.,:.,:,.:,::•:o.:,:a,,;:•r>e::>..•::r:r::.;;;.,:•>;>;:o:::r.4��•P:�:•;.::;>::.;.;>::':<::g::::G'•`.:::; !RTI 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 13E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, „.......................................:..........••.........................,•....................... ... CO ' TYPE OP INSURANCE POLICY NUMISER POLICY EPPECTME POLICY EXPIRATION: LIMITS LTR DATE(MWODYYY) DATE(MM NY) GENERAL LIABILITY GENERAL AGGREGATE i 2,000,000 ...........X : .;COMMERCIAL GENERAL LIABILITY .PRODUCTS•COMP/OP AGG S 2,000,000 :..;.:.y.u.....,. .. ..................................I......... ................ >:m ;CLAIMS MADE. X :OCCUR'. PER60NAL A AOV INJURY i 1,000,000 A NBFB40838 ; 01/01/1998 : 01/01/1999 ••• OWNER'S A CONTRACTOR'$PROT i EACH OCCURRENCE i 1 OOO OOO :..... ................................... :FIRE DAMAGE(Any one Rre) s 100,000 MEO EXP(Any one Perron) 1 5,000 AUTOMOBILE LIABILITY ANY ALTO _ ?COMBINED SINGLE LIMB = ALL OWNED AUT06i BODILY INJURY = SCHEDULED AUTOS (Per perwn) ... MIRED AUTOS 1 NON•OWNEDAUTOS ;BODILY INJURY(P*.,roaaeny PROPERTY DAMAGE i LIABILITY ..... AUTO ONLY,EA ACCIDENT i . :. ANY AUTO U O OTHER THAN AUTO ONLY: ....< ... ...... ........ ...... ..... EACH ACCIDENT 1 AGGREGATE' 5 EXCESS LIABILITY ...... EACH OCCURRENCE 1 UMBRELLA FORM ;AGGREGATE f :............ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND WC RY LIMITS i ; ER :..L.' EMPLOYERS'LIABILITY B ` :WC30285395 ` 03 10/1998 03 10 1999 EL EACH ACCIDENT 1 100,000 THE PROPRIETOR/ INCL / / / PARTNER&EXECUTIVE ;EL DISEASE•POLICY LIMB i.............. SOS,OOO OFFICERS ARE: X EXCL ;EL DISEA6E•EA EMPLOYEE 3 100.000 OTHER DESCRIPTION OF OPEPIATIONSILDCAT10NSIVEHICLESISPEC(AL ITEMS T: ... ........,.:.:.,.. .,�s` s<:i2:>�53i;; ;s;i'`�i2::'f'r'3'.":�.:?>:i!>�>'<` <?"'siiiai:i:iz>f:`>i�!'>.R>.i�i':•:i'.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES B!CANCELL[D BEFORE THE EXPIRATION DATE THEREOF,THE 46VIN0 COMPANY WILL ENDEAVOR TO MAIL 10 DAY6 WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT. Town of Barnstable BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBUOATION OR LIABILITY South Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRE78NTATIVl4II, Hyannis; MA 02601 AUTHORIZED REPRESENTATIVE Sandy C incotta 1 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 7-23-1998 DATE OF/PLANS: I TITLE: COMPLIANCE: PASSES i Required UA = 603 Your Home = 558 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 960 30.0 0.0 34 WALLS: Wood Frame, 24" O.C. 3000 19.0 3.0 158 GLAZING: Windows or Doors 510 0.400 204 DOORS 144 0.350 50 FLOORS: Over Unconditioned Space 2358 19.0 ' 112 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in ' sections 780CMR 1310 and J4.4 . Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 7-23-1998 Bldg. Dept. Use CEILINGS: , [ ] 1. R-30 ' Comments/Location WALLS: y [ ] 1. Wood Frame, 24" O.C. , R-19 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: j [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating. and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified ' in sections 780CMR 1310 and J4 .4 . MISC REQUIREMENTS: ' [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluid's below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- i i r i f { f r i i f f f i x 31.7 e 31.3 t � � w 13 20'MIN. -7J x 27.7 &PANS-1ON ARE '— --PF aPOSED SEPTIC SYSTEM #` r' f t �[? •, �" 20.9 s , 1 00 �. "_`---- I 22. Z` ILL LOT 12 27.8 / �= 59,423. sq.ft. Q ... ^7� .8 CA j :3 1.36 acres re, ,'x 17.8 cn AIL 24 r' / WETL CO co x 5� � `• ` .. �% �8.8 f 15.6 �• r. x- 21.2% M WATER: SE v+' '` f o LOT 13 Val x ?8. x 17.E ; d- 1 x 1-6 `��. '` x 7.7 I 12/17/1996 12:09 5087718923 ASSURANCE CONSTR PAGE 01 The Cottons timealth of Afassachusettx ;,;;1 ► -__:...1;� Department of ltidustriol Accidents 1 I tl MM,9//MStlpMM 6111) 11'a4singunt.Street Bustin,Alaxs. 113111; �- Workers'Compensation Insurance Affidavit Annucnn�,nrer:itiatiitn- ��' ��I 'Jtii ev■rm:e i�brre r r••+••�vmr-•s� OAL A IQ in t (] I;-homeowner performing ail work myself. �OI am as sole proprietor and have no one working in any capacity 'ter...r�l�!MM'!'y�..�N" w�M��s"'tYMI�Y.•.��/[Mof�P�!Rf_ � .. �KIC.. Vw.T _� ...r_� 1;E0 am an employer providing workers' compensation for my employees working on this-job. ss fl Ce _ R 9 0- I `�L4 1 V r -1 k�1 5 •l O 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'compensation polices: company nnine: nddr c �•• ILhens w= incurnnee eo Policy � .� ......... ... .M.n•u.-•�s..•?��•�.v.s:_:�Tr.