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Home My WebLink About0408 WIANNO AVENUE � �� w��;�o �� t e e I `i o _ �..�. __,... .,— — -- -,.r — — __,. ��4; a � I 1 a i S '� a 7 t e 1 I 9 1� I i i) !';. y o i I o a 'I 3 a o /TL�b u 11 C� OL �n o v 0 r N A.M. 163/005 �+ IF o LOT 16 A.M. 140/154-002 A.M: 163/017 vn4 & . AREA-179.789t S.F. A.M. 140/153 175.7• 1 CTF/47876 UNOBSTRUCTED NEW mo ' RIGHTS WETLANDS EXISTING OUNDATION TOF-17.1 I w A.M. 163/023 A.M. 140/154-001 112.0' b► A.M. 163/024 17 �j A.M. 163/025-002 X yL \ 'U �2 GF` GRAPHIC SCALE 100 0 50 100 200 400 ( IN FEET ) PREPARED FOR: 1 inch = 100 ft. SHAKEAB ALSHABKHOUN FOUNDATION (AS-BUILT) CERTIFICATION #408 WIANNO AVENUE, OSTERVILLE, MA. JAUGUST 6, 2014 1 J# 1492 SCALE: 1"=100' PLAN REF:' LCP# 4178M CTF : 170686 ASSESSORS MAP 140 PARCEL 154-002 0 MArr MacDougall Surveying ZONING: "RF-1" FLOOD ZONE: SEE PLAN oz�`` EDWAR cyo & Associates_ D I CERTIFY THAT THE FOUNDATION ON THIS PLAN EXISTS o A. P'.,O. BOX 2428 ON THE GROUND AS SHOWN � STONE Mashpee, Ma.; 026-49 ,0� No.28 8 � .p o ph. (508)419-1086 8 A 1 e' fax. (508)419-1087 email: macdougall survey E SIONAL iLN SURVEYOR *DATE @comcast.net I Z- s� 0 A.M. 163/005 g� 9 3�g 37.3g.W °y ns E `� �g1 0 • 193.E Nh2 N „o LOT 16 A.M. 163/017 A.M. 140/154-002 N „" „N AREA=179,789t S.F. m A.M: 140/153 �0 CV % „u r- y 175., CTF$ 47876 o N UNOBSTRUCTED VIEW 2 „m RIGHTS h WETLANDS - J � N Q � HOUSE UNDER \ CONSTRUCTION A.M. 163/023 A.M. 140/154-001 d w 5pg5 A �W S VV' CV UND GARAGE / 2�0 4�°�•� o�o FOUNDATION �'� S�0 A.M. 163/024 2s f INA d •� O A.M. 163/025-002 V - GRAPHIC SCALE G� 100 0 50 100 200 400 ( IN FEET ) PREPARED FOR: 1 inch = 100 ft. SHAKEAB ALSHABKHOUN FOUNDATION (AS- BUILT) CERTIFICATION #408 WIANNO AVENUE, OSTERVILLE, MA. OCTOBER 21, 2014 J#1492F2 SCALE: 1"=100' PLAN REF: LCP# 4178M CTF : 170686 ASSESSORS MAP 140 PARCEL 154-002 OF y4Sr MacDougall Surveying ZONING: "RF-1" FLOOD ZONE: SEE PLAN o�� EDWARD cys & Associates 1 CERTIFY THAT THE FOUNDATION ON THIS PLAN EXISTS o A. P.O. BOX 2428 ON THE GROUND AS SHOWN CJ STO E Mashpee, Mo. 02649 .00-� 28 ph. (508)419-1086 fax. (508)419-1087 G� LAN email: macdou gall survey PRICIFESSIONAL LAND 113URVEYOR DATE @comcast.net TOWN OF BARNSTABLE BUILDING PERMIT A`PPLICA-TION Map Parcel / C)o� Application # Health Division Qate Issued t b l I Conservation Division �t�,�� Application Fee Planning Dept. Permit Fee , row Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis z7 /_' � I Project Street Address ` o q LV 1roll tlo c�✓C� Village S A y yr Owner&'5, ,a&,,/a Al'<A a(0 kaun Address �� i o'»�o Telephone D Permit Request f3t�� iye-t,., ` E. :5 a- 4Y3 X �`� n� lr`v,�►��act Square feet: 1 st floor: existing yy proposed 2nd floor: existing proposed Total new Zoning District g, Flood Plain Groundwater Overlay .Project Valuation Construction Type IVe 4' Lot Size I Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family,'❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure \ Historic House: ❑Yes UkIgo On Old King's Highway: ❑Yes U Pd07 Basement Type: ❑ Full ❑ Crawl �0 Walkout ❑ Other Y f Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No �3 Detached garage: ❑ ❑ ne size size existing _ ool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name � '/� w w 6 1/4Y Telephone Number 5-0 O— 3 930 Address 3 Oct✓fS t J f l 4e. � License # ceS FCA"1 Y"ICs y ! Home Improvement Contractor# a 2 5 3 6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO r0 t Py v ,, SIGNATURE (� DATE 1 —I-e2 FOR OFFICIAL USE.ONLY APPLICATION# DATE ISSUED 7 MAP/PARCEL NO. <' ADDRESS VILLAGE \ OWNER ; r DATE OF INSPECTION: I FO.UNDATION!wH.ywftr. FRAME - - - a_•INSULATION.:L.:,A I:,•- FIREPLACE t ELECTRICAL- ROUGH FINAL ` PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i The Coatstiz'onitwulth o,f Massachuselfs Departrnent of liulustrivl Accidents Office of finvertigations 60,0 Washington Street Boston,MA 02111 wiviv.raass-gosAdia Workel<-s' Compensation Insurance Affidavit:Builders/Contractors/EiectricianMumbers Applicant Information Please Print Legibly Nam(BusinessJOrganization/fndividnal): �S h�w n, G;��, - Address.- VOL vJ-6 t✓ ffe no r City/Stat&Zip rl�-1 hv✓ Phone 47 Vyo,,an employer?Check the appropriate box: T of o"ect r mire4. I aim a contractor and I J a employer with ❑ 6_ ❑New oomsi;nic#on employees(full and/or part-time)-* have hired the sub-contractors. 2_❑ I am a sole proprietor orpartner- listed on the attached sheet ?. ❑Remodeling ship and have no employees These sub-contractors have 8. E]Demolition w for me in an capacity_ employees and have workers' ��, y t 9_ 0 Building addition [No.workers' comp_insu ance comp_insurance repaired] 5_ ❑ We are a corporation and its 10.0 Electrical repairs or additions officers have exercised 1$_ irs 3_❑ I am a homeowner doing all work officers id their ❑Plumbing mPas or addition myself [No workers•ODMP right of exemption per MGL 12-0 Roof insurance required,]F c. 152,§1(4),and we have no �s an employees_[No workers' 13-❑Other comp_insurance requir -J,, 'Any aap that checks boa*1 toast also fill out the:section below showing their worjkere compensation policy infarmztima- T Homeowners who submit this affidzvn indicating they are doing s1I wilt[and then hire outside contracmrs=st submit a new affidavit inf[stio;such Lcontoicmrs thst check this back must attached an additional sheet showing,the nmne of the salt-ors and state whether ormot those enmities have enplayees. If the sub-contiactars hake empIoyaes,they must provide their workers'comp.policy number. I am art employer ileac is providing ivorkers'compa7mation irmirance for aty employees: Belotv is Ste polio}acid job site in formation_Insurance Compauy Flame: G`S s G t �`� �i V � —)115, /i 115- 69 Policy 0,or Self-ins.Li(4 fit/C C-�O o— J�O/`�C-/o�9 2 d/� Expiration Date: Job Site Address: q0 If 0 ew, CitylState/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL r 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 farm of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification_ I do hereby certify render thepains acid penalties o per.Ury that the information pravided abm�e is hue and correct Signature: Date_ Phone#: ✓e <6 J Q — J Offrci.ad wre only. IM not smite in this area,to be completed by city or town officiaL City or Town:. Pernrit/License# Issuing Authority(circle one),: 1.Board of Health. 2.Building Department 3.City/Fown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written_" An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." - MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct bnildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required.- Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority-" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certiiicatc-(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance- If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit may be submitted to the Department of Indu;aiai Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The a iida.vit 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•?rokers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one a ida.vit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations ilz (city or town)."A c opy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be;filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industdal Accidents Office of kwst gatians 6-00 Washington Street Dastou=MA 02111 Tel.#617-727-4940 w 406 or 1-877-MASWE Revised 4-24-07 Fax# 617-727-7749 www.mus—gov/dia Town of Barnstable Regulatory Services BARNx � v M�i E Richard V.Scali,Director �AlE16.39. ,0 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 -- Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I oln as Owner of the subject property hereby authorize S �./n. r( to act on my behalf, in all matters relative to work authorized bythis building permit application for. Uwe. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner ignature of Applicant Print Name Print Name 57- Date Q:FORMS:OWINTERPERMISSIOhTPOOLS . Town of Barnstable Regulatory Services �ofmE roiyL Richard V.Scali,Director P Building Division • EARN L « Tom Perry,Building Commissioner xra_ss. 200 Main Street, Hyannis,MA 02601 QED ' www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone fA work phone n 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,-a tached 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." 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"I x 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. Q:\WPFII.ES\FORMS\building permit fomu\EXPRESS.doc �• Revised 061313 �J yGfi lQ -41 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration .._ _ r — — — Registration: 126858 i z j Type: DBA Expiration: 7/30/2016 Tr# 252739 SHAWN GILFOY CONSTRUCTION " �., SHAWN GILFOY .' ' z 123 DAVISVILLE RD J.1�1 FALMOUTH, MA 02536 date Address and return card.Mark reason for change. scA, G 20M-0U11 Address Renewal Employment Lost Card C�c�'anvneoraucull�n�C�/llaalCiC�c11cI13• �. Office of Consumer Affairs&Business Regulation License or registration valid for ind'Ividul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: fregistration: :�26858 Type: Office of Consumer Affairs and Business Regulation piration: J/30/2016 DBA 10 Park Plaza-Suite 5170 , = Boston,MA 02116 SHAWN GILFOY CONSTRUCTION s - 3 1;; SHAWN GILFOY 123 DAVISVILLE RD FALMOUTH,MA 02536 Undersecretary Not valid wi ut signature Massachusetts-Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License:CS4)50469 I IS SHAWN D GR"3t ; 123 DAVLSVHJX-W s E FALMOUTH NA kv -,� Expiration Commissioner 09/12/2016 TOWN OF BARNSTABLE BUILDING PERMIT,OPPLICATION Map '7Parcel �. 2Application V `f Health Division 0% a %te Issued f Conservation Division Application Fee Planning Dept. , Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis , Project Street Address u (✓ Village "Owner l��Q�A U ��l 96 Address 4 4/ s fJ� `� ✓ �'� Telephone rsafe Permit Request ` ' n� ?I OA-Y&41 n; '101 QPA, VUJ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project .Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name to Telephone Number ��- 122—(Dgd S, Address License.# C,S' f y 9 Home Improvement Contractor# f� f Email eL T ►y 01 C O '\ Worker's Compensation #. ALL CONSTRUCTION DE RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNA E DATE Yh If FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. s -ADDRESS VILLAGE / f' OWNER DATE OF INSPECTION: FOUNDATION r, r E' FRAME INSULATION FIREPLACE "- ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' ASSOCIATION PLAN-NO. TO, Var �tab3-building��arertroc��. Re:New rfit-,id nmd construction-ate ttsterville�MA €205 Permit 0., 014-00 7I The current liged contractor,Shaun G{lEoy,of Ga4fay Construction,zs no hall r thaa peneral icontractor or involved in the construction of our house, We have hired Tate Isenstac t,T I Building&Remodebriq,to take over the pros ct and finish construction of the hovsr Thank you Shakeib Alshabkhoon r CO �t y r .5�� Town of Barnstable ♦ ♦ Regulatory Services ' Richard V.Scali, Director Building Division Paul Roma,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY ��o s , Construction Supervisor License # L175' 2,y 8,,/hereby certify that I have assumed responsibility for the project under construction, as,authorized by building permit# d0 ql issued to (property address) Y Q�A)bq*f4 0 P'J(f�Q Z°�U on 0 , 201�. The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License ExemptionTorm (if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable). �S L LICENSE HOLDER DA q/forms/newcontrb rev:07/18/16 4 , 1 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor a- . License: CS-098149 TATE D ISENSTAJ�T PO BOX796 s � Hyannis Port MC-026f� , _ww" Expiration Commissioner 03.124/2017 dTX' TplYI71g7la9z ea.1�a�� u�aac�cute<C/ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only r y ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: �55997 Type: ; Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 xpiration: ^5/29%2Q1�7;^ Private Corporation Boston MA 0211 tt REALTY GROUP :INC': `s_ `r TE ISENSTADT PORT, MA 02647`- Undersecretary •_Not h without signature IdIA, ter-- v AVC o ►�' r �-2 The Commompeah*qfMassadiayetts Department afludasttridAcccidenys Ojrwe qf g 600 Washurglon meet Boston,MA 172M iptnnmas g—ov/dia Workers' Cmmpensafian Insurance fffihait:Bailders/ContractursXlecuicianslPlmmbers Applicant Infmm,afian Please Print Name ea �ro 0 C Addre= 6 SA AVuAxe an employer?Qreckthe appropriate ;c Type of project(regdred): I. am a employes silty 4 afn a general contractor and I 6. ❑New oe nstruction eroploFees;(full andfor P }. have lured the sub-contractors 2.ElI am a sole prnpFdetas orpsrtuer- Tisfed Cattle attached sheet I ❑Remodeling ship and have no employees . These sub-cendractors have S. ❑Demolition wcddng for me in any capacity. employees and have worcrs' INo Wor errs'Comp.insurarice comp.trlavxarcr I 9. ❑Budding addition required-] 5. ❑ We'are a corpomfion and its 16-❑Electrical repairs or atiiions 3_❑ I am a.homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself[No worms'gip- riot of a =pEioa per MGL L.❑Roofrepairs insurance requin- d,]p c.152,§1(4h andwe have no employees.[No workers' 13-❑other cam-insurance re1dUed-1 Any apprra=fttchecdsbox in Must RLsn filiouttha seciiaabeTowshoni�theirsvodcexs'campensatiaaporicpi�zms�om Muneawnas Who submit dris dfdavir i—Trutiag dLY axe doia.1 RU wC01 Rod&M him autside coat ux-tors—s#submit a new affidavit in Mating such. iCauuctaa'&=chestthis box must attached Rasddilirm street showing ther—of the sub-c and state Whether or not those entitiesbav employees.Ifthesub<mmzaoshaveempiofe?-%therm=pmvideamar aadurs'comp.IGrmynumbm I am are euipiirpar tlLat is providing ttaorkets'cotnpensaion iriszirance}or arcy em,vTny eex Stow is Lie padicy job rya informaiDn. Insurance Company Name: Pflficy or Self-ins.Iia t �pirafiaaI?ate: Job Site Address -- ©� i A rt0 ��✓1� CitylStatel7sp: �u/v (i��' Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date}. Failwe,to secures coverage as requirednuder Section 25A of MQ.m 157—can lead to the imposition of criminal penalies of a fine up to$1,50a Oa at&or one-gesrimprisonnenk as Well as civil penalties in the fans of a STOP WORK ORDERand a Kne of up to$250.0!0 a dap against the violator. Be a&used Brat a sappy of this statement may be forwarded to the office of Itrvestegatiaas offfte DJA for'Rarance coverage verification- Idfo hereby csrtzfy s andpBnaIfies Q�Fe7W7 fJtat$ra inforwrai<ionptnotiiW abutis and correct Date- Ojokid am alily. Do not r~t.rke in fish area,€a be cotnpTeted by dip ortoirn zffil dmL City or Town: PermiffIcense;9 Issuing Auflwrity(circle one): L Board of$eaIth r.BuUmg Deparhtaent 3.drawn.Clerk 4.Electrical hispeetor S.Phunbing Lnpector 6.Other Contact Person: Phone#- laformation and lastruc-lons, ; Massar.3usef s coal Laws chapter 152 rmjm=all empIayeas m provide wurl=ass'=oap=s-E±km far their employees. P tr this Vie,an MPIay=is dcfoed as¢-everypersonm$ie service of another order aay cont-art ofhae, =pr=or implied,oral or wiftten." A3:L eznpkye'is defined as "an individual,paxtn=3123P,assocZ±Lon,CulPmalon or aft=legal entity,or any two or mare of the foregoing ea9aged is a joint and inchzdmg the legal n� mafr seves of a deceased employer,or ine receiver or trash of an individnal,p�sbip,association or otherlegal entity,employing=3PIOY=r- However file owner of a.dwelling hone having not more than three apartments and Who resides ffierein,or the occupant of the - dwelling house of another who cn:pIop persons to do maw,camUnction or repair wo&on such dwelling house or cn the grounds or b ildmg appur�ffiereto sbaH not because of surly employment be deemed to be an employer_" MM chapter 152,§25C(6]also states that"every state or local lic=sing agency shag wifhhoId flee issuance or renewal of a license.or permit to operate a baseness or in construct bmHdings in the commoz:Wealth for any applicantwho has notprodnced acceptable evidence of compliance with the insurance.coverage req¢a ecL" Arir tibnaIly,MCEL chapter L52,§25C( )suer¢Neithcrthe cammua[Weellhnor airy ofiispoIiiical subdivisions shall enter into any ccar a f6r the perfi:.ance ofpnblic warkuniI acceptable evidence of compliance the i asar-� .. regU=C r eats of•this chapter have been p=mlted to the contr aatTiouty." ' Applicants NCi. .' - r � . Please fia out the wodam'.compensation affidavit completely,by checldng the bmces that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone Trr= cr(s) along with their certifrcate(s)of insurance_ Limit&d