�!f�..bf+��-•�.3ian1 , ri� r rrrr� 'fri � �';,-�},++�-w., •^--n- camtleay naatte nasresso c6tv• phone M• insurance co olio•# _ Attach■Jditltlaflsheet it riecesfur)'�:�;r:��` . trr,;�lsds,�: ia;;�,,; `:� a� Fuilurc to secure co-crane as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a roar up to SI-WO.00 andlur unr ycan'impri:ronment as well as civil penalties in the form ors STOP\PORK ORDER and a fine of5100.00 a day against me. 1 understand that 9 copy of this slaicuicut may be furwarded to the Office of Investigations orthe DIA for coverage verification. t do herehr certify t role.Ihe,.4aiof p allies of perjure.1 t the ittjormation provided above is true and correct. Signature atc �� - �� Print name VY /• 'S M hone 0_ �7 l' 7 10 official use only do notvirile in lhi;4 area to be completed by ein-or town oMcial city or town! permitllicense 0 nnulldinp Department ❑t.lcensing Board p check irimmcdiate respunae is required Q5edeetmen's Office plinith Department contact person: phone ti; nUther ,ro�d.d Y*NA1 i . r�►�®stir. CERTIFICATE OF INSURANCE � I5111111DAU (MM10OIM 10-22-96 �ovvicea THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CER lFIlCAT HOUGAN-JAMS S INS AGCY DOER NOT AMEND.EXTEND OR ALTER THE CMERAQE AFFORDED BY THE PO BOX 250 - POLICw*01911.10w. 44 SARSTABLE ROAD HYANNIS MA 02601 COMPANIES AFFORDING COVERAGE DOMPANYU:TTER A THE TRAVELERS INSURANCE COMPANY i COMPANY B WSY11lP '� _ LE1z[R CARLETON. ROBERT T 8 STAFFORD, COMPANY C �T SEE ENDORSEMENT WC 99 os 01 LffTr 298 MAIN STREET COMPANY SUITE NS ,,Br*em d HYANNIS MA 02601. — - COMPANY E LETTER 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, L POYOY w"CT14E POLCY DIPRAnoN UYatf TYPi OF INWMNCS POLICY Ntlll�ill DATE(MWDO/W) OATS(MWDDN`� tI UIRAL LjMUTV GENERAL AGGREGATE !1 COMMERCIAL GENERAL LW8IUTY PRODUCTS-OOMP/00 AGO. CLAIMS MADE a OCCUFL PERSONAL i AOV,INJURY i OWNER'A&CONTRACTOK'8 PROT. EACH OOOURMNCE i FIRE DAMAGE Wry on*R(o) MED,iXP m(Any on*9~1 t AU"MMLI LLOANATY COMBRYED SINGLE L ANY AUTO LIMIT ALL OWNED AUTOS BOOILY INJURY 501411OUL10 AUTOS (PN Puaon) • HIIIiD AUTOS SOMY INJUIIY NON•OWNFD ALrMm (Pa Aooldorlq S GARAGE UAIIAM PROFffRIY DAMAGE i oIc-l"LIAMLM EACH OOCURIIINCE i UMOREL.LA FORM AGGREGATE 6 OTHKR THAN UMiR4' A PORN RATUTORY LIMITS A wawmrOcoliraNMnoN B57K7855 03-14-86 03-10-87 EACHAtC*0T E 00010000( AND 015EAas-P000Y LIMIT 6 00050" "PLO'Y!R'D LIAf,w" 0I6EAU-ILACH EMPLOYEE t 000100001 enlpl Da9c wm"OP oNRAnoNUL ooAnopinANroL\DlDRCYLL ITme —— -- THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. TOWN OF SANDWICH OHOULD ANY OF THE ABOVE DESCRIBED POLICIEO BE CANCELLED BEFORE THI ATTN: SLOG INSPECTOR EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR T( 16 JANE SEBASTIAN WAY MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEDTOTHI SANDWICH MA 02563 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OF LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPREIIENTATIVESW406 . AUINOMM M MUNTAYIYI 1ACdM0>I -R�IMOj A+COIIt�.IOQIhM1011MiriOti4ls TO 30dd dlSN00 30Nvdnssv EZ68TLL805,. . .L9:TT 966T/Li/ZT i.� 1 •+"!—•�a���i\�i�1�. 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NL IYWiS IE58NEG OO W�R�CQC!w�TWUI i� O/1 i HOME IMPROVEMENT CONTRACTORS REGISTRATION 30ard of Sui.id.zrry Regulations and Standards One Ashburton Piace - Room 1-301 i 80st0n a Massachusetts 02106 .YMR►ROVEME'NT CONTRAC-i OR - y�'Z : rat.3on. Ii0190 Expiration 20/09/98 PARTW-PSH 10 OW J!lOMMENT CONT@ACTOO ASSURAW type -.:O�STR4 ilt3h' O i9tra tll iJD� „• �0WARD T ST_ Af=FORG E.xpiratioa lO/OW'48 � _-Z>- 9 1lAII4 SY Sd;I C R-4YANNIS MR 02601 - tbtti3I�TJ08i ETA I. ST#Tw UIN S? ,um 5 `(i UHE ASHBURTON PLACE, RH 1,Q1 ROSTON, 14A 021.08- 618 CC.N )7RUCTI:ON SUPERVISOR us 04E420 i111.4/1998 lliIV 1950 Restricted To: + F:DWARL `_o d �iqr r_Nn ^ 298 MAIN ST #5 � � Q v 1 t�ac.,, alid 13m.1I dLE3 Li'c_nse card. HYANNIS, 14A 02601. Keel) top for receipt and change if iddress :'PJr.ifl^dtl'::i .i/� )ly.I.Y a::p:tn!a21� t7�. �(iJ::l3i'/�:i_:•-�� 1 832*26 i i : ;� ;;?.f•p _.C: 'i.�')' `:act �( -_a 3.310� FN Cc-5: MW i P m . . m 4 ° G G n G n I u 4 n 6 9 4 n G , Western Surety n G p n G G p I ' n F LICENSE AND PERMIT BOND ° For County,City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, 4 Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. G n KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P• 4 2k6 9 8A14 8 G Thatwe, Robert Carleton & Edward Stafford dba Assurance Const . Co. of the Town of Barn-c:tablP , State of Massachusetts , as Principal, and WESTERN SURETY COMPANY, a Corporation duly licensed to do business in the State of Ma G Ga rh„eet t e , as Surety, are held and firmly bound unto the TQtan Of Barnst�bl� , State of Massachus etts , Obligee, in the amount (Valid only when a County, City,Town or Village is named as Obligee) of One ThQ13sand DOLLARS ($ 1-,�000 . 00 ), (NOT VALID FOR MORE THAN$25,000) lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, jointly and severally. I , THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed Street Opening Permit T.Ot#1 2 49 Seanui t Rr3 , ns'tPrvi 1 1 e , MA by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and comply with the laws and ordinances (including all amendments), pertaining to the license or permit, then this obligation to be void, otherw4s'61,0", emain in full force and effect for a period commencing on the 1st day of y�A -m••.•. �� Ju 1 19 9 7 , and ending on the 1st day i Of�' •• , 1 9 a R , unless renewed by continuation certificate. ZZ �•>hs�bond may'bei£2rminated at any time by the Surety upon sending notice in writing to the Obligee and to hnncipal, in a elf the Obligee or at such other address as the Surety deems reasonable, and at the e'xpira- qo%O-f shirty-f:ve (3k)days from the mailing of notice or as soon thereafter as permitted by applicable law, tee . wEYieuer-isllate ;- : is'bond shall terminate and the Surety shall be relieved from any liability for any subsequent acomis he Principal. D9aI edit i s� day of T„1 V , _19 2Z. Principal Principal Countersigned WE STE R N U Y C O M P A N Y r G G BY By Resident Agent President ACKNOWLEDGMENT OF SUUETY G STATE OF SOUTH DAKOTA (Corporate Officer) County of Minnehaha ss On this 1 s t day of Ju lam, 1997 ,before me, the undersigned officer,personally appeared Joe P.Kirby,who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY,a corporation, and that he as such officer,being authorized so to do,executed the foregoing instrument for the purpose therein contained,by signing the name of the corporation by himself as such officer. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. G G S. BARNES i G NOTARY PUBLIC .� NotaryPublic, South Dakota I '1iAL SOUTH DAKOTA s � ;C e G My Commission Expires 1-22-99 Western Surety Company p Y ® Form 849—6-93 h�'�%��.�5�%+���b���:�t���G� + 1-605-336-0850 ' F y " ACKNOWLEDGMENT OF PRINCIPAL 'y (Individual or Partners) n STATE OF ="1� i y F _t >> ss F County of 6 y ' On this day of ,before me personally appeared ; U 1 1. F F c U 1 6 F U known to me to be the individual_ described in and who executed the foregoing instrument and y c u - U a acknowledged to-me that_he_executed the same. My commission expires Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) Y STATE OF SS County of i-: On this day of ,before me, personally appeared , who acknowledged himself to be the of a corporation, k, and that he as such officer`;being authorized so to do, executed the foregoing instrument for, the pur- poses therein'contained by"°signing the name of the corporation by himself as such officer. My commission expires Notary Public c c r � r F c F . w 1 t r O W � v U F F ry F F �. Cd ;z z Ln d, a O + a cd C!1 35. A. w•� xc3 2ul \ \ 2 Ir s 1 Y x 34.5 LOT 13 C t'I!1 MCv'? 2`l wr0y I I 32.0 ZONE RF-1 _ x r r _ 'a.C:B.'FND'"OFFr_ n _ L.C. ON NEW x :-.. N87-4y_45"W. ° �+• LOT.UNE ZONE RC = x '26:2 S.'{ 13'i0 retaininy�woll )fix. 46,895. so,f%. O ..S70J)3 f \.., 3' 31. D. BOX 4S.�0, 'Ilk ti 1x PROPOSED S °TIC SYSTEM � d"' EXPANSWd`AREA 31.3 ^ �` 6 x 29 ir, x 27.7 '- Cr 0 is a 3 s? c� �. ri $2Cr Ln LO in 04 GO ul ,. _ . x 28.5 00. -0.00_ >, \ _ - 2.2 o \ GP� p0 x 2 LOT 12 n 1 -\ 1 0 27.8 1. 59.423. sG.ft. o \S\ N x 25, ` 2�.7\ , x 24.8 1.36 acres w `. J oD 17.8 24.8 4.3 �o 00 �p 3 WETLAND PROPOSED SEPTIC SYSTEM _. ; aP �I , - O. 8.8 x 15.6 r� n FND. OFF ':; .x.21. 00 / x 21. vvvvvvvvvvvvvvvvvvvvvvvvvv r _ \ ' � \ \ / LOT 13 _ J 00 x 23.0 0 vvvvvvvvvvvvvvvvvvvvvvvvvv � _ v v v v v v v v v v v v v v v v v v v v VVVVVV _ yyyyyyy yyv a vvvvvvvvvvvv - ` vvvvvvvvvvvvvvvvvvvvvvvvvv , Op ^ v`R.vvvv v vvvvvvvvvvvvvvvvq�dv 18.4 \ N _ 'gyp' 'o, i N v0) iL� \ 3/4" TO i 1/2" LOT 13 - WASHED STONE i TOPPED '•rATH 3" OF PEASTONE x 18. x 17.5 _ er;. � .-•�.p ) 7 ? JIB EXPANSION AREAco M �y N PLAN OF LEACH FIELD d`G_ J :as x 7.7 12.2 y x 15.1 SCALE; 1' = 10' 1 �60 x 11.9 .1) REMOVE UNSUITABLE SOILS BENEATHrROPOSED SYSTEM. BACKFILL ,`. - ,A;- 1%-1 1 /x AITH CLEAN GRANULAR MATERIAL FILL TO BE GP.PDED AS FOLLOVS: NOT x Q�•'S 1� F - / - ; , VE NOT MORE THAN 90%RETAINED x.12.0 •BORE THAN 15% RETAINED ON No. SE � , JN No. 50 SIE've. OF FRACTION PASSING NO. 4. 10%OR LESS TO PASS NO. ii0 SIEVE AND SR DR LESS TO PASS No. 200 SIEVE, S01L 70 BE APPROVED - �_K_ f`�� y Lzh, i BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE• `" '. := '�- (c/ AT LEAST 72 HOURS I _) LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN. �1,, ,'r.