Liability Companies(LLC)or Limited LiabrlrtyPartnessbips(LIP)wiffino employees other fhan the members or partners,are not reed to carry workers'compensation insaz-ance_ If an LLC or LLP does have employees, a policy is requirech B e advised that this aftidayk maybe submitted to the Department of Iudust-W Accidents for conffimation of insurance coverage: Also be sure to sign and date the affidavit Zhe affidavit should be mtrmmed to ffie city or town that the application for the permit or license is being requested,not the Department of Tnrin.ef,ia11�_=dmtL Shauldyon have any questions regarding the hrw or ifyon a=e rued to obtam a wormer' compensation policy,please call the Department at ffia mmmBerlwted below Self-mmuEd coMPenies should en ..their self ins[n-ance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and priufedlegibly. The Deparimenthas provided a space at the botlma of the affidavit for you to fill out in the event the Office of Iuvesti moons has to comacf ya¢regmiEng the applicant: Please be sure to f ll in the pen iWlicease manber which-will be used as a mfe=ce m=bcr. lh-addition,an applicant that must submit mulfpIe PmmOlicen se.appU aitious m any given Yeat,need only submit one affidavit inri g cat policy hZam ail on(if nwzssary)and under`rJob Site Address"$ire applicant should write"all locations m (may of town)-"A copy of the affidavit that has been officially stamped or mam$ed by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future pars or licenses_ A new affidavitmust be filled 0i1 Ckch year_Where a home owner or citizen is obtaining a license or p�m not I@ztod to any business or commemzial vermaz (ie- a dog license orpmmit to bum leaves eta-)said pegson is NOT required to complete f3is affidavit The Of Em of aVcs 9Bfi would 111ae to tbank you m advance for your coapeaad=and should you have any questions, please do not hesitate to give us a caIL The Department's address,telephone and fax umabe� Dq=trnm±cf Accidents face of InVe .fio= B MA Oil 11 Ta#617- -49W axt 4-06 or 1-.SW-IL4.QZAFE Fax#617 727 7M Revised4-24-•07 W� ��a TDIRE-1 OP ID: KG CERTIFICATE OF LIABILITY INSURANCE DATE 07120120`16Y) o7i2o/2o1 s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(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: Kathy Geddis Northwood Ins.Agent; ,Inc. P ONE 540 Main Street,Suite FAX AIC No E :508-771-1632 AIC No):508-393-2955 Hyannis,MA 02601 E AIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC INSURER A:WESTERN WORLD INSURANCE CO INSURED TDI Realty Group Inc. INSURER B:AmGUARD P 0 Box 796 Hyannisport,MA 02647 INSURERC: INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE LTR POLICY NUMBER MMIDD MMIDDlYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE MOCCUR NPP1427371 01/1612016 01/16/2017 DAMAGE TO RENTE PREMISES Ee occurrence $ 50,00 MED EXP(Any one person) $ 5,00( PERSONAL&ADV INJURY $ 1,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- JECT LOC PRODUCTS-COMPIOPAGG $ 1,000'00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PR PERTY DAMAGE $ AUTOS Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYE RS'L[ABILITY Y 1 N STATUTE ER B ANY PROPRIETORrPARTNERIEXECUTIVE CERT WILL FOLLOW FROM CO 09/18/2015 09/18/2016 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? N 1 A (Mandatory In NH) ITHI N 5 DAYS E.L.DISEASE-EA EMPLOYEE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION TOWNBAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 230 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 07/20/2016 11:14 7734723381 FEDEX OFFICE 1935 PAGE 02/02 To: Barnstable Building Department t7 Io E7 Re: New residential construction at: V) o ,_, I— -n 408 Wianno Avenue Osterville,MA z 02635 �'-� co Permit#:2014-00474 rn co The current listed contractor,Shawn Gilfoy,of Gilfoy Construction,is no longer the general contractor or involved in the construction of our house. We have hired Tate Isenstadt,TDI Building&Remodeling,to take over the project and finish construction of the house. Thank you, Shakeab Alshabkhoun OM FAX NO. :9419660702 Mar. 05 2010 01:24PM P1 � E Tow - of Ba n—stalble ` )Regulatory Services '-P?�. Thomas F_Ga41br,Director ...Building Division Tom rerrys BuDding.Commlaaioner 200 Main Street,Hyannis,MA 02601 wwwJown%barnstable.mo.ua. Of re: 508--802-403'9 Fix: 509-790-6230 f Prope4- der must Complete and Sign.This Section YJ n A Bni er 0 errt 7:5 , as Owner of-iie subject pr ,p y hereby autho rite 914 u%d'� j � ' to act on my behalf, all=ttets relative to work authoriud bythis building permit ap,pkatiozi.for (Address of job) Signat�ase of Owner ato' � a �00 o UAV i . h Pit Name If r0pQnw QM er is applying for pe- It please. complete the Homeowners Liceme Exemption Fan-n-on the reverse side. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 00 0 Map.1401 IS41M Parcel Application # Health Division �F / Date Issued Conservation Division�V� 5E3 -5 k30 Application Fe "P ,�s� Planning Dept. Permit Fee p�J w Date Definitive Plan Approved by Planning Board B Historic - OKH Preservation/ Hyannis Project Street Address /4 0 9 Wlajaip M o . q Village 0�5�"Q.I'x/II(.QJ "J Owner 1) 15jab K h 0 U n ,5hC�k0 a h TR Address 3. WcAio Ann Sf H ►ij Telephone Permit Request m d i-? Ire �0 7�6- lV�� Lio�Te Square feet: 1 st floor: existing proposed R46D 2nd floor: existing proposed 'L5DO Total new er .Zoning District - / Flood Plain Groundwater Overlay k roject Valuation Construction Type l woat Lot.Size- - F Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;;�� Two Family ❑ Multi-Family (# units) Age of Existing Structure 10,0 r Historic House: ❑Yes ®'No On Old King's Highway: ❑Yes ❑ No Basement Type: Cull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft'.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of.Bedrooms: existing __Z'new Total Room Count (not including baths): existing new /3 First Floor Room Count Heat Type and Fuel: (ZGas ❑Oil ❑ Electric '❑ Other Central Air: O'Yes ❑ No Firep aces: Existing New .S Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑'new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size= �ttached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use LC5 id, APPLICANT INFORMATION (BUILDER OR HOMEOWNER: _ Name %au) n P�IIAU Telephone Number(* 50 0) 56 0- 39,36 Address I d ba V4V I License # 0 S0 4 99 L . U a9(0 Home Improvement Contractor# 1 a 6 �� 8 �� • 5�10. >r Worker's Compensation # [A)CC-\5QQ-,50 1 A09'-Q )2� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ' nn Q 1 SIGNATURE DATE i al 13 z "g FOR OFFICIAL USE ONLY APPLICATION# r5 DATE ISSUED MAP/PARCEL NO. ram. ADDRESS VILLAGE OWNER C DATE OF INSPECTION: }' ;iu ,EOUNDATION_ '- FRAME r INSULATION A ' FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT s ASSOCIATION PLAN NO. i � r To?7.n' of Barnstab e* Regulatory Services Thomas F. CcOtr, Director �b O;F i3uEding Division Thomas Petry, CBO, Building Commi Dner atn Strcc[ $ anMS,MA D601 2D0 M Y ' . pp�•pc.foWn.barnstable.ma.vs �� V Fax: 508-790-623C 508=862-4.038 PLA-N RF-mw . OWnc� i proect Address 1 �t a B uildez- ' • � The faIIowing itL-=we.'e noted on reviewing- w �N� aw w � �s i Rev1e� by: r - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' .600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): (5 ram' �/ �/ co-n 5bac, Or Address: JJcL City/State/Zip: � '°'�✓�N t��`c, 0,2 06 Phone#: Ar e employer?Check the appropriate box: Type of project(required): '1. a employer with_�r 4. ❑ I a general contractor and I employees(full and/or part-time).* hake hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y p t3'• have 9. ❑Building addition t [No workers' comp. insurance comp.insurance -, required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.F Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers 13.❑Other comp.insurance required.] tt*Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1t*omeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and.state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1 Insurance Company Name: �-155(rLL-,% 42— r1m Policy#or Self-ins.Lic.#: 1/t/C (�--,�C�-�0/ ya2Ul��/Expiration Date: Job Site Address: L.,Y- Vfla City/State/Zip:a Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains andpenalties o edury that the information provided above is true and correct Signature: Date: 1001, Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions , Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied;oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD,YYYY) 01/27/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Joanne Bretton Southeastern Insurance Agency, Inc. acNoErt: S08.997.6061 acNo 508.990.2731 439 State Rd. E-MAIL ADDRESS: P.O. BOX 79398 PRODUCER CUSTOMER ID . North Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Arbella Protection Insurance 41360 Gilfoy Construction Inc INSURERB: Assoicated Employers Ins Co. 123 Davi svi l l a Road INSURER C: East Falmouth, MA_02536 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 2013-2 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. I�TR TYPE OF INSURANCE IINSR SWVD POLICY NUMBER MMDPOLICY EFF MPS Y EXP LIMITS GENERAL LIABILITY 8500015069 09/29/2013 09/29/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,OO PREMISES Ea occurrence) CLAIMS-MADE FY]OCCUR MED EXP(Any one person) $ 5,00 A PERSONAL&ADV INJURY $ 1,000,00 i GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,001 POLICY JEo- LOC $ AUTOMOBILE LIABILITY 1020018693 02/01/2013 02/01/2014 COMBINED SINGLE LIMIT ANY AUTO $ (Ea accident) 1,000,000 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ A X SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) 1,000,000 X NON-OWNED AUTOS $ UMBRELLA LI►B HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC LIMITS T AND EMPLOYERS'LIABILITY Y I NER B ANY OFFICER/MEMBER�ARTNEED?ECUTIVEF NIA WCC-500-5012429-2013 08119/2013 08/19/2014 E.L.EACH ACCIDENT $ 1,000,00 (Mandatory in NH) EL DISEASE-EA EMPLOYE $ 1,000,00( Dyes,describe under D SHAWN GILFOY IS INC E.L.DISEASE-POLICY LIMIT $ 1 000,00 DESCRIPTION OF OPERATIONS below , DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Town of Barnstable Barnstable, MA Joanne Bretton ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD i Registry ID Home Energy Rating Certificate Rating Number Certified Energy Rater Bruce Torrey 408 Wianno Ave Rating Date 02/03/2014 Osterville,MA Rating Ordered For 1✓ Estimated Annual Energy Cost Use s MMBtu Cost Percent 5 Stars Plus Heating 159.4 $625 35% Projected Rating HERS Index: 56 Cooling 4.7 $99 . 5% Hot Water 14.9 $53 3% Projected Rating:.Based on Plans- Field Confirmation Required. Lights/Appliances 43.0 $906 50% General Information Photovoltaics -0.0 $.0 -0% Conditioned Area 6560 sq.ft. House Type Single-family detached Service Charges $120 7% Conditioned Volume 69397 cubic ft. Foundation Unconditioned basement Total 222.0 $1802 100% Bedrooms 4 Criteria Mechanical Systems Features This home meets or exceeds the minimum criteria for the following: Heating: Fuel-fired air distribution,Natural gas,96.0%EFF. 2009 International Energy Conservation Code Water Heating: Integrated,Natural gas,0.90 EF,40.0 Gal. Cooling: Air conditioner,Electric,13.0 SEER. Duct Leakage to Outside " 195.00 CFM25." Ventilation System Exhaust Only:110 ctm,19.0 watts. Programmable Thermostat Heat=No;Cool=No Building Shelt Features Ceiling Flat R-38.0 Slab None Sealed Attic _N/A Exposed Floor R-30.0 Vaulted Ceiling R-37.6 Window Type U:0.30,SHGC:0.30 Above Grade Walls R-20.1 Infiltration Rate Htg:5.00 Clg:5.00 ACH50 Home Energy Raters LLC. Foundation Walls R-0.0 Method Blower door test PO Box 989 Lights and Appl Sandwich MA 02563 iance Features • 508-833-3100 Percent Interior Lighting 90.00 Range/Oven Fuel Electric, Percent Garage Lighting 0.00 Clothes Dryer Fuel Electric info®energycodehelp.com Refrigerator(kWh/yr) 691.00 Clothes Dryer EF 3.01 Dishwasher Energy Factor 0.46 Ceiling Fan(cfm/Watt) 0.00 The Home Energy Rating Standard Disclosure for this home is available from the rating provider. REM/Rate-Residential Energy Analysis and Rating Software v14.3 This information does hot constitute any warranty of energy cost or savings. ®1985-2013 Architectural Energy Corporation,Boulder,Colorado. J - Workers compensation forms will be submitted by all subcontractors once hired. Sincerely, I Shawn Gilfoy Gilfoy Construction i I � -ja4uj�t 1 4hiceofConsumerAffairs and B siness Regulation 10 Park Plaza- Suite 5170 Boston, Massachusetts 0211.6 Home Improvement Contractor Registration Reqistration: 126858 Type: DBA Expiration: 7/30/2014 Tray 228368 SHAWN GILFOY CONSTRUCTION SHAWN GILFOY 123 DAVISVILLE RD FALMOUTH, MA 02536 Update Address and return card.Mark reason for change. ❑ Address Renewal Ej Employment Lost Card SCA1 b 2010MII Office of License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: IS - 'i e9istraticn: 126858 Type: Office of Consumer Affairs and Business Regulation xpiration: 7/30/2014 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 SHA 1LFOY CONSTRUCTION SHAWN GILFOY 123 DAVISVILLE RD FALMOUTH,MA MA 02536 Undersecretary not valid without signature l int Massachusetts-Department of Public Safety Board of Building Regulations and Standards Cunstructinn Super%i,nr Anh License:CS-050489 �t F SHAwhi D G[LFOY - - 123 DAVIsVILLI RD _ E FALMOUTH MA 02536; Expiration Commissioner, 09112/2014 01/02/2020 22:44 FAX Q 001 i rq Town of.Barnstable Regulatory Services • rlAfl&6TAUW. Thmnas F.Ceiler,Director p° Building.Division rom Perry,Building Commissiouer 100 Main Street;Hyannis,MA 02601 www.town.bu rnstable.ma.us Office: M8.862-4038 Fax: 508-7W6230 Properly Owner Must Completc and Sign This Section If Using ABuilder r of the-,subject pmperty hereby autbotize ,S il4"Ljo ��1{ '� `to act on my behalf, in A matters telative'to wontamhorized bydtis building permit application for !fir:n-.!I (Additss of Job) L"UA� Stgnaaire of Own Date Print N me _ If Property Owner is applying.for permit please compicte the Homeowners License Exemption Form on the reverse side. p:FORMS:ONVN'EKPF.RMIS S ION r J Commonwealth.of Massachusetts Sheet Metal Permit Map r Parcel r Date: �Zi S7 .1 ermit -Ror Estimated Job Cost:` L.C,.v 6)e_) CEC 0 5 Z017 Permit Fee: $ TO Plans Submitted: YES t/NO HA�OVSr)kM l�viewed: YES NO ' Business License# 1?3 6 3 Applicant License# Business Information: Property Owner/Job Location Information: Name: Name: S c 4 Ah `i It ,/oQ"V Street: �U1Ca.Q/L(az-� �U vim;G!� Street: 7 d r fit/ Avt o AyR 1 City/Town: \0.iJ C �'' �;� City/Town: n�c-► i Telephone: �r �- '�'� Telephone: 7— 31 L 0- 3 Photo I.D. required/Copy of Photo.I.D. attached: YES NO Staff Initial J-1/M-1-unrestricted license J-2/M-27restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less Residential: .1-2 famil�/_ Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational j Fire Dept. Approval Institutional Other Square Footage: under 10,000 sq. ft. (/ over 10,000 sq. ft.. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents ' Air Balancing Provide detailed description of work to be done: Lea jz4;C;,� ti 134 J 12 4U J/j �:�_ &,k A-� J A, )`SURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes No ❑ If you have checked Y.M,indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box(],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the Le Duct inspection required prior to insulation installation: YES Progress Inspections Date Comments Final Inspection Date Comments Type of License: BY ❑ Mast / o / Title Master-Restricted City/Town ❑Journeyperson Signature of Licensee Permit# ❑ 2,Journeyperson-Restricted License Number: Fee$ ❑ Check at www.mass.gov/dol Email: Inspector Signature of Permit Approval EEAsysr � �• ASH—�..�5 Y4, 6• �-NG as roun�� r.Y• J;+ _ E�?s�x�24 M +5 . ARWE�RICI(SBURGgy : �... `_�1SrUD QI•h.2017 RW 07-151009 Q7 :: 011AMONVIIEALTH-OF MASSACHUSETTS` « BOARVLJtbF "} rrSHE61,`METAL WORKEitS ti ISSUES THE�`FOOWINGfe£N a 2 MASTER UNRESTftICT FRANKLIN W KELI EY N 24 FREDERICK.WIJR AVE ` t 02645 2134 �W HARWICH MA .;ro { : 7 ." .. 7363 fl212812019 ��230485 �. f The cfttnmozrweakh OfMaWO&USetts ` Deparftmt l f JIshid ACdAwft Office qf1mvxdgafiv= 600 WBShcglon,Sbwj Boston,M,4 02HI tVlVm7fifL£TslEa Workers' Compensafim.Ins I -an(e,Affidavit Bw1d ej*Contractws EI ers Applicant Infarmation Please Print E,et�y Address` �itylS� � � • Plvosie�• . Are pagan employer?Check_ the a�pgrapriate bam ' Iype of ject(reclnined}: (/" 4 I am a coni�ctor and I 6- �c L I am a employer vrith ❑ onstruction employees(f>a11 andfor part-time)-* have hired f to t 2.