•�:r: ��-� � , / /x 2'S =RIGP. TO ANY EXCAVATION FOR THIS PRO.IECT COr+TRACTOR SHALL MAKE - /^:A, HE REivUIRED NOTIFiCATIUN TO DIG SAFE (1-800-32'-4844) AND APPROPRIATE •t1{.:.; j' / -vATEP. DISTRICT TO DETERMINE lJTiUiT LOCATIONS. ,1`, y,�f>i .s.-`� °'- • A•,'L'ZT' i( / LOT 13 c,+ ''.. . o / JAMES H. CROCKER. JR. ' sVETLAND 1.. / +`� c,I TRUSTE- OF THE x i0 �( REALTY TRUST NOTES CROCKER PENSION EAL c y, ► N ICEVALLEY J2 0 ► ► L.D \ 91v eRle RD ► FOj>Z, m EPUIT o ► ► NORTH LOT 13 . BAY tOCuST. MAR SgBLUE HERON DR.NORTH \ ► 1 N87.47'45-W \ L.C. ON NEW Q D15 BAY LOT LINE 1 ► ( 144.48• X X s3 LOCUS MAP N PITS X X 21�i�292 \ S>ps> �� v�lt J 1 �t 1� Ft 25.20 46A41 aq tL I 1 •50 411 34 L 1 _ 23.98 D16 1 1 S36,51'14"E I I 3.77' x 11 ' X 22.2 f , 1 B �OQ o ryy9 4 x 1 Y ry n ' 1(t DRIVE 1) � R. CONC. a I ' t o 1 1 �\�' 1n ; cii x � OVERLAY D6IRICF:AP l � ' WEMVO ZONING 06fRICf: RF-1 RUIDWG SMACK REQUIREMENTS 4 GATE-T # 23.80\ D17 FRONT-30 SIDE=15 REAR.15 1 l 21.8 1 A ZONING DOW '. RC MUM SMACK LOP 12 I T. FRONT E-10 REAR-10 x ' 59.423.eq.tL ISLAND EOUSTINO I'MMATION I36 ones LOCUS PROPERTY is COMPPoSED OF \ \ 1 -. -..- F.F.ELEV.-s735' - 23.8S u . \ ' 1I1. ASSESSOR'S MAP. LAN PARCEL 124 �_ PLAN REFERENCE LAND WUIiF ISOSSN x 20.1 ► ' COMMUNITY PANEL NUMBER 250001 0016 0 - - F.LPW YAP ZONE C I I\ ``111I ORDER OF CONDITIONS(SE-3-3113)ISSUED TO�+ ASSURANCE CONSTRUCTION ON lq&M 7,1997 23.75 ; �D18 \ jqI LOT 13 .B. FIND. OAF 3.63 \ \ ' 6ARNSTAaIE CONSFAVA7)ON y 50'BUFTIR 45 Seapuit Avenue 11. \ \ ��\ 1 23.47 2 s1 Osterville,Massachusetts s.. 'X g��s 019' Ile PREPARED FOR '1• \ > 23.30' 23.22 r - \\ \ \ 8 rn °•,o.a. 1G PA'no a �3.59 ��'? Laurence Becker p \ 2.44 X 16.6 n�'•u. 3.4 23.39' �gS • '.x•23.4 °' - 1111E ?�J\\ �� \ \ 'Q•• '.,s?y •� y~ Existing Conditions(SE•3.3113) • J '•' \\ 23.45 '1' 23.5 �D20 ss Baxter,Nye&Hohngren,Inc. 2155 Registered Professional 3 \ EXISTING POOL � A, Eng a=and Land SLuveyors 912 Main e \ \ 3 3.46655 3 .54`3 2357 23.40 Phone (5088)4 8-9131 e•Fax-(5508)428-3750 \ 47 .44 23.08 \\ 23.1\ .431 23.15 1.a91 15.24 . 3.42 0' 10' 20' 40' 23./6 3. yLW 23.3 4 D21 ?� p SGLLEf•=Io' DATE 6/21/2001 s � -'�•S?• '\ per. ' t REV. 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I JOIST ANCwOR BOLT AND \ ' i 3'Y.3"xl/A'PLATE WAS4ER '+ . } } �• % IXb PT PLATE HEA [I 111 111 Itt 111 111 111 IN t11I111Illl�lllllllll 1 111 111 111 111 % ` TYP.SPACING Y jJ ^O•C GIRDER BELOW) ` ` } ♦ } } { i 3/4 T/G PLY. •Oy•'�y •.'e••• NAILED.GLUED. '.: . •• l'MIN. i f i • '• 7X6 PT ••.e•••' �• '��� ♦ . �� •0•w • '•�� SILL SEALER—,-, •d. JOIST I1�111)114111 k111{I11l111 •• •�,• ��,• ;.• �; • �; FOUNDATION WALL 17`CONCRETE WALL ..• �. .. MIN AN •. e•. 0•• e• e•. . ea•.•d•• e•• e• e• DAMP.PROOFING GSA 7X4 Pi <d. FIRST FLOOR y ,• ,_ SILL SEALER .. _ �• •• �; e'-17'FROM END • • •.• • /APPROVE. -•4• y • �•.• • .'•' _''e• 'd• •e• •d• FRAMING FLAN OF PLATES ' '0•••.'0• a •. .'Oa• j CRAWL PACE %• •• ••'• • • 7X6 KEY •d••' TYP.RIM •. .'0•. �' a•.• / / / � i '� '� • /10"X77`CONC.FTG. • / / ��' COMPACTED GRANULAR ^ ^ - . i TYP. ANCHOR BOLT SPACING D FOOTING CRAWL SPACE FOOTING DETAILS 12" CONCRETE WALL v" 11 II-1/8"ENG,1 JOIST—y G•r. 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' EXISTING WALLS ROOF FRAMING PLAN - BUILDER JOB ADDRESS DESIGN /f/f/f ff f�f f � ��j M p�TE REVISION DRAWN BY PAGE SCALE J� Des lgns KENDALL � WELCH WYSOCKI RESIDENCE NEW FAMILY ROOM WITH �✓��oU✓����1 �ll �L/O�Nao��0 U Q6-O�-10 • JB cF , v4',r-o' 45 SEAPEUIT ROAD EXTENSION OF EXISTING ~wo I =c_<E.:E. =. e�,+�-%_E<fcE _ EvR7,c�E,CK BC %EnE—n:fCC,:c LL% <LEv:rvcES c_cC, ic L C99_E. >>c.•:< c %EP ,_ - % _E C 9E- �f� �i9 i _�_— C i_E ¢Etl,G<ecD.OLEns.Of•! /50BJ 494-9534 -E BEDROOM ABOVE. , 6 iE _E3E06TERVILLE A. =3C N3,Cu%i,C4..EQ .GE3± rWALL LENGTH.26'-O' •--, r-—_—-—-—-—-—-- I FULL HEIGHT SHEATHING-•W-6"I WALL LENGTH- 16•-D• FULL HEIGHT SHEATHING-JL-O"I PLATE UPLIFT STRAP •ACTUAL SHEdTHING•�L� (Min. ACTUAL SHEATHING•,�2L. DDUEILE TOP PLATE I 1.75 I (Min. Requlred__23_a I I EDGE NAILING.—c-O.C. RATIO• 1.25 'FIELD NAILING•_�O.C. I EDGE NAILING•�O.C. I L--_---.------J 26' " •FIELD NAIL ING.JZO.C. 16'-0' 6%2' 4'•9" 5%2" 2'-ly" DOUBLE HEADER SHEA SHEAR S.1 HEADER UP'_:FT STRAP SHE SHEAR SHEAR SHEAR WALL WALL WALL ALL WALL WALL WALL FULL EIGHT STUD CUBLE JACK SPJD WNDD111 I SILL PLA TE LULAI E :. :. :.•:. : OLD DOWN EXISTING H /' ..... .. .. .. .. 9-I/2 L C'e E D- . HEi1DER'- • ,<' ,'c EXISTING '• TYP.ANCHOR BOLTS AND 3'Y.3•XI/4'PLATE WASHER,! •.'Or•.'0•••.'e•.•.'0••'.'e•. . e•. 0•• e•. . e•. d.