❑ I am a sole propriety orpartuer- listed on the atta6 d sheet T. ❑Remodeling ship and have no employees These sob-conntractats have g_,❑Demolition working for roe in any capacity emFioyees and have wadoers' 9. El Builctmg ac�ioa INo S pdmrs'comp.insur-aace Comp-°f 7"" 5. ❑ We are a corporafim and ifs 10-El Electrical repairs or addstiaas 3.❑ I am a homeowner doing all work o$ioers have exercised their 1 L❑Plumbing repairs or additions myselE p o workm' right of bn per M(H ❑Roof repairs egat>Edr]j c.f52,1I(4�andwe have no ❑Otheremployees-[No wozia=' 13.corms insarame requireA) 'Amy appfiCK8tdMtcbedsbaa91nmsielseMcntthesm6mbefowsbFnriagfliewwmkeWcampeasafi0ap0rMyi aa- Emnemwamtr]msubmitdzisaffida«7sis 6Eeyemmoo`RUW s4&Mbim=dd&caUftl t=MnLttsubmitanew:drxdzdtis SMrTL ZOO atzacra6ff=checl bkbannsastottereaaddifi sheetsbouingthenameafdow and stURWhedmarnatfoseemitksbne emplayeM Ifthe3Gb-caztMCtM uvetIpta5e2%fiLe}'mustFmvideffiea —mp•palkyn=bm lam an enrplay�ar fftat is prmJiriir;g�workers'coegreresafiott irrsriraace�vr m}z ertrPTn3�ees: BeFnw is�dtepali�y.ar�job�a . inInsmranceCompanyY+lame: V l"��-1�� J/�,, A t- Poficy�or Self-im l ic-* 17M A, 1 l I[7 �7 FxpirationDaft- �7'"� to Job Site Addt: = !I Q Attach a copy of the workers'comapensationpolicydeciaration page(shawfag the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c 152 can lead to the imposition of cximii ai penalties of a fine up to$I,50U OQ andfor one-year imprisonmenk as well as civil peualfis in the form of a STOP WORK ORDERand a fine of up to$254-00 a dap against the violator. Be advised that a copy ofthis statement maybe forwarded,ta the Office of Investigations of the DIA far insurance coverage vedfication- I afa Lret-&y cerb r aatder l,I,tsrp�er' dp`e�r�:a�f� F FdWffiattfie hirbrwrairmmpron&dabm a is bus and cmreat Phone ik O.oW d use wdy. Do not Merits in tlds area,to be cvmpfeted by city artown afrtrQLL City or Iowa: PermitiUcense 4 Ironing AxL&Grity(circle one): L Board of$ealth 2.Buffd"mg Department 3,Cltyi£ovm Clerk 4.Electrical Faspector 5.Plumbing Inspector 6.Other Coact Person: Phone#: -- 6 laformation. and Instructions Mu e��3,�et�s Ge�eaal I.a�s cha�tira ISZ req�rs all�Ioyegs m provide workers'c�r�ssfian�their employees. I' Paisua�to this sib,an�Iayre is defined as¢:e�y Person in -a service of saothes ffid�r sap coxact of Ise, + expres or implied,oral or wIftftnnf An Mpkyer is defined as�mdinvubA pmtamshT,associshCn,CMPo on,Or other legal Mt.or ray two or mO¢E of the f3regoing cMgagEd in a Joint en±erldsa,and mchxdmg the legal-imescrEEBEM of a deceased eoxplu4r,or the receiver or trastee of an mdividnal,paltOeship,association or offier Iegal CMJ tL eoxploymg eozpinyees- However Sue. owner of a dwelling house having;not mMe than Scree apm newts and who resides mm iri6 or the occapamt of the - dwP.11mg house of another who moploys persons to do make,ca sftacti:on or repair wail-on such dwellmgg house or on.the grounds or building appirkomt thereto shall not because of snrh employment be deemed to be sir.employer." MCsL cbaptea 152,§25C(6)also sirs that`zevery stare or local licensing agency shall withhold fhe issuan cB or reaewaI of a ficense or permit to operate a busnaess or to construct bvildiags in the commonwealth for any applicant who hzs notproduced acceptable evidenm of compliance with the***m*-an cn coYexage refike&" Adraonany,M(M chapter 152,§25CC7)sbdes aNeiiiiar the rximm mcwvM nor a"uy of its poEtical subdivisions shall an into any caatract for the p=Emmm=ofpnbhr,wamkuntl acceptnble evidence of campF=cewifh the insmaace. re n reuicats of this chapter hxm been granted to the cortmct3ng aumoutY = A.pPIicaats ' Please fill out ff3.e worlsrss'comprasafion affidavit completely,by wig ffie boxes that apply to your sitaa ion and,if necessary,supply s)name(s), (es)and phone n=ber(s)along with their cextificate(s)of iommmce. Limited Liability Compames(LLC.')or I ranted Liabi7ity Parfn=sbips(LLP)wino employees other than the members or partners,are not regtmrd to caory woriOess' compvws rn insorance. If an LLC or LLP does have employees,apolicyisrujaiE d_ Be advised that this atfi&vh maybe mhmftdtotheDeparfinentoflndustrial Accidents mr conf atim of ice coverage. Also be smre to stu and date ere affidavit. The affidavit should baTeamaed to the city or town that the application for Ihe permit or license is being requeshA not the Department of Jndnsf,-l 'd� Shouldybu have any questions regardng the law or ifyon are regvsed to obtam a worio rs' compensation policy,please call the Deparf ire t at fhe rmmber listed below. Self-fiL=ed em3paaies shoo lei enter their s elf-insm-aneo license xnomber on fhe appropriate line. City or Town Officials. Please be sore that the affidavit is complefn and pritdnd legibly. The Department has provided a space at the bofttm of the affidavit for you to fill out m the event the Office oflnvesfigafios has to contact you.regarding th a aPp ' nt Please be sure to fill in the peinWHcrose mmnber wbich.will be used as a refore nm number. In addition,an applicant Boat must submit mulliple pexmiVHcense appIicafims in any given year,need only salmlit one a$tdavk indicating cam-ent . p olicv mfozmation(if necessary)and under`Job Safe Add rss"the applicant should write-all locations in—(City or town)--A copy of the-affidavit that has been officially stamped or madaed by the chy or to maybe provide d-to$xe applicant as proofthe a valid affidavit is on file for fa nre'pennzts,or licenses Anew affidavitmust be filled out earh year.Where a home owner or citiz=is obtaining a license or permit not xrlaf$d in any bnsin=or commercial 4eataas (Le.a dog license or permit to bmn leaves eft_)said poison is IdOT required to complete this affidavit The of of Invm igal a would him to thank you in advznce for you cooperation and should you have any questians, please do not hesifalz to give us a call The Depart cnfs address,telephone and faxrammber. . Th,-COMM the Of MZSMCI=dbi - Departmmt ofludastdslAaaideutt' Gfrd=a Investiglafio= �4 man Sfrt� Bns m�MA O�III Tel.4 Gl'-' -4900 cat 406 or 1-977 MAMAFE Fax#617 727'7� xevised4-z4-o7 _rnasg.gagfdia. I Town of Barnstable Building Department Services Brian Florence,CBO 59. Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maus Office: 509-862-4038 Fax 508-790-6230 Property Owner Must Complete and Sign This Section - If Using A Builder TAT' 1 CS I c2 F� S� S �C/� ,as Owfier of the subject property r . hereby authorize to act on my behalf; in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not t� le,-;fffied or utilized before fence is installed and all final ins p opsare performed and accepted.. Cr rS' ture of Owner Signature of Applicant le- 19, Print Name Print Name Late Q:FORMS:OWNERPERMISSIONPWIS Rev:08/16/17 Town of Barnstable - r Building Department Services Brian Florence,CBO $ Building Commissioner` 200 Main Street, Hyannis,MA 02601, RAIMSTAMA i ems. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown 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 suFervisor. 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 struchaes'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 Rermit. (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." 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 this issue.is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q-.\WPFHM\FORMS\building permit forms\EXPRESS.doc 08/16/17 I' Client#:975889 FRANKW ACORD.' DATE 110212 CERTIFICATE OF LIABILITY INSURANCE DAT 102/2DIY017 7 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NCRMNTEA:CT USI Insurance Svcs,LLC Sm CL PHONE g55 874-0123 AX 877-775-0110 yuC,No,E-dj: A/C,No): 75 John Roberts Road,Building C E-MAIL South Portland,ME 04106 ADDRESS: 655 874-0123 INSURER(S)AFFORDING COVERAGE NAIC a INSURER A:SdetY In---Company 33618 INSURED INSURER B: Frank W Kelley INSURER C 24 Fredericksburg Avenue INSURER D: Harwich,MA 02US wi INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DDL SUB POLICY FF POLICY EXP LIMITS LTR INSR WVO POLICYNUMBER MM/DD MM/DD _ _ A COMMERCIAL GENERAL LIABILITY BMA0010573 3/16/2)17 0311612018 EEAACHpGOECCCURRENCE $1 000 000 CLAIMS-MADE OCCUR PREMISES "&ante $100 000 MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 OOO 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 NPOLICY ECOT LOC PRODUCTS-COMP/OP AGG $2,000,000 x OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 732 Main St ACCORDANCE WITH THE POLICY PROVISIONS. Barnstable,MA 02630 AUTHORIZED REPRESENTATIVE 0 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD #S21855628/M21487821 RMSZP Home Energy Raters LLC info @EnergyCodeHelp.com 888-503-2233 Duct Leakage Test Address- 408 Wianno Ave Osterville, MA Date — October 14t`', 2016 Contractor— Tate Isenstadt Conditioned floor area = 6,940 Sq Ft. Total Leakage-Includes Air Handler/Furnace To comply with the 2012 IECC Energy Code in this home the Maximum duct leakage CFM < 277 CFM (6,940 /100 x4 =277:6) Duct leakage tested = 83 CFM The duct leakage tested at this residence complies with the 2012 IECC Code Test Mode - Pressurization. Test Pressure = - 25.0 Pascals Equipment - Series B Minneapolis Duct Blaster Duct Leakage as Percentage of Floor area = 1.1% Contact our office with any questions, Andrew Popielarski Home Energy Raters LLC i ACCORLIP CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DOlYYYY) os/22/eon THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT NAME: AICN o Ezt: 800 403-2448 FAX. No):866-828-2424 USI INSURANCE SERVICES LLC E-MAIL Certificate@Hanover.com 75 JOHN ROBERTS RD BLDG C INSURER(]AFFORDING COVERAGE NAIC# SOUTH PORTLAND,ME 04106 INSURERA: Allmerica Financial Benefit 41840 INSURED FRANK W KELLEY INSURERB: Citizens Ins CO of America 31534 INSURER C: DBA FRANK KELLY PLUMBING INSURER D: 24 FREDERICKSBURG AVE INSURER E: HARWICH MA 02645 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICPOLICY NUMBER MMIDDY EFF MPOMILDICY EXP LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS-MADE OCCUR D I O RENTED PREMISES Ea occurrence $ MED EXP(Any one person) S PERSONAL&ADV INJURY S GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY j� LOC PRODUCTS-COMP/OP AGG S OTHER: $ AUTOMOBILE LIABILITY C.OMBINED SINGLE LIMIT S Ee e.,dent ANY ALTO BODILY INJURY(Per person) S 1,000,000 A OWNED X SCHEDULED N N AWN 979465506 11/15/2017 11/15/2018 BODILY INJURY(Per accidenq $ 1,000,000 AUTOS ONLY AUTOS S 1,000,000 Ix HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY CPer accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR HCLAIMS-MADE AGGREGATE S DED RETENTIONS S WORKERS COMPENSATION X I PRAATUTE ERH AND EMPLOYERS LIABILITY YIN ANYPROPRIETORMARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 B OFFICERIMEMBEREXCLUDED? NIA N WBS A791487 01 01/01/2017 01/01/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT S 500,000 DESCRIPnON OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Addhional Remarks Schedule,maybe attached it more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TDI BUILDERS AUTHORRED REPRESENTATIVE 55 LAKE AVE HYANNISPORT,MA 02647Inpwi � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Town of Barnstable &tRNsrzrg, : Building Department-200 Main Street Y 91639. � �0m Hyannis, MA 02601'OTEDMA�a Tel. (508) 862-4038 mil. Certificate Of Occupancy Permit Number: B-2014-00474-1 CO Issue Date: 1/9/2018 Parcel ID: 140-154-002 Zoning Classification: RF-1 Location: 408 WIANNO AVENUE, OSTERVILLE Proposed Use: 1010 Name of Tenant: Sprinklers Provided: NO Gen Contractor: TATE D ISENSTADT Permit Type: Residential- Type of Construction: Design Occupant Load: 0 Comments: 22 C— Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition &I Town of Barnstable a,.W9'rBLF i Building Department- 200 Main Street 9 '16 9. `0m Hyannis, MA 02601 �ATEnM Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-2014-00474-1 CO Issue Date: 1/9/2018 Parcel ID: 140-154-002 Zoning Classification: RF-1 Location: .408 WIANNO AVENUE, OSTERVILLE Proposed Use: 1010 Name of Tenant: Sprinklers Provided: NO Gen Contractor: TATE D ISENSTADT Permit Type: Residential- Type of Construction: Design Occupant Load: 0 Comments: Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition PROJECT NAME:* a e- ADDRESS: PERMIT#. PERMIT DATE: NVP• I �-t o �� - - LARGE ROLLED. PLANS ARE IN: :< . BOX . . l "7 SLOT (� ; Data entered in MAPS program on: Z BY: _ 1 r P . tl -Commonwealth of Massachusetts Sheet Metal Permit Map Parcel I✓� V U t/ X-PRESS M1 # o�sflsl� . Date: 2 Z0 Estimated Job Cost: $ 3 2 org A. � 12 ""Permit.Fee: $ '® ' OVUM OF �A R�� ,ELE Plans Submitted: YES ^NO Plans eviewed: YES NO Business License# 6 y Applicant License# . Y y77 Business Information: Property Owner/Job Location Information: Name&,j �tii' , / C,o� 4t NameyO a% .�e_ �J ' Street: 37 Z Street: t/o R. i 4nro �Iy�r City/Town: Os•'/ /1�?// City/Town: Telephone:J&S-77/-7Z?o Telephone: Photo I.D.required/Copy of Photo I.D. attached: 'YES ENO Staff Initial i J-1/ restricted-license i I J-2/M-2-restricted to dwellings 37stories or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses . Other. Commercial: Office Retail Industrial Educational Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft. ` over 10,000 sq.ft. Number of Stories: Sheet metal workto be completed: New Work: 1-� Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust System i Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: =Le _31&, i INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes RIO ❑ If you have checked Yg& indicate the type of coverage by checking the appropriate box below: A liability insurance policy []� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does nht have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement Check One Only Owner ❑ Agent ❑ Signature of Owrier or Owners Agent By checking this bo ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of'my knowledge and that all sheet metal work and installations.performed under the permit issued for this.applicaticin will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments i 1 Final.Insioection I Date Comments I Type of License: 3y aster ritle i' ❑ Master-Restricted 'ityrrown ❑Joumeyperson . Signature of Licensee IJ 'ermit# 'J ❑Joumeyperson-Restricted License Number:. 7 7Z . =ee$ Check at www,masgovldpl I nspector Signature of Permit Approval I r , Client#: 13386 2BAYSIDEEL ,ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(YWDDtY1fY`n 10ro7/2014 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 certlficate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights.to'the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling 8r O`Neil PNONE 508 775-1620 a N„ 5087781218 A/C No E:t Insurance Agency E-WUUL AOORES_S: 973 lyannough Rd., PO Box 1990 INSURER(S)AFFORDING COVERAGE NAlca Hyannis,MA 02601 INSURERA:Acadia Insurance INSURED INSURERB:Guard Insurance Group Bayside Electrical Contractors,Inc. INSURER c:Union Insurance Company 372 Yarmouth Road INSURER D Hyannis,MA 02601 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUES 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. LT R TYPE OF INSURANCE ADD BR POLICY EFF POLICY QP LTR INSR WVD POUCYNUMBER YMID LIMITS A GENERAL LIABILITY BINDER383921 10/05/2014 10105/2015 PEACH CECCTOURRENCE E 1 000 000 AVG X COMMERCIAL GENERAL LIABILITY P42MES11300 0O CLAINIS-MADE F R OCCUR MEDQP -�� .te PERSONALbADV INJURY $q 000000 GENERALA6 REGATE 1006,700 GENL AGGREGATE UIUT APPLIES PER °ROO1--TS-•C pQMPIOP AGO 12,00M00 F—IPOLICYFIM LOC. H E C AuroatoBlLEuAB1uTY BINDER383923 01051201410105/201 MBBIIND SIMPLEUMIT -'"-I,00 CIO ANY AUTO BODILY WJUR,�I(Per perser). ALL OWNED SCHEDULED BODILY WJ'JR (Per sodden[) S Q X AUTOS AUTOS NON-AWNED PROPERTY DAMAGE -� T•� X HIRED AUTOS X AUTOS 'Per ecddem rT7 X W.Oth Car S A X uYBRELLAUAB X OCCUR BINDER383924 0/05/2014 1010512015 EAcHOCCURRENCE s2 000 000 EXCESS LIAR CLAIMS•MADE AGGREGATE s2,000,000 DED I X RETEVTION$O S B WORKERS COMPENSATION BAWC560112 8/18/2014 08/18/201 X TO Y t IMI oTH- AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L EACH ACCIDENT SSOO 000 OFFICEROMEMBER EXCLUDED7 . FN N/A (Nsdatory In NH) EL DISEASE-EA EMPLOYEE $500 000 r yes.descri3e under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT 1$500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD IM,Addltlonal Remarks Schedule,N more apace Is required) Certificate holder is named additional insured when required by written contract. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived, or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED W 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S138795JM138754 LS1 01/02/2020 22:44 FAX �Q �/ /r�CJ Q 001 Town of Barnstable Regulatory Services • RARM MAUM • Th01nas F.Ge.iier,Director Building:Division rom Terry,Building Commissiouer 200 Main Street,Hyannis,MA 02601 www.town.barnstable.rnams Office: 508.862-4038 Fax: 508-790-6230 Property Owner Must C.ompletc and Sign,.rhis Section If Using ABuilde-r 1cr of the subject pn)prrry here b y authorize ji Zi 1( '! _.__—....._...__..to act on my behalf, - ' in all.mittens relative to work authorized bydh s Building permit application for. 0. IL (Address of job) 77:5 ----- __--- Signature of Chvne Date I'ri.nt Name If Property(Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OR'NF KPF..KMIS S IQ,y I The Commonwealth of Massachusetts Department of Industrial Accidents ®ffice of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Numbers Applicant Wormation Please Print Le bI Name(Business/Organization/Individual): Q •Address: ►Nl A .4h 12�a a d 1 City/State/Zip: M001 Phone.#:_ 6 Q6777 7Z Are you an employer?Check the appropriate box: Type of project(required):: 1. I am a employer with 3 5 4• ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 New construction . 2.❑ I am a'sole proprietor or partner- listed on the•attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g, Demolition working for me in•any capacity. employees and have workers' o workers' co co *• 9. ❑Building addition [N comp.insurance �•instirance.- required] 5. ❑ We are a corporation and its 10.V Electrical repairs or additions 3.❑ I am a homeowner do' all work officers have exercised their � i i 1.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12 ❑Roof repairs insurance required.]t c. 152, §1(4), and we have no employees.[No workers' 13. id Other f}Yp C comp.insurance required] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. JContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees Below is thepolicy and job site information. Insurance Company Name:_ ( )/,�Y t� �)r an(-e. Policy#or Self-ins.Lic.i$ W C (' 2 Expiration Date: 15 Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investi ations of the DIA for-insurance covcra e verification. I do hereby certify un th a* r� n� ' s ojp rju, lh >*ie information provided above is true and correct- Si ature: • Phone# " 2 7 77ran . Do not write in this area, to be completed by city or town officiaL Permit/Licease# y(circle one): 1.Board of Health 2.Building]department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: i ' Client#: 13386 2BAYSIDEEL ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE 04/(.MfDD(MM/DD/YYYY) 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620FAX Insurance Agency E-MAIL No Ext: Arc,No: 5087781218 ADDRESS: 973 lyannough Rd., PO Box 1990 Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Acadia Insurance INSURED BaysINSURERB:Guard Insurance Group 372 Yae Electrical Contractors,Inc. INSURERc:Union Insurance Company 72 Yarmouth Road Hyannis,MA 02601 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. LTR TYPE OF INSURANCE IIN R WVD POLICY NUMBER MM/DDY EFF IP�CCY EXP LIMITS A GENERAL LIABILITY BOA500837813 0/05/2014 10/0512015 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY PRAEMISES ERa o .D nce $300 OOO CLAIMS-MADE 51 OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PR-1 LOC $ C' AUTOMOBILE LIABILITY MAA500838213 0/05/2014 10/05/201 COMBINED SINGLE LIMIT Eaacddent 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per a.dent X rive Oth Car $ A X UMBRELLA LIAB IV I OCCUR CUA500838313 10/05/2014 10/05/2015 EACH OCCURRENCE $2 000 000 EXCESS LIAR CLAIMS-MADE AGGREGATE s2,000,000 ' DED I X1 RETENTION$0 $ B WORKERS COMPENSATION BAWC560112 8/18/2014 08/18/201 X T C STAT T OTH- ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 OOO OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Job:94 Wilson Ave,Framingham,MA Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION OCPD LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 4847 ACCORDANCE WITH THE POLICY PROVISIONS. Framingham,MA 01704 AUTHORIZED REPRESENTATIVE `ez�� ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S149681/M149680 MER I { R, WE S _ � :.:. •'•:�.Ala El�-bz 4NMyMBEF,7il��1 S COTUITIMA 026352544'`�i�'��+ ��u $" iiP'�Y.��ta��i'��Ti`.sY000t•aszouw�o�sY2ao9 _ x� �! fir! ` ��`COIVIIVIONVV�, . • • • EALTHOF MASSACHU3ET�s y '� r _ t r Y - • • ,v;COMMONWEALTH'OF MASSACHUSET s A e"y J + s o r>4 + Rx ?ate 1 st sSHEET METgL«, " s <r SHEE �L��WORKERSFa� sty i'ISSUES'THE '� � fWORKERS vas'., �� .:tr �: ts� � FOLL F � ISSUESr`fTHEo FOLLOWaNG'L[CENSEkr� -AS""�° OWf kG L I CENS t"r AS A MASTER`UNRESTR ITED k sw cABUSIMESS t °ems s ¢:;' vr �Xs L HEBERT a' " +'DONALD L' HEBERT 4'. A DE'EI ECTRI CAL a= t t ,w 7 YARhI0l1TH tea, CONT S I RD M ' '. !�' z jl0.�PHEASANTH M '0 Af026a< - • a:w a_„ a,} l m=.. H i.E't .�k ._k <� nu ro'OFR�. 6kj st `.�7 PROJECT,- NAME: DeA/yt a f e�C)k c� ADDRESS: PERMIT# tO 1 On`l -) .PERMIT DATE: Ll cl LARGE ROLLED PLANS ARE : B O .� SLOT 3�3 Data entered in MAPS program on: BY: ` ACORD - CERTIFICATE OF LIABI I DATE(MMIDD/YYYY) RANCE 09/22/2014 PRODUCER 508.997.6061 ; FAX 508.990.2731 TH RIS CAT IS ISSUED AS A MATTER OF INFORMATION Southeastern Insurance Agency, Inc. ON Y NONF S NO RIGHTS UPON THE CERTIFICATE OLD R. CE TIFICATE DOES NOT AMEND,EXTEND OR 439 State Rd. LTE THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 North Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE NAIC# INSURED Gilfoy Construction Inc INSURERA: Arbella Protection Insurance 41360 123 Davisville Road � \JD INSURERB: Assoicated Employers Ins Co. East Falmouth, MA 02536 1 Jl INSURERC: V 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. rA DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS NSR DATE MM/DD/YYYY DATE MM/DD/YYYY GENERAL LIABILITY 8500015069 09/29/2013 09/29/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED— X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 100,000 CLAIMS MADE � OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO LOC JECT AUTOMOBILE LIABILITY 1020018693 02/01/2014 02/01/2015 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ 1,000,000 ALL OWNED AUTOS BODILY INJURY r $ A 1X� SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) 1,000,000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F—ICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X C - - AND EMPLOYERS'LIABILITY TORY LIMITS ER B OFFICER/MEMBERANY OPRIET EXCLUDED?ECUTIVEa WCC-500-5012429-2013A 08/19/2014 08/19/2015 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 } e S yPECIAL PROVISIONS below s,describe under SHAWN GILFOY IS INCL E.L.DISEASE-POLICY LIMIT $ 1,000,000 S 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 DAYS WRITTEN Town of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Building Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street REPRESENTATIVES. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Joanne Bretton ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r - IMPORTANT ' If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. IJ 4 i ACORD 25(2009101) X TYC Crude to kVood Canstructiarr irk ffrgfr Find areas: 110 trrplr Wn d Zone Massachusetts Checklist for Compliance (7so C>l&1R53012.t_r)l Laadbearing Wall Connections - Lateral (no.of 16d common nails)__-__•_---.._:._-_---_-•--(Tables 7)_��GG_!�_- _-v 51" a- Non-L oadbearing Wall Conneciions Lateral(no-of 16d common nails)---______._._—.(Table 8)_�`Q_�L----- Load Bearing Wall-bpenings(record largest opening but check all openings fnr compliance to Table 9) K12 Header Spans (Table 9)..__:-----------._. . /U ft !n <11' 3 f3 - ----- -- --__ - (T ) Sill Plate Spans ' (Table 9)-.____ �•_-•`_'°: aft_rn _<11` - - -- - - - -•-_-•-•--- Full Height Studs (no. of �---(Table 9).__.____------------•-•_- _ [1 Non-Load Bearing Wall Openings (n�cord largest opening but check all ope�iggs$or Compliance to Table 9) -7— Header Spans-____-_--_:-_--------- ---- -- -(Table 9)-- �/�-/-t� - --._ft_in_15�1z Sill Plate Spans.----..__._----------------.-____---_.(Table 9)___- - _ft_in•512' Full Height Studs(no.of studs)-••--••------ _----_--(Table 9)___ -•_---_----_----_._—___-- Extsrior Wall Sheathing to Resist Uplift and Shear Simu!taneously4 Minimum-Budding Dimension, W - Nominal Height of Tallest OpaningZ .._.__._. -. < --- --- - =-- - -- -- - --6'B' r Sheathing Type- -- ---- -- -- -- (note 4)--------------------------------------- -Edge Nail Spacing-------- •_--_-:—,._--(Table 10 or note 4 if less)----------_--___ in. --2tr Feld Nail Spacing------ ----- --: ---.....(Table 1 D)------------ --- ---- .—. !n Ia it Shear Connecien(no.of 16d common nails)(Table 1D)-------- _-------•-_---__--.-_--.----_-�-- r � PertentFulpHeightSheathing.-_-------------((able 1b)---•_-------------.------------__.. % Cr 5%Addrlional Sheathing for Wall with Opening>S'B`(Design Concepts).__.__.._._._ Maximum'Bulding Dimension, L Nominal Height of Tallest Openingz----------------------------------------------------------------------- Sheathing Type---------------- - - - (note 4) - --- - - ---- - -- - �K Edge Nail Sparing-----_-------........-------_____{Table 11 or note 4 if[ess)__—__..___-•- m. _ Field Nail Spacing.-----------.--_.___.,..._-.--_.(Table 11)--___---------_. - --------- Im r. Shear CDnneCSDn(no. of 16d common nails)(Table 11)---------___._._..__._____-_._._.._•:__-•_ �-//�00 Percent FuikHeight Sheathing--.____--.----_(Table 11)---------------------------------_-----��A 5%Addrdonal Sheathing for Wall with'Opening>SS'(Design VVatf Cladding Rated far Wind Speed?--.-----� -- - ----- -- 5.1 ROOFS Roof framing member spartts Checked?.-•----------_-__-.(For Rafters use AWC Span Tool,see B.BRS Website-) Roof Dverhan '�?ti------_----- ---------(Figure 19 ff s smaller of 2'or U3 $'r ' Truss or rafter Connections at L-Dadbearing Walls Proprietary Connectors UPrrff--------------_------------------(fable 12)--------- •------ -- -----U= a� if Lateral.....__ ----- able 12 .__—__-------____-- - --�_? - Shear------------------•--------------fable 12)--------------•-•-- P. - Mdge Strap Connections,if collar ties not used per page 21... (Table 13)---------- - pff Gable Rake or C12 Outlooker-...................----------_--_-_-- F ure 2D ft smaller Of 2' 9 ) •---••-•-••- Truss or Rafter ConleCtiOns at Non-Lnadbearing Walls Proprietary Connectors r4a�OC. Uplift--- -- ------:(Table 14)-- --- ----------U__ !b. Lateral(no.of:f6d Common nails)__(Table 14)-------------,-------.----------------- = Ib. - Roof Sheathing Type—___.__.:.__._—_______—__._(per TBD.CMR Chapters 5B and 59 rj c 0 4 Roof Sheathing Thickness----•---.--.----------:__--_ ---:-------------_-__in.?7116'1vSP Roof Sheathing Fastening-_____—--------------------(Table 2)-_------,---.---:______-._..---------.._..(i r`• dotes: - - f, : This chaddrsf shall be met in its entirety, excluding the spat is exraption noted in 2, to comply with the requirements of TBD CMR.5301.2.1.1 Item 1. If the checld'ist is met in its entirety than the fo[lawing metal straps and hold downs are not nEquired per the WFCM i 10 mph Gi ide: a. Steel Sflaps per Fgure-5 6. 2b Gage Straps per Figure i 1 a- Uplift Straps per Figure 14 c� Alt Straps per Figure 17 a Comer Stud Hold Downs per Figure 1Sa and Figure 18b. Exception:Opening heights of up to B fL&}tall be permitted when 5°A is added to the percent full-height sheathing nqulraments shown in Tables 10 and 11. The bottom sill plats in exterior walls shall be a minimum 2 in.nominal fh Ckn&ss pressure ti—Gated#2 de AWC guide to Wood Cons-tr acdorr ur Hji� r Knd Areas:_ 10 * 'k k�ndZorre• Massachusetts Checkdgt for Com'p ianee (78o arizs30t2_f.l)r - E?1 chi Cbmp1iancc. 1-1 .SCOPE Wind Speed(3-sec gust)-.--_ _._;__-.._--.--_. _:____ _._.___.-._---------_..-•----:-------_._110 mph Wind osure o Wind Exposure Category................Engineering Required For Entire Project--...._...___ ._ _...----••- .._...0 12 APRUCA.BIUTY Number of Stories(a roof w Wch exceeds 8 In 12 slope shaIl be-considered a story) �' stories _<2 stories Roof Pith _.._-...------------- Mean Roof Height'_-_- --- ---- =-(Fig 2)- ------ -------------------- 'ft s-33' Building Width,W_ - --------—-------------- - -- -(Fig 3)-- - -- =------- ft 5 a Building Length, L -•----------- _ _ --- -�-- -(Fig 3)-------------- -- --- .... ';1 5 80' Building Aspect Ratio(V - -- -(Fig 4) -- --- ---- -� - - -- 7� _<3:1 Nominal Height of Tallest Opening? 1-3 FRAMING CONNECTIONS General compliance with framing co-nnections_...._____—.(Table 2) 9 4i 00 2.1 FOUNDATMN ' Founda5on Walls meeting requirements of 780 CMR 5404.1 r, C.DnciEte--.........•.........•......•........................................ r Conctate Masonry.......------------ ------------------- =--•---- 22 ANCHORAGE TO FOUNDATIDNt'' 5/8'Anchor ROts4mbedded or 5/8'Proprietary Mechanical-Anchors as art alt-emative in concrete only S Bolt Spacing-general.....................................---:.'(Table 4)------------------------------------------- Bott Spacing from endloint of plate...........—>._------•(Fig.5)----------__---------------------- in.5 6'-12', Q� Bolt Embedment-concrEte_--- -- - -_---------(Fig 5)------ - = y-- in._7' Bot Embedment- - _ -- =- --(Fig 5)-.; _ ------------ in.>151 Plate Washer_'- ' asher..- — - -- - -------- - (Fig 5) ------- -------- -''-3+x 3`x Y' 3.1 FLDDRS Floorframing member spans checked:-.---_----------_----•(per 7BO CMR Chapter 55)_________-___________-_-• Ma)jmum Floor Opening'Dimerrsiori_---_---------------•--•(Fig 6) _-- _. ft<_12' Full Height Wall Studs at Floor Openings less than 2`from E�r'ior Wan(Fig 6)_________________________ ......... Mk_dmtim Floar Joist Setbacks Supportng Laadbearing Wallis or Shearwall___---_(Fig 7).___•-------_-__-_._--------___-- ' ft s d Maximum Cantilevered Floor Joists_ . Supporting Loadbearing Walls or Shearwall......._-_---(Fig 8).....---------- -.-_ ft _<d . FloorBracing at EndwafLs--- - - ---- _- (Fig - Floor Sheathing Type '.:_---.----------_••-------____._------(Per 780 CMR-Chapter 55)------------------- Floor Sheathing Thickness ---•--------_----__-------- (per 78d GMR Chapter 55):_._.____--__:_. in. Floor Sheiathfig Fastart ng____--------- __...____.:__..=__.(Table 2)_ _d nails at in edge!_in field 4.1 WALLS Wall Height Loadbearing wars.----_----•--_ :_--.(Fig 10 and Table 5)__..-----,----_--•_ft _c 10' Mon--Laaobea6ng-toffs..___.__-=.----_----- (Fig 10 and Table 5)---------------------_ft's 20, Wall Stud Spacing _ (Fig 10 and Table 5)-__._:_ _in,<24'o.cL /--7 . Wan St Offsets- --- --- ---- __-- �_(Figs 7 B)--------- ft s d 42 DCTERI OR-WALLS' Wood Studs Loadbearin vlalLs:.-.-----•_-•_---- ' g _ ..__.._--------------•(Talale�}__--=-----------_-_-....2ac�-_ft_tn. Non-L. armebring-walts.-.-._..-----_.-------.•----_•_--___---.(Table.5)--------------------------2x --ft_in. Gable End MR Bracing' Full Height Endwall 5h rds._ - --- --_ - (Fig --- WSP-Attic Floor Length------. .-•-----(Fig 11}----------._---- -------_.__ ft�:W/3- 'Gypsum Ceifing Length(rf WSP not used) -=-(Fig 1I)._- ft?0.9W abd 2 x 4 Continuous Lateral Brace @ 6 ft o.c-(Fig 11�......................__......-- ------_---•- br 1 x 3 ceiling fim ing strips @ 16'spacing min.xiffi 2 x 4 blocidng L 4 ft_spacing in end joist or truss bays Double Top PtaEe Splice Length - --•- - _---(Fig 13 and Table 6) ft Splice ConneC6Dh (no-of 16d carnmon nails)----------(Table 6)--=----------------•-------- �/.-/GrJ L ?M,R'$�C1 V 1`� sD iCi¢0`� I/VtAt�NO Avvil OSTeN-v(Lt.¢/ l'/A IOF `f V4FC4 4-1 IVC Guide to ffoad Construction in High Wind Area.': /10 mph Wind 'Luce Massachusetts Checklist for Compliance (780CMR53t11.2.1.1)' 0 Check Al t4 Compliance 1.1 SCOPE WindSpeed(3-sec. gust).................................................................. .................................................110 mph WindExposure Category.................................................................. ....................................................G... X 1.2 APPLICABILITY Number of Stories ..............................................................(Fig 2)............................ 3 stories <_2 stories RoofPitch ..........................................................................(Fig 2) ........................................k 2 L< 12:12 MeanRoof Height ..............................................................(Fig 2)..................................... 3 ft :533' BuildingWidth,W ...............................................................(Fig 3)..............................................; ft <80' BuildingLength, L ..............................................................(Fig 3)................................................r�2ft <_80' BuildingAspect Ratio .... .. . . '' P (LAM . . ....................................(Fig 4)..............................................�,� _3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4)..................................................f� 6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry ..................................................................... ................................................................ 2.2 ORAGE TO FOUNDATION7.3 3' 5/8"A chor Bolts imbedded or 5/8"Proprietary Mechanical Anchors s an alternative in concrete onl olt Spacing-general ..........................................(Table ...................................0......... in. ' Bolt Spacing from endloint of plate ............................(Fig 5).................................... —li in. 5 6"-12" Bolt Embedment-concrete.........................................(Fig 5)..................................................L in.>7" Bolt Embedment-masonry.........................................(Fig 5)............................................ -` in. >_ 15" PlateWasher...............................................................(Fig 5)...............................................a 3"x 3"x '/4" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)..........................L/Zft<_ 12'or L/2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)........................................ Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7).................................................... — ft <_d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)....................................................=ft <_d FloorBracing at Endwalls...................................................(Fig 9).................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).......................... ......... Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)....................'S in. Floor Sheathing Fastening..................................................(Table 2)..$d nails at_Y0 in edge/lZ in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)......................... . ft 5 10' Non-Loadbearing walls................................................(Fig 10 and Table 5)........................... ft s 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)...................1 i in.<_24"o.c. Wall Story Offsets .........................................................(Figs 7&8)............................................ — ft <_d 4.2 EXTERIOR WALLS Wood Studs ft in. Loadbearing walls.........................................................(Table 5)..............................2x ft�in. Non-Loadbearing walls................................................(Table 5)..............................2x Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10).......... ... WSP Attic Floor Length................................................(Fig 11 �J..... ...::..._... ..'. ft>_W/3 ( 9 )......... .. ypsum Ceiling Length(if WSP not used)...................(Fig 1 a 0.9W �,pF MASSgCy 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. ..(Fig 11)............................._............................. HA �g NE�o p Plate / ► o �Gop1��P� key Length ...... . ....... ..� ... K.... 11.�Fig 13 and Table 6).2(e�.7....INAI.C.�.. .. ft �VGtU 4 pli Connection (no. of 16d c m-on nails)..............(Table 6).................................................... ....�D 5T 3A7 10, FGIS��P�'C>2� `� SS101A �NfCH AWC Guide to lVood Cotistruc•tion ur High Wiud Areas: I10 mph Wind 7.one Massachusetts Checklist for Complian/cAAe--(780 C M R 53411.2.1.1)1 Loadbearing Wall Connections mm9 -YOU-4-cm Lateral(no.of endnailed 16d common nails)..............(Table 7)........................................................ 2 Non-Loadbearing Wall Connections Lateral(no. of endnailed 16d common nails)...............(Table 8)........................................................ !i Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9)................................. ft in. <_ 11"'�(3)Pa6 Sill Plate Spans ........................................................(Table 9).................................�ft in. <_ 11'Full Height Studs (no. of studs)...................................(Table 9)........................................................nk. /J�1/,, Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9).................................. ft y in. s 12' SillPlate Spans...........................................................(Table 9).................................. ft in. s 12" Full Height Studs(no.of studs)....................................(Table 9)................................:....................... Exterior Wall Sheathing to Resist Uplift and Shear imultaneously° Minimum Building Dimension,W=5�t e9w Z(5e� Nominal Height of Tallest Opening .............................................................................._5 6'8" Sheathing Type..............................................(note 4)...A.,1.74.......................................1ji_L Edge Nail Spacing.........................................(Table or note 4 if less)........................ in. Field Nail Spacing..........................................(Table 10)................................................. in. Shear Connection no. of 16d common nails �r....... Ft ( )(Table 10)........................................... Percent Full-Height Sheathing.......................(Table 10)........................................��:�:Q >t 5%Additional Sheathing for Wall with Op nin >6'8"(Design oncepts �..�.... I Maximum Building Dimension, L = 82! �5� N P��) � x�� G >Jr`f'�/,�rS�N11 Nominal Height of Tallest Opening ............................. Sheathing Type..............................................(note 4).. Of?........................................ � Edge Nail Spacing Table 71 or note 4 if less)........................ _ in. Field Nail Spacing..........................................(Table 11)................................................. 17- in. Shear Connection(no.of 16d common nails)(Table 11)..........................................�...... Percent Full-Height Sheathing.......................(Table 11).........................................3 a.... V' n S 5%Additional Sheathing for Wall with Opening>6'8" (Design Concepts)z.......2t'.r•. T__ Wall Cladding r 32 u Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ................... ............................... (Figure 19)............4-2 ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors -1ee , 1'' Uplift................................................(Table> )/!...................................:.....U--✓ Cnt)A Lateral.............................................(Table 12)..............................b ....... (Ala/�INC Shear...... ... .....................(Table 12)............................/....� .�..S= 2 Ridge Strap Connections, collar ties o sec r page 21..... (Table 13).6[L.......................T= Gable Rake Outlooker......................................... (Figure 20).P/A.....=ft s smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift:...............................................(Table 14).......... ...............................U= - lb. Lateral(no.of 16d common nails)...(Table 14).......... ............................L= ' lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. Roof Sheathing Thickness........................................... ...................................... 7,"in. a 7/16"WSP Roof SheathingFastening ..... 9 .......................:...................(Table 2).....�?�::t?.`j. Notes: 1. This checklist must be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item'1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a 2. Exception: Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. OF MA MAss 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness. pressure treated#2-grade. pit qoy MICR ELE GAF GG o CuI)II- S RAL n TFtUG�U ,A„a '0 9FQISSEP�G�� SS100- 1, ERAL NOTES AND MATERIAL SPECIFICATIONS: (Residential IRC Construction) SK-1 G EN l latest FOUNDATIONS others. v rkmanship to conform to the requirements Plan Massachusetts State Buildingvel come ositionedOther soils encountered, I•All ° radio information.se 2. For site location and grading 3000 psf,for a medium sand/gra 3. Assumed net allowable soil bearing capacity,q= designed per American Concrete Institute Code,latest contact the Engineer of Record. psi,3/4"aggregate. 4. Conc Minimum 28 day strength,fc=3000 pr Code Checklist,or in 4„ ��,/2_1/2"hook spaced per e Bement,etc.). issue,maximum slump= alvanized,min.5/8"diameter, 12"long, construction(i.e.Gig a.) Anchor bolts ASTM A307 g SPACED 2' o/c for slab-on-grade concrete piers w/Simpson ABU-series base; prevent shrinkage b•) All walls to have min.2#4 top horizontal;2"clear,to in between wall joint. c.) All walls longer than 25' shall have vertical control JO1 Massachusetts State Building Code,latest edition. FRAMING withwaterstopP l All workmanship to conform to the requirements oft e 2.Structural Design Loads: g g Components sf plus drift)With applicable reduction Dead Loads:Actual Weight of Building Live Loads:Snow Load =30 P20 sf ATTIC Storage Living Floor=40 psf Sleeping Floor=40 psf r lans sf Wind Load: Criteria used for 1 Decks and Balconies= P 10 MPH Exposure B or C as note per P Structural Steel- required) paint.Thru-Bolts: ASTM A30 a. ASTM A572 Grade 50;shop pa 7, 1/2"diameter,punched holes: 3. pain rust inhibitive p use E70xx electrodes. 9/l6"diameter. plates to columns:shop weld bearing plates to beams: b. Welds: Shop weld cap and base Alternatively,field weld by certified welders. c. Deflection Criteria: L/360 total load deflection. _ psi,or better. 4.Timber��' Pine-Fir No.2 with Fb=IOOOp''EEI 600 000 psi,or better. r=750 psi, a.All new timber framing:SP psi.E=1,900 ksi,Fv=285 psi,Fc�e p•T. Southern Pine with Fb=1300 p psi:Fc er-750 psi, b.Pressure treated timber( ) shall be psi.E=1,900 ksi,Fv=285 p c.Laminated Veneer Lumber:AIIAI V.L.Sshall be min E1.9E ES with Fb 900 Fc_par=3035 psi. parallam(PSL): be used interchangeably. Fc-ppar-2900 psi. Note that Microllam and Parallam may royal prior to materials purchasing• 1. Deflection Criteria: L/480 Live Load,L/360 Total Load 2. Optional: Provide shop drawing submittal of engineered lumber systems for approval P 5,Meal Connectors: Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail As manufactured by Simpsonspecified by mfgr.or herein. ► wood,spaced 16 aced l6"o/c holes filled,with the size nail as or Simpson Straps over top of plywood sp a. Rafter to Ridge Beam. Simpson LSSU-senes,or Simpson Straps over top o P Y Rafter to Ridge Platte: C S meson H2.SA6@ 16"o/c at top Dist b. Rafter ends to top p sat 4'o/c: CS-14R-48"centered at band J c. Band Joist: Simpson strap 6.Bolts: malleable iron washers,or square plate washers.All nuts shall be Bolts in wood framing shall be standard machine bolts unless noted otherwise.Bolt holes in wood shall be l/32"larger than bolt diameter.Bolt heads and nuts shall bear on standar ma retightened at completion of job. 7.Blockin g th of member. plywood e nailing a.Blocking shall be solid blockin .2x minimum,and full dep b.Stud Walls.provide blocking at 8;-0"o/c,maximum he'g Comers to be blocked at 48"o/c with I woo edge to this blocking for the first 48' of these building comers- c.Nailing Schedule: 2-8d toenails ea.side attach Solid Blocking to Bearing lane at all edges; Blocking Between Studs 2-IOd toenails ea.end,or 2-16d end-nails ea.En New Framin :Provide 2x blocking for 2 joist/rafter bays and spaced 48"o/c in joist and rafter p i is blocking plywood edgesth 8.Nailin Schedule: Appendix 120.Q,unless noted herein specifically. All nailing shall be in accord b eC 12"staggered Multiple Studs a.All nails shall be common wire nails. b.Sub-bore where;nails tend to split wood- use 2_2x6;all others than 4'-0", per MA State Building Code. 9. Headers less CONSTRUCTION DETAILS FOR THE APA NARROW WALL BRACING METHOD / FIGURE 1 NARROW WALL OVER CONCRETE OR MASONRY BLOCK FOUNDATION Outside Elevation Side Elevation ---- -- Extent of header(two braced wall segments) ---- - i I i Top plate continuity is Extent of header(one braced wall segment) - i I required per R602.3.2 Sheathing filler ' ' 3'"z L1=t/4• needed re - if�i-cesdj r., 2'to 18' finished width ----- ,., • �•� ( ) S }. �• 16d sinker nails • �_ w•� I ' 0.148"x3-1/4" Fasten sheathing to header with 8d common j; (� � ) • nails(0.131"x 2-1/2")in 3"grid postern as shown S v° in 2 rows @ •r and 3"o.c.in all framing(studs and sills)typ' j f 4 N. 3"o.c.' �..1 �•) 1,000lb.heoder-to-jack-stud strop w; , '"• 11,000 lb. header- ' MI on both sides of opening „'Y. to-jock-stud strop (install on backside as shown on on both sides Max. I;; ^•i Side Elevation,Ref.No.LSTA24) ww ` w of opening(Ref. height 10' �i Min.(2)2x4 yp. �^ No. LSTA24) , w � )''' Braced wall 'N If panel splice is needed it shall occur within 24"of mid-height. segment per ; M 44 ,o��. g R602.10.5 ,j �ti' ;r 3/8"min. Blocking is not required. ; "� thickness wood structural panel ^' �• Min.width based on 6:1 No.of' ''w ^' sheathing height-to-width ratio:For jack studs "^, w• , example:16"min.for 8'height, per table i 20"for 10'height,etc. R502.5(182) „ `�• ;, ;o ;w•i ;;. Min.TxT0/16"plate washer — —— Anchor bolt per R403.1.6 Typ. Foundation per code Not to scale 'Or other code-recognized fasteners providing lateral resistance equol to or better than the prescribed nails. Not,!- This narrow.call bracing sel;r�etii nweis use mininiu i req'mn:nieni< !ot wall br.,cii:g FIGURE 2 trA,Amg !oad, in the plane ,t i:ie w.i!1) The Innldu:g de,igner Should deterrenc what 'pe EXAMPLE OF REQUIRED OUTSIDE CORNER DETAIL(IRC R602.10.5) rtL,dnails are ne:es,ary•to pt'oetde a .,mytlrir fond bath Inr cant;dn,hraemg in J�.-� _ At corners,connect the 16d nail of 12"o.c. two walls together as outlined in this detail to provide overturning Orientation of stud may vary restraint. i / Gypsum,when required, / �/ installed in accordance with IRC Chapter 7 ��-- Wood structural panel 6 `w tom, @ 4166N11"No Ave , , 0570 . N , r-M 11A aF 4- .4 W'C'Guide to Wood Constructu►n in High Wind Areas: !10 nrph Wier!%our Massachusetts Checklist for Compliance (780CMIR 5301.2.1.1)' 6*rLA_&e9 0 Check Compliance 1.1 SCOPE WindSpeed(3-sec. gust).................................................................. .................................................110 mph WindExposure Category.................................................................. ..................................................�..... 1.2 APPLICABILITY Number of Stories ..............................................................(Fig 2)............................_stories <-2 stories RoofPitch ..........................................................................(Fig 2) ........................................... t5 12:12 MeanRoof Height ..............................................................(Fig 2)............................................ . . ft <_33' BuildingWidth, W ...............................................................(Fig 3)................................................ s 80' BuildingLength. L ..............................................................(Fig 3)................................................. 3 <_80' Building Aspect Ratio(UW) ...............................................(Fig 4)..............................................�,. :53:1 Nominal Height of Tallest Openingz ...................................(Fig 4)................................................ <_6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)................................................................ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.............................................................................................................................. ConcreteMasonry .................................................................... ................................................................ 2.2 ANCHORAGE TO FOUNDATION'.3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an altemativq in concrete only _5.=V Bolt Spacing-general ..........................................(Table 4)....... . 7 . ..i.r......... in. Bolt Spacing from endfjoint of plate ............................(Fig 5).....................................�i in.s 6 -12" Bolt Embedment-concrete.........................................(Fig 5).................................................--Z in.a 7" Bolt Embedment-masonry.........................................