•. _T --r77 V-31t" 6'-3tS" SHEAR SHEAR SHEAR 5HEAR . 6.. .'0•. ,'0•. .'0•. .'0•. .'e•. .'0•. .�e•• .'Oti .'e•• WALL 24'-0" WALL WALL 26'-0" WALL • • , I rIW— —G— — r'ALL------------- L LENGTH• � FULL HEIGHT SWEAT H—ING•—II-T" FULL HEIGHT 6HEATHING•J''-]° ACTUAL SHEATHING•. I SHEAR WALLs -EAR WALL , ACTUAL SHEATHING• -x I (Min.Required__5q-9.) I REAR ELEVATION !RATIO- 1.2 Ired�4%1 FRONT ELEVATION RATIO. EDGE N4ILING• I EDGE NAILING•�_O.C. I I �-O.C. I STUDS AND HEADERS FIELD NAILING• -O.C. FIELD NAILING•JZO.C. L.—'—_—_—_—.—_J L.— —-—-—-— — J r-- —'— —_— — AROUND THESE WALL WALL EIGHT SHEATHING. I FULL HEIGHT SHEATHING•10••B"I OPENINGS ONLY ACTUAL SHEATHING•_�A . I (Min.Required _.) RATIO. 1.25 EDGE NAILING•_.JC_O.C. I FIELD NAILING•�O.C. —'---. —...J 3'-0 2'-4" 2.4 3-0 I RIDGE VENT 2x12 RIDGEAN 2XIO RAFTERS•16"O.C. IT 1/2"PLY.SHEATHING IT , IS•ASPHALT PAPER "p SPHALT SHINGLES 2Y-0'.C.J.V 16"O.G. fR3 e S ASPHALT ROOFING ASPHALT ROOFING X 3 STRAPPING IS•ASPHALT PAPER EXISTING I/2' WALLBOARD '•, 15•ASPHALT PAPER • •• 1/2' SHEATHING v •,• 1/2"SHEATHING • -•---------2XIO RAFTERS o 16"O.C. i- BEROOM•4 1/2"PLY. SHEATHING TYP.H2.5A TIE$ Tl"P. H2.54 TIES 3/4"T/G PLY. 15•ASPHALT PAPER DRIP EDGE DRIP EDGE A NAILED•GLUED. ASPHALT SHINGLES - 5"GUTTER 5"GUTTER ENG. I JOIST PER MANUF. ® ' Ix3 STRAPPING 1!2"WALLBOARD a IXB FACIA IY•B FACIA ® ' • WALLBOARD IX SOFFIT IY. SOFFIT NE I/2"m 2.1/4" VENT (�• .D W 2X6'e•16"O.G. 2-1/4" VENT 11111�UIIII o� •i FAMILY 1.3/4"BED T'ILDG. R19 INSULATION 1-3/4"BED MLDG. ROOM 1/2"PLY-SHEATHING NC TGH FRIEZE NOTCH FRIEZE TO RECEIVE SIDING. • /' TYVEK WRAP OR EQUAL TO RECEIVE SIDING. ./............•........ .� �2.t'.�7.•. SIDING ••• ................•., NAILED E GLUED. . ENG.I JOIST PER MANUF. _ __ _-- ;.EAR ' - SHEAR �a• SHEAR 3.2Y.12'i GIRDER Rig INSUL. / WALL WALL WALL O 3-I/2"GONr_, FILLED 20'-0" V LOLLY COLUMN. A"CONC. SLAB rWALL LENGTH. FULL HEIGHT SHEATHING. 12.-0•.I SHEAR WALL ACTUAL SHEATHING•__kQ,. EAV EAv I RAT(Min,1.25 LEFT ELEVATION EDGE 02 EAVE DETAILS •3 EAVE DETAILS E .15 I E NAILING• 4"O.C. I CROSS SECTION DETAILS •FIELD NAILING.I2"O.C. 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ST MAR S s' _ C.B. FND. I C.B. FND. SITE CLEARING: ISLAND - 60.83' S8 24'09"E BLUE HERON DR. x A MINIMUM OF THIRTY PERCENT (307) OF THE TOTAL UPLAND AREA J OF ANY LOT SHALL BE RETAINED IN ITSXNATURAL STATE, WITH ' NOR ONLY LIMITED SELECTIVE CUTTING OF TREK AND CLEARING OF J UNDERSTORY SHRUBS AND GROUNDCOVER ALLOWED. J LOCUS MAP o SCALE,. 1 t 25,000 f a FLOOD PLAIN LINE IS BASED ON ASSESSORS j U) r. FLOOD INSURANCE RATE MAP COMMUNITY PANEL NUMBER 250001 0018 D MAP 118 PARCEL 124 Q REVISED: JULY 2,1992.: . . 377 ELEVATIONS ARE BASED ON N.G.V.D. GRAPHI2 SCALE BUILDING RESTRICTION LINE 0 40 LOT - _ . , L.C.C. 15055H ( AP JAMES H. CROCKER, JR. ! RESIDENCE C TRUSTEE OF THE in - •»'` MINIMUMS L ISLAND-PLANTING IN DRIVE RETAINED+0 HOUSE BORDER CROCKER PENSION REALTY .TRUST `" _ AREA 43,560 S.F. WITH 1'--6" HGL NATIVE STONE WALL- it3' WIDE FRONTAGE _ FRONTAGE = 20 BRICK WALKS IN-RUNNING BOND, SOLDIER COURSE ! WIDTH 100' SET IN STONE DUST. t FRONT SETBACK = 20' l o C SIDE SETBACKS = 10' t ! SWIMMING POOL AND APRON: DECK SURFACE IN "GRANITECH" ECLIPSE AGGREGATE ON CONCRETE BASE AS DIMENSIONED. x 36. WIT 7 REAR SETBACK = 10' BUILDING HEIGHT = 30' g) 'GRANITECH' AGGREGATE STEPS AS DIMENSION, RETAINED `C�� L.C.C. 15055H WITH NATIVE STONE WALL. { � s`�-�-, _ _ _ ! MINR� � JAMES H. CROCKER. JR. Iv4S 3c'� , - .. I 0 TRUSTEE! OF TNE.__.._ - �........�...�..,�.� . ...,. IMu NA�JvE r> c ��-reli►Ilz►Ir. tie�L rso•nL�r__ r� hjr •rn As ur•-r ��os 9 , - QMUCKtH PtH'IQN RCALI: 'P.UST um W AREA = 43,560 S.F. -- �mi,It TE.IFODTING. ORNAMENTAL PICKET FENCE 4 HGT. i t �y to . FRONTAGE = 20 ERRECTO ON TOP OF WALL WITH 4' WIDE GATE AS SITED. R s� ! J t to WIDTH = 125' G POURED CONCRETE RETAINING WALL TO RETAIN GRADE AT +nt ' FRONT SETBACK = 30' " CRITICAL ELEVATION. 4 5 FROM WORK Uk1IT LINE SIDE SETBACKS 15' �- :C 3 REAR SETBACK = 15' @ 4' HOT. VINYL CHAIN LINK FENCE AS DETAILED ON PLAN. qQ� o - BUILDING HEIGHT = 30' aD z *4cl - x 36.5 i� p l 35CO c� M x 3 2 x 34.5. LOT 13 - 'x 32.0 ZONE RF-1 _ x i. � C.S. FND. OFF N87.4�'4 / ` ''�. L Q ON NEW ZONE RC 5 w x . v� 32 � xi 26.2 23.btor uNE - f 144.481 �.�s ado `° •- 1 31.7 0 0 � 7• ti i l33 E x 25.231.3�¢�� S.� � 16.10 1 3p 7E 4fi,895. sq.ft. �-- t X 29.3 _ - 0 AGE 27.7 C�lz S� PROPOSED BIT. CONC h• / I �► s ' tiD 2 DRIVE ¢ I ,�, 00 x 28.5 �- 4' TE =o ----'6 ` F , coo 26.5 .7�i 7�i !�1 _ -.._ �_ /a.. T"""t i �A .