(Fig 5)............................................ - in. >_ 15" PlateWasher...............................................................(Fig 5)...............................................a 3"x 3"x'/4" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension...................................(Fig 6)............................ — ft<_12'or U2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)........................................ Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7).................................................... —ft s d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8).................................................... —ft <_d FloorBracing at Endwalls...................................................(Fig 9).................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).................................... Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)....................... -- in. Floor Sheathing Fastening..................................................(Table 2)..—d nails at —in edge/ ----in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and Table 5)...........................Cq ft 5 10, Non-Loadbearing walls................................................(Fig 10 and Table 5)........................G[aft s 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)...................0 in.s 24"o.c. WallStory Offsets ........................................................(Figs 7&8)............................................— ft s d 4.2 EXTERIOR WALLS3 Wood Studs Loadbearing walls........................................................(Table 5)..............................2x ft _ in. Non-Loadbearing walls................................................(Table 5)..............................2xG ft in. Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10)................................................................... WSP Attic Floor Length................................................(Fig 11)............................................. — ft>_W/3 Ana Gypsum CeilingLength if WSP not used ....(Fig11 ?..2,'!-ft a 0.9W �F SSgCyG yp 2 x 4 Continuous ous Lateral Brace )..6 ft. o.c. .. Fi 11)..•. .... ... .... ... ... .... s� @ (Fig )............... �0 D L Top Plate t G��1 Q► `�` ice Length . ...... ... .................... ...............(Fig 13 and Table 6).. �j,.Q'. 6 ice Connection (no. of 16d common nails)..............(Table 6)..... .............................................. .... -� ZZ r Z / 1/ - � eo►st�P�� - G �1�� 2� 5 p Lie.e SSIONP�'�/� A WC'Guide Io lVood Construc•tton ut High Witid Areas: //0 mph Wittd Z. Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)' Loadbearing Wall Connections 1knA&':e Lateral(no. of endnailed 16d common nails)..............(Table 7)..............j. S.. .......... ................. Non-Loadbearing Wall Connections Lateral(no. of endnailed 16d common nails)...............(Table 8)........................................................ Load Bearing Wall Openings(record largest opening but check all openings for complian to Table 9) Header Spans ........................................................(Table 9)........................... -ft SillPlate Spans ........................................................(Table 9)............................... . —_in. <_ 11' Full Height Studs (no.of studs)...................................(Table 9).............................. ...... ............... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9)..................................�ft=in. 5 12' SillPlate Spans...........................................................(Table 9).................................._3 ft in.<< Full Height Studs(no. of studs)....................................(Table 9)........................................................ + Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously° Minimum Building Dimension,W I N Nominal Height of Tallest OpeningZ ............................................................................ <_6'8" 7 SheathingType..............................................(note 4)...................................................... Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ in. Field Nail Spacing..........................................(Table 10).................................................jj:in Shear Connection(no.of 16d common nails)(Table 10)............................... ............... .. ..... � Percent�Full-Hei ht Sheathin Table 10 .................... ..i�..3.� 9 g................... ( ) 5%Additional Sheathing for Wall with Opening>6'8"(Desi Concepts)..................... Maximum Building Dimension, L i Nominal Height of Tallest OpeningZ..................................................................... d s 6'8" SheathingType..............................................(note 4).................................................... VJsP Edge Nail Spacing.........................................(Table 11 or note 4 if less)........................in. Field Nail Spacing..........................................(Table 11).................................................1 Shear Connection(no. of 16d common nails)(Table 11)....................................... OA 3�- Percent Full-Height Sheathing.......................(Table 11)......................... .. /o 5%Additional Sheathing for Wall with Opening>6'8"(Design oC ncepts)..St '......... Wall Cladding Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked? .......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ................................................... (Figure 19)...........!9,- Zft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls SfA4 r_22 t 2 Proprietary Connectors Uplift................................................(Table 12)............................................U= Lateral.............................................(Table 12).....................................:.......L= Shear................ .(Table 12)................................... S= Ridge Strap Connections, i collar ti of se er page 21..... (Table 13). ............ /��E....T= Gable Rake Outlooker.. (Figure 20).N �Zft,�smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift.:..............................................(Table 14)..... .....................................U= - lb. Lateral(no.of 16d common nails)...(Table 14)...... .................................L=, lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. Roof Sheathing Thickness........................................... ..................... . 7 in.>_7/16"WSP Roof Sheathing Fastening ...........................................(Table 2)d` �d.�. .. .c.........5?$la ......... Notes: " l� >Fl�_W 1. This checklist must be met in its entirety,excluding the specific exception no(pted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item'1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a 2. Exception: Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. - ASsq�ti 3., The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness. pressure treated#2-grade. 4: cul C� C STRUCTL y NO.34774 o Q • �`�/�� 9FQIStEP��`� �SSIONAL� W6? EDGE , � e l�r�wMtior,�Tti I I CB IN'Sk.��tf.DlkY� F N1bt7YP. I 1 6U t I Ilall Ip WSPATTACHMENT Rolf TO 5G416.E To% VERT• Ab- AL)itIZ. �TTAGAMBNT _ NOTES: Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: -- — --- i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints'shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of Uie upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and i lower attachment made to lowest plate at first floor framing. y v. Horizontal nail spacing at double top plates,band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment • o 4 EsTs O� I�I I�I I, li ii I NOOO OL N I•� � Ii ! i � I� IT Wool) -q'TRU(,TOZArL FAMEL W-SP e)OAT 40 WSP ATTACHMENT No7 TO S C/A 1.L 0 - to IC AL #4oRIZQWTA.L XTTA CH M BNT -. Doca941.876 09-26-2003 11:21 Ct f#:170686 BARNSTABLE LAND COURT REGISTRY QUITCLAIM DEED I WE, DELILAH C. WHEATON of Barnstable, Massachusetts, and SHERRY LOMMQAN of Barnstable, Massachusetts, and CHRISTINE FITCBETT, of Barnstable, Massachusetts, all as Trustees of THE DELILAH C. WHEATON REVOCABLE TRUST, under a Declaration of Trust dated July 27, 1995 registered as Document No. 646,330 at the Barnstable District Registry of the Land Court FOR CONSIDERATION PAID in the full amount of Two Million Four Hundred Five Thousand Dollars and No Cents ($2,405, 000.00) GRANT to SHAKE AB ALSEMK OUN, Trustee of the ALSBABKHOUN ESTATE NOMINEE TRUST OF 2003, under a Declaration of Trust dated September 24, 2003 recorded herewith, of 844 South Washington Street, Hinsdale, Illinois 60521-4597 1��rAvG p ° r44 1 ,r7S. WITH QUITCLAIM COVENANTS, that certain parcel of registered land together with buildings and improvements thereon situated at 408 Wianno Avenue, Barnstable (Village of Osterville), County of Barnstable, Ccnmonwealth of Massachusetts 02655, more particularly described as: LOT 16 on Land Court Plan 4178-M dated May 15, 1979 prepared by Baxter & Nye, Inc. , Surveyors, and filed in the Land Registration Office on June 21, 1979. SUBJECT to a Taking for building lines set forth in Document No. 4380. SUBJECT to a Massachusetts Wetlands Order dated October 7, 1980 LAW OFFICES OF filed as Document No. 286,071. THEODORE a SCE LING,r.C. 1550 FALMOUTH ROAD BUTTE 10 CENIERVILLE,MA 02632 J I _ FOR title see Certificate of Title No. 138106. WITNESS our hands and seals this sixth day of September, 2003. DELILAH C. WHEATON REVOCABLE TRUST VO By: O(P6, aw c. KJ a[/ox-) DELILAH C. WHEATON, TRUSTEE REG GF REG EaRR BLE Pt 4 etc.- 4G/�"�� By: 9 09 I03 10:28AN 04 SHERRY LONERG , TRUSTEE 000000 #2489 FEE $&^25.10 By: GASH $5225_10 CHRISTINE FITCHETT, T USTEE THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE COUNTY, SS SEPTEMBER 6, 2003 Then personally appeared the 'above named, Deli ah C. Wheaton, Sherry Lonergan, and Christine Fitchett, T stees aforesa'd and acknowledged the foregoing instrument to the free ac nd deed, before me MWRY A IId.Il3G MY COMMISSION EXPIRES: NOVEMBER 21, 2008 t t 11 Fz- W 1-•- O p 0 C`J D2edWi8flloAve i /4 ¢ O Cry M N N Cb GD m =! LAW OFFICES OF t U A t t7 N O 7MODORE A.SC®dA>'1C,P.C. t w 1550 FALMOU[H ROAD 1 � t C`J N SUITE 10 i 1._ j ON CENTERVILLE,MA 02632 x ¢ I'n s w Lc I— rCLA.3 s_ Q r I Trustees' Certificate 'WE, DELILAH C. WHEATON of Barnstable, Massachusetts, and SHERRY LONERGAN of Barnstable, Massachusetts, and CHRISTINE FITCHETT, of Barnstable, Massachusetts, all as Trustees of THE DELILAH C. WHEATON REVOCABLE TRUST, under a Declaration of Trust dated July 27, 1995 registered as Document No. 646,330 at the Barnstable District Registry of the Land Court, hereby certify; that 1. The above trust is in full force and effect; 2. We are the sole trustees of said trust; 3. The trust has not been amended; 4. we have full authority to sell real estate situated at 408 Wianno Avenue in Barnstable (Osterville) , Barnstable County, MA 02655 being LOT 16 on Land Court Plan 4178-M shown on Certificate of Title No. 138106, in accordance with the terms of said Trust. WITNESS our hands and seals this sixth day of September, 2003. DELILAH C. WHEATON REVOCABLE TRUST By: By D��./ WHEATON, TRUSTEE �1 By: SHERRYTRUSTEE ONERG , l CHRISTINE FITCHETT, TRUSTEE THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE COUNTY, SS SEPTEMBER 6, 2003 Then personally appeared the above named, De to Sherry Lonergan, and Christine Fitchett, Trustees a aid ck dged the foregoing instrument to be their free act a ed, o m TH RE A. SC LLING TARY PUBLIC MY COMMISSION EXPIRES: 11/21/2008 BARNSTABLE COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST BARNSTABLE REGISTRY OF DEEDS JOHN F.MEADE,REGISTER Dec. 6. 2013 11 :36AM No. 0349 P. 1 NSTAR One NSTAR Way EL EC TIq/C Weah=d,MacaachuMfts o2oeo GA S December 6, 2013 Shakeab Alshabkhoun 844 S. Washington Street Hinsdale, IL 60521 .RE.-40Mi0-6o---KVenue,usterville,"FAX _... : :. _.. . ...__. Dear Shakeab Alshabkhoun: ` At NSTAR, we're committed to delivering great service. This letter serves as confirmation that, as of 11/25/13, the electric service to 408 Wianno Avenue, Osterville, has been removed. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at(888) 633-3797. I a mer!Con rets r Centerville-Osterville-Marstons Mills Water Department P.O.BOX 369-1138 MAIN STREET OSTERVILLE,MASSACHUSETTS 02655 www.commwater.com $ OFFICE OF P BOARD OF WATER COMMISSIONERS u WATER WATER SUPERINTENDENT DEPT. TEL.No.508428-6691 FAX.No.508-428-3508 1 December 11, 2013 Barnstable,Town of Building Department 200 Main Street Hyannis, MA 02601 Re: Account#6389 Dr. Sheakeab Alshabkhoun 408 Wianno Avenue Osterville, MA To Whom It May Concern: On September 25, 2013 our technician turned off the water, pulled the water meter and the private line is disconnected in the meter pit which is located approximately ten (10) feet in from the street for the property mentioned above. It is our understanding that the owner plans to demolish the house, re-build and will install a new water service at a later date. If you have any questions,please call our office at 508-428-6691. Very truly ou , Glenn Snell Assistant Superintendent GS/jw "1937 to 2012 Celebrating 75 Years of Service" i nationalg rid November 19,2013 To: Shawn Gilfoy Re:408 Wianno Avenue, Osterville MA This letter is to notify you that after our investigation it has been determined that there is No Gas service @ 408 Wianno Avenue, Osterville, MA If you have any questions please feel free to contact me at 781-907-2931 Sincerely inda Gadourey GAS CUSTOMER FULFILLMENT National Grid 40 Sylvan Rd Waltham, Ma 02451 781-907-2931 Dec. 6. 2013 11 :36AM No. 0349 P. 1 NSTAR one NSTAR Way ELECTI4/C Wes .Maeachusatts 02090 OAS December 6, 2013 Shakeab Alshabkhoun 844 S. Washington Street Hinsdale, IL 60521 . _. . ..RE: 4'08 V1lianno i�venue,-�fenrille;..�A.. .. .. ._. .... . .. ... .._ ... . ..........._... . :. ......... .. . ... ._.. . ..._-. Dear Shakeab Alshabkhoun: At NSTAR, we're committed to delivering great service. This letter serves as confirmation that, as of 11/25113,the electric service to 408 Wianno Avenue, Osterville, has been removed, Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at (888 633-3797. E y, y stomer Con rets Town of Barnstable . 200'Main Street Hyannis, MA 02601 ERIK °erg BARIN IVO E ,�E�� Notice of Intent to:Demolish or Move an:Historic Bulltling/Structure �flio FE8 --9 F11 2: Lj. Is Building/Structure located in a Local or Regional Historic District: YES NO If YES, Protection of Historic Properties Bylaw does not apply and it is not necessary to fill out the remainder of this form. PRINT IN INK Date of Application: cq., q Building/Structure Address: q0 iv tAA/!" Q /` U 0SI-eyyi IIt Number Street Town State ` Zip Assessor's Map #: IV6 Assessor's Lot #: 4L ) — Is Building/Structure listed on the National Register of Historic Places or on a pending list with the National Register of "U Historic Places: YES NO A How old is the Building/Structure: How is the Building/Structure Occupied: LA C,rt1� S i h Si Number of Stories: Architectural style of Building/Structure,.describe if not known: K"d L)J/L� Material of Building/Structure: Id y 6 P Is this Building/Structure associated with one or more historic events or persons. Please list event, description or names: - O Type of Building/Structure and proposed work: s I Aj4,f`-it� �B Al L Y 9 -DCV-40 U S Explanation of the proposed use to be made of the site: Zoning District: -R �`"'l Fire District: �C6Ak LU rn Ap�l`icant's.Name: 7f 1 1AA 6��V J A) S�T11 A I-GA(2-n. Ardress io Numbe`. Street Town State Zip O�er's Fome: � �Q !✓� Ad&ess:� L� Numbed Street Town State. Zip Goo trac o' � aL: d r,9 Lin) �f Address: _1 0A -:S 1PAV XW\LL(;, NO LM DUT'0 A4 1 O Z<-3 5� Number Street Town. State Zip Program of Lot and Building/Structure with dimensions: r Name: TOWN OF BARNSTABLE 70.0 FEB 22 4 �OFTHE T Town of Barnstable 1� . °�► Barnstable Historical Commission . � . a 200 Mam tr et;H' anm�`iVia��achusetts 02601 * MABMWSS. * 508 862)W86�Falxq 508 862-4725 9 A 1639• A10� www.town.barnstaUle.ma.us rFD MA'1 O ,LZ February 18, 2010 n Linda Hutchenrider, Town Clerk "A 367 Main Street rn Thomas Perry, Building Commissioner p� 200 Main Street -� Hyannis, MA 02601 Shakeab Alshabkhoun,Tr 844 South Washington Street Hindsdale, Illinois 60521 Shawn Gilfoy 123 Davisville Road, East Falmouth MA 02536 Re: INITIAL DECISION of the Barnstable Historical Commission,pursuant to the Code of the Town of Barnstable ss 112-1 through ss 112-7 an application for DEMOLITION of property as follows: Location: 408 Wianno Avenue, Osterville Assessors map and parcel: 140 154-2 Owner: Shakeab Alshabkhoun,Tr. Applicant Shawn Gilfoy Based upon the,review of the Inventory form B, photographs submitted by the applicant and site visit, at their duly noticed meeting held February 16, 2010, the Barnstable Historical Commission voted on an initial basis to find that the house at the above referenced location is a significant building and that it is architecturally important to the area in terms of the period and style, and is.a highly,visible,-historic building important to Osterville. The Commission's inventory file indicates that the building is a shingle style, two-story gable style building that was constructed in the 19th Century. It is an imposing two-story house with additions including an octagonal tower with a bell shaped roof in the Queen Ann style. The applicant Shawn Gilfoy was informed that the owner must sign the application or provide a letter to the Historical Commission indicating the Shawn Gilfoy has the authority to make the application on behalf of the owner. A public hearing will be held upon the application for demolition March 8. A copy of the legal notice is attached. NO WORK ON DEMOLITION SHOULD OCCUR AT THIS TIME AND THE BUILDING SHALL BE SECURED. Sinc ely yours Bar ara Flinn, Chairman Attachment Form B .COPY OF LEGAL NOTICE Town of Barnstable Barnstable Historical Commission Notice of a Public Hearing Acting under the provisions of the Code of the Town of Barnstable, ss 112-1 through 112-7, the Historical Commission will hold a Public Hearing on the application for Shakeab Alshabkhoun Tr. Estate Nominee Trust of 2003 for demolition of a historic building located on Assessors' Map 140 Parcel 154-002, 408 Wianno Avenue, Osterville. The hearing will be held on March 8, 2010 at 4:00 p.m. in the Selectmen's Conference Room, 367 Main Street, Hyannis, MA. Information is on file with the Barnstable Historical Commission, 200 Main Street, Hyannis, MA and may be viewed weekdays, 8.30 AM to 4.30 PM. Barbara,Flinn, Chair February 19 &26, 2010 Barnstable Patriot Town of Barnstable ' 206 Main Street Hyannis, MA 02601 [� rD � J --- -}A.- C E Notice of Intent to:Qemolish;or Move an:;Historic 13W. ing/Steuctur..6 Is Building/Structure located in a Local or Regional Historic District: YES NG If YES, Protection of Historic Properties Bylaw does not apply and it is not necessary to fill out the remainder of this form. PRINT IN INK Date of Application: Building/Structure Address: qo Cl jA/tAA1tJ Q A Q E 0S1-4941'VJ II� Number Street Town State Zip Assessor's Map #: �yLl Assessor's Lot �— Is Building/Structure listed on the National Register of Historic Places or on a pending list with the National Register of Historic Places: YES 'NO I How old is the Building/Structure: How is the Building/Structure Occupied: h Number of Stories: Architectural style of Building/Structure, describe if not known: Ka Let ,it 't,—I Material of Building/Structure: j1/ y 6 P A�, Is this Builcjino/Structure associated with one or more historic events or persons. Please list event, description or names: . Type of Building/Structure and proposed work: _ t 1 TLC /4,L1( rat ry4e L4 S t{ h Explanation of the proposed use to be made of the site: Zoning District: Fire District: cblvl�"l Applicant's Name: T 1 1_6 RAG V--::A()J tJ S tf A Address: C.. Ast+-i.,Jt, (,vJ 14I r4KON,C f0-, � Number, Street Town State Zip Owner's Name: Address: _ A�A�— Number Street Town State Zip Contractor: _l �/��d Al �-+� r C,�it �! Address: f IDA �S��L' �117 (' ��1,�I d )�t <3 5O Number Street Town State Zip Program of Lot and Building/Structure with dimensions: ti Name: °F1HE t° Town of Barnstable Barnstable Historical Commission * sAxxsTABi.>✓, ; 200 Main Street, Hyannis,Massachusetts 02601 9 MASS. g (508) 862-4786 Fax(508) 862-4725 039• 10 www.town.barnstable.ma.us ArFO MA'1 A February 18, 2010 Linda Hutchenrider,Town Clerk 367 Main Street Thomas Perry, Building Commissioner 200 Main Street Hyannis, MA 02601 Shakeab Alshabkhoun, Tr 844 South Washington Street Hindsdale, Illinois 60521 Shawn Gilfoy 123 Davisville Road, East Falmouth MA 02536 Re: INITIAL DECISION of the Barnstable Historical Commission,pursuant to the Code of the Town of Barnstable ss 112-1 through ss 112-7 an application for DEMOLITION of property as follows: Location: 408 Wianno Avenue, Osterville Assessors map and parcel: 140 154-2 Owner: Shakeab Alshabkhoun,Tr. Applicant Shawn Gilfoy Based upon the review of the Inventory form B,photographs submitted by the applicant and site visit, at their duly noticed meeting held February 16, 2010, the Barnstable Historical Commission voted on an initial basis to find that the house at the above referenced location is a significant building and that it is architecturally important to the area in terms of the period and style, and is a highly visible, historic building important to Osterville. The Commission's inventory file indicates that the building is a shingle style,two-story gable style building that was constructed in the 19th Century. It is an imposing two-story house with additions including an octagonal tower with a bell shaped roof in the Queen Ann style. The applicant Shawn Gilfoy was informed that the owner.must sign the application or provide a letter to-the Historical Commission indicating the Shawn Gilfoy has the authority to make the application on behalf of the owner. A public hearing will be held upon the application for demolition March 8. A copy of the legal notice is.attached. NO WORK ON DEMOLITION SHOULD OCCUR AT THIS TIME AND THE BUILDING SHALL BE SECURED. Sinc ely yours _ d �GV-4 ( Bar ara Flinn, Chairman Attachment Form B COPY OF LEGAL NOTICE Town of Barnstable Barnstable Historical Commission Notice of a Public Hearing Acting under the provisions of the Code of the Town of Barnstable, ss 112-1 through 1124, the Historical Commission will hold a Public Hearing on the application for Shakeab Alshabkhoun Tr. Estate Nominee Trust of 2003 for demolition of a historic building located on Assessors' Map 140.Parcel 154-002, 408 Wianno Avenue, Osterville. The hearing will be held on March 8, 2010 at 4:00 p.m. in the,Selectmen's Conference Room, 367 Main Street, Hyannis, MA. Information is on file with the Barnstable Historical Commission, 200 Main Street, Hyannis, MA and may be viewed weekdays, 8.30 AM to 4.30 PM. Barbara Flinn, Chair. - February 19 &26, 2010 Barnstable Patriot oelm r Town of Barnstable 04, Regulatory Services Y + + BARNSfABL v MASS. E, Thomas F. Geiler, Director 039. 1%� Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsfable.ma.us Office: 508-862-4038 Fax: 508-790-6230 February 23, 2010 Mr. Shakeab Alshabkhoun, Tr. 844 South Washington Street Hindsdale, Illinois 60521 Re' 408 Wianno Avenue, Osterville Dear Mr. Alshabkhoun, This notice is in reference to 408 Wianno Avenue, Osterville Map 140 Parcel 154-002. This building is open to the weather and unsecured. According to 780 CMR section 121.2 this office is ordering this building to be made safe and secure. This must be accomplished by March 3, 2010. These openings must be secured by the standards set forth is 780 CMR section 121.7. Refusal to do so shall result in this Division securing this property and the necessary liens placed on the property to recoup the expenses incurred. Respectfully, T as erry, CBO Building Commissioner J cc: Shawn Gilfoy Barnstable Historic Commission �'ME A Town of Barnstable °�► Barnstable Historical Commission >�RxslnsLE, 200 Main Street, Hyannis,Massachusetts 02601 y KAss. (508) 862-4786 Fax (508) 862-4725 1639. www.town.barnstable.ma.us Argo�r A March 26, 2010 Linda Hutchenrider,Town Clerk �d 367 Main Street /Thomas Perry, Building Commissioner ' 200 Main Street Hyannis, MA 02601 Shakeab Alshabkhoun,Tr w 8,14 South Washington Street Hindsdale, Illinois 60521 Shawn Gilfoy 123 Davisville Road, East Falmouth MA 02536 Re: LD„ECISION of the Barnstable Historical Commission,pursuant to the Code of the Town of Barnstable ss 112-1 through ss f1-2-7 INSTITUTING A DEMOL-IT-ION-, DELAYI'or property located as follows: Location: tq8 WWianno_Avenue,-Osterville Assessors map and parcel: 140 154-2 Owner: Shakeab Alshabkhoun,Tr. Applicant Shawn Gilfoy Background: The Barnstable Historical Commission considered an application for demolition of the George Hinckley house at the above address at their meeting of February 16, 2010. Upon review of the information the Barnstable Historical Commission voted on an initial basis to find that the house at the above referenced location is a significant building and that it is architecturally important to the area in terms of the period and style. The Commission voted unanimously to refer the application to a public hearing. PUBLIC HEARING: A duly-noticed public hearing was held upon the above referenced application on March 8, 2010. At this hearing the Owner was again represented by Shawn Gilfoy. Mr. Gilfoy spoke of the deteriorating condition of the building and offered to perhaps incorporate a tower into the new design. Although no plans were available for the new structure, Mr. Gilfoy produced a photograph of a home in the Chicago, Illinois area that the Owner wishes to simulate at this location. The property has been inventoried, and the historic inventory Form B filed with the Massachusetts Historical Commission documents that the building is an unusual combination of Queen Anne elements with the original core and tower, and later updated in Cape Cod's shingle version of a Colonial Revival. It is an imposing two-story house with additions including an octagonal tower with a bell shaped roof in the Queen Ann style. It has been deemed individually eligible for the National Register of Historic Places. Further investigation by ttl Associates indicates that while the building may date from the early 19th century, the architectural appearance is primarily late 19th/early 20th century. The house retains a high degree of architectural integrity from this period including the following character defining features: the octagonal tower, decorative shingle siding,large main chimney, and several integral porches. It was concluded that the building at 408 Wianno Avenue, Osterville is importantly associated with the architectural history of the town, with the Wianno area in particular, and that the building should be considered for inclusion in an extension of the Wianno National Register District, as a contributing building. The building at 408 Wianno Avenue is an excellent example of the late 19th century/early 20th century Queen Ann style, Cape Cod shingle style that retains a high degree of architectural integrity. Based upon the information submitted at the public hearing and site visits by several members, the Barnstable Historical Commission voted as follows: A motion was duly made by Nancy Clark, seconded by Jessica Rapp Grassetti, to enact a six month demolition delay in that the above referenced building is preferably preserved and is a significant building. Present and voting to enact the demolition delay were: Chairman, Barbara Flinn,Vice Chair,Jessica Rapp Grassetti, Nancy Clark, Nancy Shoemaker, Marilyn Fifield, George Jessop, Len Gobeil A SIX MONTH DEMOLITION DELAY IS IN PLACE FROM THE DATE OF THIS DECISION AS FILED AT THE TOWN CLERKS OFFICE. No work should be done to demolish this building during this time period. Sincerely yours, Barbara Flinn, Chairman (? c, �74c S 12/29/2019 02:04 FAX 001 Town of Barnstable TOW% OF BA NSTABLE Regulatory Services _ PP1 �: 3 WuveTAeLK + 7gla (BAR 16 Thomas F. Geiler, Director TFOM{dA Building Division Thomas Perry, CBO Building Commissioner DIVISIQN 200 Main Street, Hyannis, MA 02601 www.town.ba rn sta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 February 23,2010 Mr. Shakeab Alshabkhoun, Tr. 844 South Washington Street Hindsdale, Illinois 60521 Re: 408 Wianno Avenue,Osterville Dear Mr. Alshabkhoun, This notice is in reference to 408 Wianno Avenue,Osterville Map 140 Parcel 154-002, This building is open to the weather and unsecured. According to 780 CMR section 121.2 this office is ordering this building to be made safe and secure. This must be accomplished by March 3, 2010. These openings must be secured by the standards set forth is 780 CMR section 121.7• Refusal to do so shall result in this Division securing this property and the necessary liens placed on the property t�rec94—the-CxRens$s_inc.urre.d.. Respectly, T Zsfuelrrv-CBO Building Commissioner cc: Shawn Gilfoy Barnstable Historic Commission . r U.S. Postal Service,:, CERTIFIED MAILTM PtECEIPT V (Domestic Mail.Only;No"Insurance Coverage Provided) ° L For delivery information visit our website at www.usps.come r , � r I. r) PS Form 3800,August 2006 See Reverse for Instructions Certified Mail Provides: ■ A mailing receipt * r ■ 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 Mails or Priority Mails. ■ 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"Return 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". ■ If 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 3800,August 2006(Reverse)PSN 7530-02-000.9047 i of r Town of Barnstable Regulatory Services • BARNSrnsi.e. „ASS. Thomas F. Geiler,Director . 1639i63y �0 iOlE Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ms.us Office: 508-862-4038 Fax: 508-790-6230 July 30, 2013 Mr. Shakeab Alshabkhoun, Tr. 844 Washington Street Hinsdale, IL 60521-4597 Re: 408 Wianno Avenue, Osterville Dear Mir.Alshabkhoun, In response to a complaint, this office made a site visit to the above referenced address. The building is open to the weather and is unsecured. Under the provisions of 780 CMR Section 115 this building must be made safe and secure and the work must be completed by August 30, 2013. Failure to do so will result in this office securing the building and attaching liens to the property to recoup expenses. If you feel aggrieved by this decision or have any questions, please contact this office. Sincerely, kul Roma Local Inspector SENDER:COMPLETE THIS SECTION ■ Complete items 1,2,and 3.Also complete item 4 if Restricted Delivery is desired. nt ■ Print your name and address on the reverse �`� Addressee so that we can return the card to you. s: g. a ived by(Pri ted Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery ad ss diffeyent from°i�em 1? ❑Yes 1. Article Addressed to: If YES,ent deli ry addres elow: ❑ No 0 y (OL LI V 7 3. Service Type ❑Certified Mail ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) 7 012 1010 0000 2850 97 9 8 PS Form 3811 I'August 2001 1 1 1.1 Domestic Return Receipt ` ''' ` 102595-02-M-1540� UNITED STATES POSTAL' ..VICE ,,� kmi Mail � ees Paid G- ties (�4v • Sender: Please print your name, address, and ZIP f�� I I TOWN OF BARNSTABLS BUILDING DIVISION 200 MAIN ST. HYANNIS,MA I i I = ��;;`; I I ' r � s �� I �v O � �� Town of Barnstable ti Regulatory Services MAS&LE, ` Thomas F. Geiler, Director i639 Ar�nr► Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.maxs . Officer 508-862-4038 Fax: 508-790-6230 November 21, 2012 Mr. Shakeab Alshabkhoun, Tr. 844 S. Washington Street Hindsdale, Illinois 60521 Re: 408 Wianno Ave, Osterville Dear Mr. Alshabkhoun: This notice is in reference"to 408 Wianno Avenue, Osterville Map 140 Parcel 154-002. This building is open to the weather and unsecured. According to 780 CMR section 121.2 this office is ordering this building to be made safe and secure. This must be accomplished by December 27, 2012. These openings must be secured by the standards set forth in 780 CMR section 121.7. Refusal to do so shall result in this Division securing this property and the necessary liens placed on the.property to recoup the expenses incurred. Please contact this office at your earliest convieniece 508-862-4038. Respectfu Thomas Perry, CBO .. Building Commissioner - i Loop Up Print Page 1 of 3 . Owner Information-Map/Block/Lot: 140/ 154/002 -Use Code: 1010 Owner Map/Block/Lot GIS MAPS 140/ 154/002 Owner Name as of ALSHABKHOUN,SHAKEAB TR Property Address 1/1/12 844 S WAHINGTON ST HINSDALE, IL. 60521 408 WIANNO AVENUE Co-Owner Name ESTATE NOMINEE TRUST OF 2003 Village: Osterville (�A K-e— V4C-10 C�emu, -(—Town Sewer At Address: No . Assessed Values 2012 =Map/Block/Lot: 140/154/002 -Use Code: 1010 2012 Appraised Value 2012 Assessed Value Past Comparisons Building $ 359,800 $ 359,800 Year Total Assessed Value: Value Extra $47,000 $47,000 2011 - $ 2,346,300 Features: 2010- $ 2,346,800 Outbuildings: $ 13,000 $ 13,000 2009 - $2,497,400 Land Value: $ 1,794,600 $ 1,794,600 2008 - $ 2,519,200 2007 - $2,567,200 2012 Totals $2,214,400 $2,214,400 2006- $ 2,615,000 . Tax Information 2012 -Map/Block/Lot: 140/154/002 -Use Code: 1010 Taxes C.O.M.M. FD Tax $ 3,166.59 (Residential) Community Preservation Act $ 559.36 Tax Town Tax(Residential) $8,645.25 Fiscal Year 2012 TAX RATES HERE 22,371.20 . Sales History-Map/Block/Lot: 140/ 154/002 -Use Code: 1010 History: Owner: Sale Date Book/Page: Sale Price: ALSHABKHOUN, SHAKEAB TR 9/26/2003 C170686 $2405000 WHEATON, PAUL W& DELILAH TR 8/15/1995 C138106 $1 WHEATON, PAUL W 10/16/1978 C75920 $0 . Photos 140/ 154/002-Use Code: 1010 http://www.town.bamstable.ma.us/Assessing/print 12.asp?searchparcel=140154002 11/27/2012 0 Town of Barnstable Regulatory Services « MUMSTesM • „IL Thomas F. Geiler,Director ' Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 October 14,2011 Mr. Shakeab Alshabkhoun,Tr. 844 South Washington Street. Hindsdale, Illinois 60521 Re: 408 Wianno Avenue, Osterville Dear Mr.Alshabkhoun, This notice is in reference to 408 Wianno Avenue,.Osterville Map 140 Parcel 154-002. This building is open to the weather and unsecured. According to 780 CMR section 121.2 this office is ordering this building to be made safe and secure. This must be accomplished by. October 27, 2011. These openings must be secured by the standards set forth is 780 CMR section 121.7. Refusal to do so shall result in this Division securing this property and the necessary liens placed on the property to recoup the expenses incurred. Respectful , Thomas Perry, CBO Building Commissioner cc: Shawn Gilfoy Barnstable Historic Commission COMM—Fire n � s o 21'-0' 1 r -------------------------- Pit I� li Fm20•-4•=Ldva I g I I I a<� X >< I •< I � � I I r— I 11 I 1 � II ®LLJ n I I I Tr I ; II I I I I I J I • ----- ----------------------J I� Im I 122'-2. I ICI (22'_2' Em u ' I r— II zo_2. I I I J 4 I I 1 .7 a I I I I III R3�� I a I i2X12 G-"' O.C7. I I I i 2%8 R II II I LJ 1 r— II 0 y I I LJ S e7 b I S b•`< �> u m dr C i i IE9it II0 _________- � � Z r7 II I - ---------- I I I I < go II I II „ II W L J y yb ��o� 1 I� �� f�sA�{ �� I�I N � �O'"� � �,• 3'-9' IT_9• lO •.6 I6 M. �•-2• 2�•4• IZ ICI `g -0' 122--2. !z = Irn— p vg o> a y A NEW RESmENCE FOR: 's€q 26 SIB„� p r ■ PARSONS ■ HINSDAL�IL 60521 .a D o m o Dr. Shakeab ALSHABKHOUN � � N -i Z D m w ! w1ONE: 6303259135 4 0 < JOB WIANNOAV&VUE �i7R e Q p,rn OYMVI1�R.MA � P� ARCHITECTS. 