� r - ---• �•� ter• �f~X ,`- r7 _ 27.8 'i8.6' o -2 LOT-12 al• x _ ISLAND EXISTINGFFUgDAMON 0 5 PLANTING -t3�„ 59,423. sq.ft. W r 25.1 F.F. `- 27.35' x 1.36 acres CA -Pyti+. x 24.8 2 �,, 24.8 Cow �---- a 17.8 V cr / I 24 9 X 24.327.4 ,I'• WETLAND C.B. FND. OFF x �'�. .9 l CO co X .21.5 / 21.2 )) x .8 J x 2 ! 15.6 x 21.2 ' . x 23.0 o TURF LOT 143 to r • c� 24.3 L- 18.4 O� `"`` ' 'LS �'' 4' GATE / • a1,. LOT 1 -- 22.4 Tu l✓'' •s' / �N �,� DECK 9.5 • TOP EL. _ 22.0' -�•. ty � � o x I i . / • • "� � x ? .4 OOL " � 6 / .�..... Co '�j19.0 L / 17.5 f 0) / w 3 alr. 17.6 �3• .. / i� �.. • ~� PUkIp HOUSE F_ SCREENED WI - \- �- 76 f LA110E FENC1 I14G f" 7 � •• R\1 1.9 0 No- 4, \ - \ x 13.7 '` �e! �g .1•�5 Z� / �.-x 12.5 ro INE TLAN D tU! l �.- ''� / / LOT 13 l t� CA 10.8 / / JAMES H. CROCKER, JR. " i 3.5 X ', -� �,, TRUSTEE OF THE _ • . rk()ru>:Q D�'nrernnr ;�Crr'ry -,-nL'�7 x 6.2. • SITE PLAN Off' LOB' 12 . L.C.C. 15055H 'IN _ (OSTER\ALLE) x.13.0 BARNSTABLE MASS*' FOR ASSURANCE CONSTRUCTION CO, SCALE: 1"= 20' DATE: NOV. 12, 1996 REV_ DEC. 11, 1996 (ADD WORK LIMIT) REV. JULY 1, 1998 (RESITE HOUSE) x 13.6 REV. JULY 13,1998 (RESITS HOUSE REV. SEPTIC) REV. APRIL 5. 1999 ' (FOUNDATION, SEPTIC LOCATION, POOL, DRIVEWAY, & LANDSCAPING.) REV. APRIL 14, 1999 x 13.6 (DIRT DRIVE, POOL, & LANDSCAPING.) x 14.8 _ BAXTER & NYE INC. REGISTERED LAND SURVEYORS 01 CIVIL ENGINEERS ❑STERVILLE, MASS, P9614312 coICEVALLEYRD cn ZONE N V Q G.P. \ G o . ..',DESIGN DATA NOW: X �o z� - ,x ply IVlJ lLOT COVERAGE: z SINGLE FAMILY- 4 BEDROOMS EPUIT �o l Ro"'. NO GARBAGE GRINDER NO MORE THAN FIFTY PERCENT (507.) OF THE TOTAL UPLAND AREA NORTH DAILY FLOW = 110 X 4 = 440 G.P.D. ( PUBLIC WAY 33' WIDE ) OF ANY LOT SHALL BE MADE IMPERVIOUS BY THE INSTALLATION OF SAY SEPTIC TANK = 440 X 200% = 880 G.P.D. x 38.� BUILDINGS, STRUCTURES AND PAVED SURFACES. 'ST. MAR S s' USE 1500 GAL. SEPTIC TANK C.B. FND, ISLAND BAD fit. C.B. F ND. SITE CLEARING: BLUE HERON DR. X 60.83' S87 24'09"E �5 A MINIMUM -OF THIRTY PERCENT (3O7.) OF THE TOTAL UPLAND AREA 1 OF ANY LOT SHALL BE -RETAINED 1N ITSxNATURAL STATE, WITH NORM TIM G D=GN I ONLY LIMITED SELECTIVE CUTTING OF TREES AND CLEARING OF BAY ! UNDERSTORY SHRUBS AND GROUNDCOVER ALLOWED. ALL PIPES TO BE .SCHEDULE 40 PVC PERFORATED ( � LOCUS MAP WITH CAPPED ENDS 1 + _ SCALE 1 � 25,000 USE 2 - 4" DISTRIBUTION LINES IN A I o 12'X 50' WASHED STONE FIELD FLOOD PLANE LINE IS BASED ON ASSESSORS -fl FLOOD INSURANCE RATE MAP AS SHOWN COMMUNITY-PANEL NUMBER 250001 0016 D MAP 118 PARCEL 124 SYSTEM IS WITHIN 250' OF A RESOURCE AREA THEREFORE THE APPLICATION RATE EQUALS + a REVISED: DULY 2,1992. ALE 440 G.P.D./.74 = 595 S.F. OF BOTTOM AREA REQUIRED 37.7 ELEVATIONS ARE BASED ON N.G.V.D. GRAPHIC NO ALLOWANCE FOR SIDEWALL AREA - - .{ 0 20 40 BUILDING RESTRICTION .LINE USE 12'X 50'= 600 S.F. AREA PROVIDED CLASS 1 SOIL PERCOLATION RATE 1" IN 2 MIN. OR LESS i ?+ _ 13NES a) AP L.C.C. 15055H RESIDENCE C JAMES H. CROCKER, -JR. TRUSTEE OF THE I MINIMUMS CROCKER PENSION REALTY TRUST � AREA = 43,560 S.F. I > FRONTAGE = 20' I ° � WIDTH 100' - I FRONT SETBACK 20' ° SIDE SETBACKS = 10' ?, REAR SETBACK _ 10 x 36. LOT w BUILDING HEIGHT 30' ' n L.C.C. 15055H RF-1 ' ! JAMES H. CROCKER JR. MINIMUMS TRUSTEE OF THE AREA = 43.560 S.F. I CF:'-)CKER PENSION REALTY TRUST J FRONTAGE = 20' WIDTH = 12 5' FRONT SETBACK = 30' •\ N, SIDE SETBACKS = 15 . I REAR SETBACK = 15' BUILDING HEIGHT = 30' t•�i N o '�if�/�/��� x\35. I x 36.5 O I x 35. OD N MI � o x 3 .2 + I` LC I � 3 - x 34 5 LOT 13 ,x 32. ZONE -RF-1 pl- �� 'x i•i.,.,, ry r r C.B. �Nal. err R10'7e f� LC.I 4�'45 W f a\ € L.C. ON NEW x ZONE RC 'S. = -1-6`1 Q'-, E"i x!26.2 11 LOT LINE I -_ o f t 46,895. sq. t 0 VENT 31. ! tntnC� AIL D. BOX f I 4 5�33'E 1 E Jam•�, PROPUS,D SEPTIC SY G`3 A' 31:3 r, Ix 29•8 £XPA JSION AREA !� j� 1 w# TP r r x 27.7' (. f� co #2 GARAGE h s CY z ` ��`` �- °�: 22:2 I Ike --�______ - ` T 1 . I- f rI w 27.8 I x 25. 2 :7 P - ' x 24.8 j R. � sq.ft. CA oN \ �� 59,423.36 ` f' 1.36 acres -► C Ir, Q OD x 24.8 �` ` 17 8 f �`x � ! • ' 50 _.� -" \ u---•-,....� ._.� (,�, L: �' a al ;_ r r, VENT \ R ERWCE PROPOSED SEPTIC SYSTEM -,\ x�-__24 3� WETLAND ao C.B. FND.. OFF \ ` x .21 5 v v V v v v v v v v v v 0 v v v v v v v p v �( f><�.8 23.0 � � vv � vvvvvvvvvvvvt7v17vvvvv - \ \� f f O l/Vl 13 N ` .- vvvvt7vvvvvvvvvvvvvvv �70vvv � �, _" ✓ '°• � ' v v v v v v v v v v v v v IV, v IV, v v v v v v v v v v `€ I e all, AAV 0 - _ ,...,._....„. k 'Y� ,.'''" � 3/4" TO 1 1/2" LOT 13 "" to WASHED STONE ` \ __ ryN• r ! - .� t1, i14 TOPPED WITH 3" OF PEASTONE \ \ \� e x \� ..: .�ems"'" "• r r„ _ 1�Y � 1` I EXPANSION AREA �t -- _� ` • -`, x 18: ° �- - x 17. ° 00 PLAN OF LEACH FIELDLA � �\ r \ \t�• � ° SCALE 1' = 10' 12.2 4\ \` xx 7.7 f a, p� x 15.1 I , I `�Y � ��t ,4 �..•s'`~ • ` ma`s � 1 � `�cP 1 11.9 � _ Vb 'I ILA NOTES: (1) REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL \ /' I WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT 1 MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED x sr. tr• �' + �; x ON No. 50 SIEVE, OF FRACTION PASSING No. 4, 10 o OR LESS TO PASS No. ? 12.0 1' / x 2 2 100 SIEVE AND 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE ,,PPROVEDNam- BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. air, \ I I e P / (2) LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS f PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE ,r, �� / THE REQUIRED NOTIFICATION TO DIG SAFE (1-800-322-4844) AND APPROPRIATE �.6 y \ /x 12.5 WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. ,9 _ o k. ,22'� / LOT 13 WETLAND. W `, N61°t� \4 / JAMES H. CROCKER, JR. NOTO ,tL, x 10.8 ;;I X 1 / / TRUSTEE OF THE Oj a_ CROCKER PENSION REALTY TRUST 1Q FOP. ALL ASPECTS OF THE SEPTIC SYSTEM THE CONTRACTOR � / SHALL COMPLY WITH ALL GOVERNING CODES AND REGULATIONS. IN PARTICULAR 310CMR 15.000 THE STATE ENVIRONMENTAL CODE TITLE 5, THE TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS PART VIII: PLAN T A N OF LOB'('! 12 ON-SITE SEWAGE DISPOSAL REGULATIONS AND THE BOARD OF HEALTH / 1 ��`'�Ir 1 RECOMMENDATIONS FOR ACCEPTED PRACTICE: / / / a SCALE; 1' 20' x6.2 SITE PLAN OF LOT 12 T LOCATED IN POTENTIAL TEST 1 HOM L.CeCO 1 5055 I ALL COMPONENTS VEHICLE TRAFFIC AREAS OR BURIED 4 FEET P-8620 IN COVERS LOCATED TO WITHIN OR GREATER SHALL BE H-20 LOAD CAPACITY. WELLER & ASSOC. 12" OF F.G. (OSTERVILLE) PIT #1 EL>=V.= 7.0 TEST v ELEV. - 30.0' BARNSTABLE MASS . 2 F.G.= 26 t DB3 (H20) OR EQUAL VENT 1 Er,.7 1 �1C�LE O f, TOP OF FOUNDATION \ �, P-8721 - -2 FOR F.G. =26 t 24.6 F.G.= 26t WELLER & ASSOC. LOAMY SAND - E INV. _ � ASSURANCE CONSTRUCTION CO / /, a 10f, INV. _ 1500 GAL. 4" DIAMETER T i"i�rs1 .Z .FT, L�vcc - O 24.4 DIST S� PIT #1 : SANDY LOAM - B SCALE: 1 "= 20' DATE: NOV. 12,1996 SEPTIC TANK INV. 24.2 INV. =24.0 80 �� 40 P V C PIPE TOP ELEV. 24.6 ELEV. = 10.7' -32" 6" CRUSHED_) INV. =23.8 �3" COARSE C REV. DEC. 11 ,199 (ADD WORK LIMIT) 1o•00'_} INV. = 23.6 vvvvvvvvvvvvvvvvvv - REV. JULY 1 ,1998 RESITE HOUSE MIN. '-1 STONE BASEvvvvvvvvvvvvvvvvv = LOAMY SAND - A SAND ( ) v v v v v v v v v v v v v v v v v v -16 REV. JULY 13,1998 (RESITE HOUSE REV. SEPTIC) BASEMENT FL. EL. 19.5 SANDY LOAM - B -48" PERK TEST :. �. BOTTOM ELEV.22.6 ;;_: z1:: BAXTER & NYE INC. -30 MEDIUM - C REGISTERED LAND SURVEYORS COARSE - C SAND CIVIL ENGINEERS \F��HOF,'ygSs SAND OSTERVILLE, MASS. �o`'� STEPHEN qcy� OF I z AL>YN -48" PERK TEST = -126" EL. 19.5 .i o Uf ILsoN No.30216 - MEDIUM C NO OBSERVED WATER o _ SAND sAx404 T- F. EL. 5.9 OBSERVED WATER r= EL. 5.9 .-58" OBSERVED WATERersrE Fss PROFILE _ 9614312 NO SCALE i I ZONE N 10EVALLEYRD N _ o 0 D A G.P. DESIGN DATA , x n � o 0 ' NQTE.- c Q `� w SINGLE FAMILY- o 4 BEDROOMS o � LOT _ D , SRo" COVERAGE. z c .�lr1l V,l � RD. NO GARBAGE. GRINDER T � PDAILY _ _ °' o FLOW 110 X 4 440 G.P.D. NO MORE THAN FIFTY PERCENT 50� OF THE TOTAL UPLAND AREA ( 'PUBLIC WAY 33' WIDE ` 7H I NQR1 SEPTIC TANK 440 X 200% = 880 G.P.D. OF ANY LOT SHALL BE MADE IMPERVIOUS BY THE INSTALLATION OF BAY y LOCO f USE 1500 GAL. SEPTIC TANK x 38 BUILDINGS, STRUCTURES AND PAVED SURFACES. I l .. ST. MAR SS 6 S87 24 0 " C.B. FND. ISLAND x 0.83 9 E SITE CLEARING: s BLUE HERON' DR. 8 50.00 A MINIMUM OF THIRTY PERCENT 30% OF THE TOTAL UPLAND � ) AREA E LEACHING FIELD DESIGN , OF ANY LOT SHALL BE RETAINED IN ITSXNATURAL STATE, WITH NORTH - ` ONLY LIMITED SELECTIVE CUTTING OF TREES AND CLEARING OF BAY ALL PIPES TO BE SCHEDULE-40 PVC PERFORATED UNDERSTORY SHRUBS AND GROUNDCOVER ALLOWED. j WITH CAPPED ENDS ' USE 2 4 LOCUS MAP DISTRIBUTION LINES `(N A , 12 X 50 .WASHED "STONE FIELD o SCALE 1 25,000 I FLOOD PLANE LINEIS A O AS SHOWN BASED ON FLOOD INSURANCE RATE MA ASSESSORS SYSTEM IS WITHIN 250 OF A RESOURCE AREA �' P THEREFORE THE APPLICATION RATE EQUALS COMMUNITY-PANEL NUMBER 250001 0018 D MAP 118 PARCEL 124 440 G.P.D./.74 = 595 S.F. OF BOTTOM AREA REQUIRED a REVISED: JULY 2,1992. ' NO ALLOWANCE FOR SIDEWA A 37.7 LL AREA ELEVATIONS ARE BASED ON N.G.V.D. GRAPHIC SCALE BUILDING RESTRICTION LINE -x- 1 USE 12'X 50'= 600 S.F. AREA PROVIDED 0 20 40 I ` CLASS 1 SOIL P ERCOLATiON RATE 1 IN 2 MIN. OR LESS I AAA LOT 6 ZONES ' AP L.C.C. 15055H � { JAMES-H. CROCKER, JR. RESIDENCE C TRUSTEE OF THE II MINIMUMS CROCKER PENSION REALTY TRUST i AREA I ' E 43,560 S.F. t FRONTAGE 20 WIDTH 100 r FRONT SETBACK 20 _ -SIDE SETBACKS 10 1 X LOT 7 RA . REAR SETBACK .. 10 _ W _ BUILDING `HEIGHT - 30 L.C.C. 15055H Ln SLn o\�. DAMES H. CROCKER, JR. RF 1 o�,c��' TRUSTEE F v MINIMUMS v' 0 THE I \ 9 J d S ! CROCKER PENSION REALTY TRUST AREA s 43,560 S.F. \� F S ff RONTAGE _ 20, WI_ DTH 125 j N = FRONT SETBACK 30' SIDE SETBACKS 15 f O o t ! REAR SETBACK = 15 to N N a O QP BUILDING = z HEIGHT 30 ck 1 - lr q 0 q A � x l � � � aC - l) , `l 1 t X 36.5 t i x oil 35. CO oK M ,N K3 f o `� .. x 3 .2 - -, ! I t4 t � , Ii x` 34.5 I - . LOT .13 f x 32. 0 r -... '� ZONE li -� C.B. FN'D. OFF ZONE RC • „ -_.y N87 4•�7`a- ( L.C. ON NEW 45 W W, retainin W x LOT LINE 46,895. s ft'. 9 cr(i 26,2 o ` r 0 , _ - f D. BOX , i F .. � F , � 4 PROPO E SED S ry EXPANSION AREA TIC SYSTEM OO i EA 31._• 3 > x `29.8:� : _ - r v- cr TP 0 i 1 q _ , t � � cfl d' S :t 1 , r _ , r O n # 2 6'. f 0 O G 31 20.9 `�- ,- - o y -o _ .ham 1 -. f O 22. i I ! i► , . LOT 12 f , , 27." Cn I x 7 8 f 25� 59,423. :3 s .ft. , a _ q .. N _.. x t _ 24.8 W o- ` � : 1.36 r , - - ac es � -(��� { xL O• �/ _ 24.8 I l0 l0 , ) � i f :x 17.8 cr\ } v ``ter ., 0. O ' 1 i.c t9 \ _ \ �. /. : PROPOSED _ I ED SEPTIC SYSTEM ---..,. \ p x 1 , s • 4.3 0• WETLAND vvIIvvvv:vv,vvvvv0vvvvvvIIVVVII :. C.B. FN \• m ., - co I D. OFF x t .21.5 -' o- x v v v v II / x x vIIvvvvII'vvvIIIIIIVIIvvvvvv 1>�3.8 vvvvvvvvvvvvvvvvvvvvvvvvv o x 21, 15.6 O ,� v �X p x cv - 23.0 r-- � . -� o. ,- .- IIvvvvv`vvvvvvvvvvvv ,p d- � � �" ;�= rn i IIv"v � v vv o LOT 13 \ � v v v v v II v v v v II v v II II O v II v_ v E II 0 v � f 1 v II II v v v v v v v II v D p v v II v II II v v v v 18.4 -� LOT 3 _ _ �._ \ ` oo ry ; WASHED STONE -_ - O - 5 , o. , ry ,>Lf N TOPPED WITH 3 OF PEASTONE \ i, ry i .. - --•� = V _ , EXPANSION AREA ` ------�_ _ 1 ,� � _ I x 18.�# f � ,. � - x i 7.5 '�. f r , 00 I P o I LIAN _OF LEACH FIELD SCALE; 1 10 -- 12.2 �` lei v' r x x ,15.1 �. 7.7 CSC , r „ ? F etc ,t1 NOTES: °21 j I 1 REMOVE UNSUITABLE I O LE SOILS BENEATH PROPOSED SYSTEM, BACKFILL WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT ' MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED x ON No. 50 SIEVE, OF FRACTION PASSING No. 4, 10% OR LESS TO PASS No. �' x x _ 100 SIEVE AND S% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED sl •12� � ,'fy x�-3:2 BY ENGINEER FOR COMPLIANCE -PRIOR TO PLACING ON SITE, N /�y /' . � e AILE �p .i e p (2).LOCATION OF UTILITIES NOT .SHOWN ON THIS PLAN, AT LEAST 72 HOURS - I PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE THE REQUIRED - / Q ED NOTIFICATION TO DIG SAFE (1 800 322 4844) AND APPROPRIATE sll:{c. '• j / x 12.5 _ WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. <- 1.6 • o 2 2 13 �, : . 5 / LOT .:WETLAND ik r t , , NOTES , 6 N a � DAMES H. CROCKER JR. .y _ , c _ = TRUSTEE OF THE I I 1 ..FOR ALL ASPECTS OF THE SEPTIC SYSTEM THE CONTRACTOR CROCKER PENSION REALTY - - SHALL COMPLY_WITH ALL GOVERNING CODES AND REGULATIONS. `z / - IN PARTICULAR 310CMR,15.000 THE STATE ENVIRONMENTAL CODE TITLE 5, 'THE TOWN F 0 BARNSTABLE BOARD OF HEALTH REGULATIONS PART'VIIL / Ov _ ON-SITE SEWAGE DISPOSAL REGULATIONS �c ; ULA ONS AND THE BOARD OF HEALTH / I RECOMMENDATIONS FOR ACCEPTED PRACTICE. / � PLAN OF LOT 12 L SCALE; 1' 20' 1 ! S c ITE PLAN OF LOT 12 TEST ALL COMPONENTS LOCATED IN POTENTIALHOLE •r• ; VEHICLE TRAFFIC AREAS OR BURIED 4 FEET P-8620 L.C.C. 15055 H COVERS LOCATED TO WITHIN IN n OR :GREATER SHALL BE H-20 LOAD CAPACITY. WELLER' & ASSOC. 12 OF F.G. OSTERVIL 1 � �E) ACM PIT 1 >I v E PRECAST EtE 27.0 - tr TOP OF G• 26 t v ELEV. = 30.0' BARNSTABLE MASS: DB3 OR EQUAL TEST HOLE FOUNDATION (} F.G -26'f P ' 8721 -2" FOR INV. 24.6 1r.G.= 26t WELLER -& ASSOC. LOAMY SAND - E 1500 .GAL 4. QIAMETER .• ..... -low INV. - T ASSURANCE CONSTRUCTION .: � CO. 24.4 DIS :::: _ scy _ iNv. - ED PIT 1 ..... 24.2 U ..... .SANDY LOAM B >, , SEPTIC TANK INV. � BO 4O •::::. _ . 24.0 p y, ..,.. SCALE. 1 20 DATE. NOV. 12,1996 ptP TOP`;ELEV. 24.6 ELEV. = 1 :.: _ 0.7 ... 32 i " iHv. =23.8 O :.. 6 CRUSHED .. REV. DEC. 11,1996 ADD WORK LIMIT 1 10.00' -3 _ ( ) il�v - 23. v v v v v II COARSE C I vvvvvvvvvvvv : MiN. STONE BASE LOAMY SAND - A ... .SAND vvvvvvvvvvvv"vvvvv , ;, BAXTER & NYE INC, BASEMENT FL EL. ` 1 vvvvvvvv.vvvvvvvvvv R 9.5 ._., ,, EGISTERED LAND 'SURVEYORS ::.. -48 PERK TEST SANDY LOAM - B BOTTOM 22.6 ....: CIVIL ENGINEERS EI.EV. ..... i .... _ OSTERV 30 ILLE MASS, MEDIUM C COARSE - C SAND i .• N f2f I - SAND t-A of a ct� I'ETr�R� I ..• _ � SULLIVAN rn 48 PERK TEST A .� o 126 EL, 19.5 w N0.2..733 1 s , in -MEDdUM. . .. C :_ _ _ _ CIVIL w,uacs NO OBSERVED WA ,. i A E TER ' SAND � •9 Fr Esc. :, ,. o . I rs ' EL. 5. _ . I 9 OBSERVED WATER EL. 5.9 58 OBSERVED WATER PROFILE NO SCALE 9614312 i ! i ! - I !