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I I I i 0 .9 .�,--"1;. . \ .11 �� I , � -, 5 -7 I I ,,� 1� I , � I I I I I I � I I I � (NOT TO SCALE) I i =20.5 , , R / 7f - - I I \ I I 1, � .. . � 11 I "111� I I I I I I I I I , i __\ / I 4 ", 11 S / .- � . \ I , - , \ '1�4&)-, 1& � -\, \ I - j, ��- "I I �s � '.- 11 /,,Nv' , � .7'i� " \I \ AL I I � I / I I \ , -, (51 ; , 11,11,0111- \ '_T � � Vl 02 ' TOP OF FOUNDATION I � L11, 11 ,. ."i,-;-, ,,, / S _ -_ \ - I \\ \ �I k \ i ---,-< � 11_� 1, I AL ' L 1 . I � I I I I I I I I �1\ - , / I �,�___� I I I ELEV.= 20.5 � I I .�,_5 I I,?,5 1�i - � 11 4� 0 � \ , \ _7 -1--l- I \ \ \ '\ , I I I I I I I , e i - � �' . \ I '� I I I',- I -N , I I I I I I I I � 4" SCHEDULE 40 P.V.C. I I . I i / I � 11 IZ7 - � � �� I I � \\ ) I I " I I I r MIN PITCH 1/8 PER FOOT : � I I --'!I-I - 11-111*" I I � I I I I I � ! I I � ! I � G, '17- -1- ,11 Ir I 1___� ,:q \ I � I I I I I I I : � � - . I � I � I 1 , r - MINIMUM4-� 1 � I I , D 11 , I\ I "\ ! i ,�._ q � \ - I \ DWELLIN - - \ � -k- I i I --- \ , I .� Is � % � I .11-1 I I / - - � , - 1 Z � - I ", I ! I , I I / F11 � ., I B I)."- Sw,� \ i b I �_ \ I I I � I I 10 I ! I e � 7 �I I `1 - \ j= -4_� W _p'. I I � \ \ �' I � I � � I �, I � I I - \ TOF=17.0 ICZ17 , &�4 � I � I I I I � I k , % . AL . I "�� ; I I SWEEP CLEANOUT � I /I I I --/, \ a\_\_ - - I % ) ( , /" , ,� - " i � 1 , I EL= 18.00 1 : _-D (IV � f� 1. \_....�_ ,TO GRADE W/SCREWCAP � \ W I \ (:y I I � i 1, k � - , � � , , , I ...1.11.11111111-111111............... I EL= 15.5 i I � 11 � � - I I 1,� � i I I I � I I I I I I "��XMII "I..........I..", _ : I Ij 1 1 , I 1 6" MAX' I ,, i I I 1-1-11-111%, I : � : I I I I _-= " '�'. '.'\ . I ' * �"*" i � .7 7� \ � � I I I I � " I I 11 I I 'n,.--.'_z%,%%,%1'1�111 , %" % i 1, , "I �\ _::_ _�,_ �k I 1-4 z � i I I I I , I � I � v � I � I � I I ,�� ,��,,,,,, - MAX. '%%.......%-1-11 .�� ' : , - \ -�,- d () - I I � I 1 / / is" - \ , � t I / I , �', I \1\ ( ( : I I N�"4 . ___. \ - \ - I I I z , I I CO I � � � 11 � 101 I � I I .. . . RISER RISER 6' i - . I (Iv "�. F - - - - I � � I I . \, I / i I I I I I I � I � ; , I _- , 1. � 1 i I i I I I I I / , I I I � I . . I COVER COVER I I � I i I I I �,� � ; 11 \ I � � I I � i / z - \ t k \ \ 1/11�" I I I I � CONC. � I / - % , I % I I I � I I I I I . I e SCHEDULE 40 P.VC. (IF NEC.) (IF NEC.) , \ � I I ,I I I I � � / / I � I �__��_ �� . � I � i I LO I I I I i I I RISER & j C� I � � I I I I . I MIN. PITCH 1/4- PER FOOT P% = 17.25 � / 1\ , --,,J\ , 1 I I k \ \ \ I : \ N , � I I I LEVEL � 1-� I Z"11 \ � , , \ I I " I I � I I I I � I I I � I ' I I X I � I - ; I I f " / I I , I vv% \�\ k, I I \ I I \ , 11 I I - 0 S=.025 ,, 47' TO CLEANOUT FOR I I I I G�� , 1 4 \.__� ."I . � _> I I , / ,, � I I I I � I � � - _Z� � i , \\ \,,I --,# I A , I � . � , I I 1-1 \ \1 1�3 ,, '\__�' I ,�,. I \ 11 � I I I I F OW LINE , --- - - � 1� I \ : I, 0 \ I I " I � I I 1;1 : T I--Il - - If . i I / - I I \ .\ "', \ I , � , I I \ \l '' i \ , I I I I � I I � I � - �-r,, . I � I 11 . I : \C� I I � I . INVERT i 91' S= .05 1 1 %S1 �� , � 1 , I I 11 ,p 00 : I I I I - I I 11 I I INVERT : 10 I INVERT 11111 N � I I , � I I � I I . 149t INVERT I I I -,,-\- \ �\ \ . '1� 1%� �0,0 \ \ _> " \ , I \ I I I . I I � I A.M. 163/023 1 EL=16.50 EL=16.25 MIN. EL= 16.00 1 , \ / I � I . . � , � EL= 11.4� 1 1 "_�_ � , � , \ � � I I : , , I I I . I ADD 6" SUMP EL=11.25 / \ I - \\, 0 � I I Ir I I �_> � , I I I I I . I I'll . . I I . . � I \\�,�,!�, I I I I I I 1, 1 4 \ , I I � 1� , \ , I I 1 I I I 1� I I I I I . GAS � � I � 11 I 0,�,,V,�/ I I � I I I I I I . . 6" BASE OF MECHANICALLY ! i ,� � I I I I I I I \ � ` I \_ � A,-I"�'-�� \ � � \ � q. 1 ,�- : \ ': . \ � r / I ,I I I I -1 I I I ''I - I I �� 11 I � I '' I I I I . I ... I BAFFLE I . : w�( I �C 1�6 , I I . . I COMPACTED SAND 11<-51 I., ,p \� k I �1 . I \\ % , I ,: I I I I . � - (?' \,�-/ lz�� - � I I I � . . k r �_ ,b I I I , �,1� . I %, , , I , , , I I - I ,�, I I I I I � . � I I . I ; � I . � � ,/ 1;D�� , , , , I I I I I 11 I I I . � . I PROP. D83 (H-20) I Pl� � � , - I I I .. . 11 I I � � 0 \ I / , � _�v I - C) ( - ",IN I I I A, � . /. - I I � ,, I I I I I I I � I � I I "I 11 , , I , , ", I , w,`�,V I 1 I I - � I I � � t I � I , _`_ I I / I �, I , �% 11 I ?11� 11 �. I I I I I � 11 I I 11 1��, � � . I R= 11-7 1. 11 I - " I - I __ , - 1 I � � I I � I�, , - ------., _1 11.___.1_ __ � I I -- I � � I I I ,,-, I I I I I � I I I I I I I � -_ ___ - I - � � /A \,`� _�, \ �4 \ , ,/ , k '\� � I I I I I ", \� 10 I/ . \ \\,\ t. 11 -\Ar � ;�+ �, I - 11 I 11, � I �, - � � I D'STR!2_170N � / : _X __ � 0 I � I 1 ,,Y4�' 1 1 � I I 1, I I I I I I 11 I I I I I I � _ � � - 1 .9 , I - e, r� ' \ �, , 1 I I I I I I I � I I � I � I � 1. . I., 6" BASE OF MECHANICALLY I I I � � i � , ) I ,-� � \ § � 13.9 � r- I """ -, � ,-.,.,/$ 1 1 1 � I I . I I ! -ool � 1� ,% I t__ - -10 _'O I I I " \�\ $ '� � I I I � , I ., I I I I �� 11 I I I I I I I ... I I COMPACTED SAND , BOX , -\�; i� � \\ , p , I I I I A.M. 140/154 . � , \ - 03 C) � I N \,, '\\1 . I ... : / r , I I I �, r I I I I I 1� I i I i I - ly 'I'll --O � I � I � I 11 I PROFILE OF MAIN ,HOUSE ! I Sz, 1 ;O 1 5,0 1 . 7 U-)0 - �O 1 -5 \\ 11 I I I � I I I 11 � � , I 11 I I I I I � � PROPOSED . '___ � I I I � ! � . `% � \,\\, '5 � I I . I I SEWAGE DISPOSAL SYSTEM I I ,I I W 1, 0 1, \�Y,,,?� - rn.S7 0 1 - I 1 , \ 17P :�r-�a r�O_0 � 1?) \ " , I I .\, \ � k\ -3;, 1 1 1 , I I I I I I : I I 1 1 ,500 GALLON TANK . � I r _- ,V7, � , .,, '� \� I � I ,�k.q I I � I I I 1, : I 1. � I I � 1 ' 61 1 i " DO I 61 Vr- 0- )��'�e� i I bc I � � I � \ _F1 v , 0) I i I I TOP,�OF FOUNDATION I I I 1, . (NOT TO SCALE) I I I I I \ I 1 I .0-\ \ I i 1 2 10 , �Oc�go (, , �\ .-,, I I � I I : \ I I I \ ., N " I �,.., " TOP \ \1 Ly'. / _z_ � i � ELEV.= 17.0' 1 1 1 1 1 � I ,� 2" LAYER OF � Top � " , \ � I-N I ..,.11' I -.1 UPOLE I � . 1, i ! 1 I I ,,,.� �, "', - I I , I I I . I I � \ + I 0 1 11 . � I I �I I I � I I I I I - PER FOOT I CB/DH I I \ \ , �� I � I � 1 4* SCHEDULE 40 P.V.C. 1/8" - 1/2" . 1_\ � \\ 0, I �. , I MIN. PITCH 1/8 1 1 _16 0 \i ,I 0, 2 " I I I I I 11 e I B. ,\, ,, I I )O � "__ B/DH \ , I _ .( I I I I ��' I I I I I 0) \ 1. ��, I � � I 01 ` I-, \ i �:\_`/, , -, -10 ! I 1,� /-' I","" ." I I I I I I 1. I � . I 10' MINIMUM No I � I I I I I I I I � I OR FILTER FABRIC I co \ �� \ � I I .��_ -\13 " \\, I" I` I I I I I I I I I ..... I I (d I I �/. I , ,-- \ � S � 1�\ I 4"61"1� I � I I .11, I EL= 16.3' 1 1 1 FG; EL= 15.3 1 - I ...,.,..","",""""""'ll""I....__, I I EL= 15.0 1 1 .�M�NI�11� 111-11111111111 � (O \ , \ I I ; �" I ,'%%%%, __\ I EL= 15.0 \ � -_ \ � I`__ [ . . I I 1 6" MAX-z'N1.11.111%1%Z ',.Zx,30..n.n."zin"'n"n" I N�%1111,%"*,% -z""I'll I _�, / NN � I I ..............%%,,,,,%,%,% __ %%,� M� ,-��_.n�.�- - - i. � � ...-1-11%%1111 I'll � -_-_ I : I . / I ...�1. .111, 11-1 11 11 3* MA "I, ...... - \ il � 7 1 __ sa , -1 � � � , i7 MAX.% "I,%,",�"-l'-'��,-%%,,�,,,,,, niM_,,� X� " I \t �, 11\ R'3?. , / , I . � .....31 - ... -, ...��.... .. \4 1 --\,,'_%%"""'v'1'1,*;',',,N........%........%,,,',',',','%',.,v,'%.,, . - I I I� __%%.............%....%.... ,4 -...%'11111111. I ...Xx�1111111"I'll- ...........111%, %1�,�� \'',-'11%1-1-11- � I . I I I � - ,%\%, 4 ....... . : I Q� 1--, , "z- \\\ I . . � I � 25 - � , I I I F-W I i __ /,!�� / ,,,- 1 3;- / � I I . . I 11 I ISER ER & t I :)W . ... �� / I I,\ /` 1.11 / � \ I I / I I .... COVER RISER & i I I � I I 41- I , 'IQ 11 / - i I "OVER 0< INVERT i I ; \/ $ 1 1, ... 4" SCHEDULE 40 P.V.C. IF NEC.) I a-_j ! / // I I I I "1\1 � I I NEC, COVER EL= 1 1.0 PER 310 CMR 15.255 361t , . I � � \\ Wj � )/, I / / I .� . .. MIN. PITCH 1/4- PER FOO' , ) EL= 15.6 1 * I 1 '�9 1 � :3�! i I'v \ I \11 I� . I I I FIF . I �0 - 1 41 �_w I ) k I : �% I � , - I T r% (IF NEC.) LEVEL I I � I On V� I . � I FCR 2' . I � 0- ! \ �/, � " I A 0) � A.M. 163/024 1 _ZZ I I I - _... . ...- I i L_4�j - "*11� - 11 . I � I I I 1 � , I I 1 �c I i % I / I \ , � � I I I � I I I ..... 10' 0 S=.025 I En \ I I I 11 UPOLE j I . I 1 22' S= .1 3 `� EL= 12.0 1 1 1 1 .Vl I ! \ " - ___ ..r 25' S=.O1 to R 1�\ / ---- F I z � , �,,,I � - I � I I V ""', /, I I I I � I I � , � � - I I �I I r V VV Ll IN r- I - -_ - � If) ! _T77 I : I I \ "' I , 11 � I _?, I I . I 11 � I , � I 11 I I I 1, I � .. - 1 INVERT il O" i INVERT I - v � 0 - 0 1 1 i $ . I . . 0 0 0 O/ = = 0 0 01p ,R � .. . _�t � I I / ,3?1. t I I I I I I I I � � I I 0 ' EL=14.6' 1 ' 'INVERT f 00 = = I = = = = 0 0 0 . . I e ,I , i i I �' / I � 0 EL=14.85 �q � Q f ILK I \ I \ I INVERT INVERT 0 0 i I I I I , I , � t I I A EL= 11.43 6" SUM FL= 11.25 00 � � I � � I I I I I I I I I � '' I 1: ..,. 0 0 Cp � TOP I I I I( � I I 11 � \ I � , I. I I I ,11 I I I I I � MIN. I DD 1 24) = === I = === 00 i \ I , 1, ,/ ", 1, � I I . � A. I = 0 I � , � I I I I I I 1 . I � I I � I 11 .I.. 11 . I I . I I I CP ) F� I I I __��_ I I CB/DH I �\ , ,, ,?,,,-j",," I � I I I I I � I I I I .X I I I I I I I I I 0 � . T \ \ I � . I I I � I . . I I I COMPACTED SAND � .0 '\ / - � i I I i I I BAFFLE 6* BASE OF MECHANICALLY I � I � 1110 0 OCY .1 1: _ : I EL=13.90 \ , , 1, �. I � � I I � I .. . I I I I 1 1 1 L 0"; -_ , 000 0 EL= I N GAS I I 0 ,p 0cp i I I - - - ---------- I _� � 00 " � I I I � I I . . : I I I I I I . . i I . . 1 -20) 1 1 � � � I .,/ , 11 I/� - I i I I T' I I I � : I I . 1 � I I, 1,� , I EL= 10.0 PROP. DB3(H / 4.0', 1 1 . 1.8' �, ; I � .1 ii I I i � I . ""I � I ,��"- 11 , 0 C-LAYER I I I I I I I � I I : � . / - ," I I � I I I �, ft.I.6 , - I - , 11 UP LE I , ", � I 1 5' STRIPOUT I I I I I I I I I I I I DISTRIBUTION : 8.5' � I 1 4.0' � 1, 11 __,-,1__/ 11 I I / I ALL AROUND, S.A.S. I I I i I I I I I I . I I I I � I . I 1. 11 �, 6* 13AM OF MECHANICALLY , . BOX W/T %,� TYP.) I I� I I- I I I I I I .1- I I I I ........ . I � I I I 11 I I COMPACTED SAND I � � - � - I I I I , 7d 1 1 . - 68' � , 7d ,�', \1__..1__1' , � � � I \ I 1, , I I I PER 310 CMR 15.255 1 � I I I 1 3/4" TO 1-1/2" 1 1 . ___j � I I _ �,"` ,., ( I / I I 1, �, .," I I , ,i I I I I I I I I I � '.ZZ X I � I I I I I I ' I I I - " I I , / � I I � I I I � I I I I I I � DOUBLE WASHED STONE 6-500 GAL. (H-20" DRY WELLS (4'-10" X 8'-6" X 3p-091) � % . ! �J, ik ' L ' I I � I I I I ; � b(3 "�, �� 16 .........___ - , I I . 1 2� ! \ ,�___ _. .. _ I I I I I � I � I I : "�� 7 1,__ _ 1� , ,/ , I POLE I I I I I I I I� I � I I I I I ,I I I ) - :E 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 __� � z � � I > 11 _", � I I � � I � �, �, ,--,,,, -i - W ,-"-'I *r M A G N XI L ' , I : I I . I I I I � I I I I � I 1 1 ,500, GALLON TANK - �i � r - I I ,il�_ I -.- CP ,_ __ ,N1 , "' Z�' I I I I . I , I I I I I , I �I I I �, I . � I 1, I'll I I I 11 I I I 11 I I 11 I I I I � � I I I SOIL ABSORBTION (TRENCH FORMATION) 0 1 1 � '56 � 1> __ �1` EL=17.8 - I I � 11 � � I I I I I I I I � I I I I I . I 0 \ ,." L L 1. � I I I I I I u') i ; � I 0 " __�> I I I I � I I I � . I I I 1� � SYSTEM (S.A.S.) 1 3' X 6 8' 1 1 i I .,\r - . __11_____, ,� I - ,I I I I , i � I I I � .3 N___ I "I,,"', "", __ I I I I I � I I I I I I I I I ., I � I . I 11 I I I � I I I� . I � I I I I I � I I � �, "��'� '1�1�_:�- I I I I I : I I I I I I I . I I � I i I \Ab;\ 0 ...- ", .,_ OP I I I I I L' I I I I I - l, 1___�,____- - __zl �,, ...... ,� I I 11 I I I I I I I I I I : \,,,-, \ \�,,��, �� SB/DH , I I I . I I I I I 11 � I I � � : T:� I .1-11'' ",,"', �"" 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 \ ,,-�, _,_11 ., I...11 EL=1 6.31 1 1 ,� 1�, - I .1 I I I. 11 � .1 I I I �I, I I "I I I � I I I I � I I I I I I 11 I � I 1, I I � � I I 'l I- `5' 1 1 1 1 1 � I I I I � I I I I 11 � 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 . 11 r � I I :, I I r I I i ') " .�,,, I I . I 1: � I I 11 I I I� I I I 11 I I I I I I I I I L I � I 11 I- I � , 1. ,77), ,;�:.... .." I I � I I I BOTTOM OF TEST HOLE #3 ELEV.= 1.9 �k \ , ,�.3 �.A \ \1 W ,-,- �. .... ..... I ��` I I I I I I I 1\ \ \ � -,, - , _�, .1-11 "', '.." I � I I � I I I I � I I I I I I 11 I I � I I I - I I I I I 11 I I I I . I � �� - I I � I I � I i C,B�/D H 3�1 __1- (........ I I I r,�' I I I �_ I � I I I � . I I . � I I 11 11 I I .11 I -1 � I I I I I I 11 � � � 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 11 i \,",�\ 'r X-3 I I I � I I I GENERAL NOTES I I CERTIFY THAT I AM CURRENTLY V THE DEPARTMENT OF . � � V3 ( I I I- 1\ I I I I I � I I r I I I I I -51 � \ - \ UPOLE I I I I I I I I . I '1 1 - I . I I 11 I P # 14161 TEST PIT ' RESULTS: �, 11 t A - 1 \ , \\ I _ I I I - -1 I � I I I I I I I : � I \ \ \ \ I I,- '11-1 I I I I ; " I I I I I I I I I I I ENVIRONMENTAL PROTECTION PURSUANT TO 310 CMR' 15.017 TO CONDUCT I : I I I I I I \ \ V.3 1 (5) \w I ,1...""I" ,\ - ,,, _\ 11 .1 I I I I ,� I I 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. I I I i X I -A k � .- I I__- I "I I I I I I I I I I I I 11 11, 11 I I TITLE 5 AND THE TOWN OF ND REGULATION I S I SOIL EVALUATIONS AND THAT THE ABOVE. ANALYSIS HAS BEEN I I I � I I I I I UP%E \ \ - " �, I Ilk �- � "`_ I \ I I I I " I � I I , , I ' . I � I I � \ I --'�' \� - , I I � I - � I I I I I I I � � ,I , BY ME CONSISTENT WITH THE. REQUIRED TRAINING, EXPERTISE,'AND EXPERIENCE -OBER 28, 2013 � - I I I I I r SOIL TEST DATE: OC� \ �� VN \ _ 1'� "1A_--- "I I � 11 , I I � I � FOR SUBSURFACE DISPOSAL OF SEWERAGE. I , I I I I I SITE & SEPTIC PLAN � \ __-,", \ - 111\"l q?, .ol� 11 . ' ' i \,� �\ _. ll I I - , I 1, . I � , . 2. ALL ACCESS PORTS OVER TANK TEES SHALL BE , I I I DESCRIBED IN 310 CMR1 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY � I ,�� . I - I I I I I f I I,,_, \ �', I ^\ , I I I I I I I I I I TION FORM, B.O.H. AGENT: DONNA MIORANDI, R.S. I LOCATED AT: �� \11-1 1 \� I V� 1-1 ^\ I I I I ACCESSIBLE WITHIN 3" OF'FINISH GRADE, NTH ANY REMAINING , ,, 11 I SOIL EVALUATION, AS INDICATED ON THE ATTACHED SOIL EVALUA I 0 "' \,A V? """,\ , ,.,- , I--- I I I �;I I I I � I I I --- - <1_1& \ I I I - I I I I 1. I I I I � A 1 � CMR 15.100 TH I D,`�RREN M. MEYER, R.S. I I I I ::O I - I I I I I I I � I I � , I I I � I 11 HT TO WITHIN 3" OF FINISH GRADE. 11 � I �, TH 310 1 ROUGH 15.107. 1 1 1 . SOIL EVALUATOR: I 1 408 WIANNO AVENUE � 5� \ , ��,,,,,, \ --,,,, _� "'JA I 1 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE I I Ar'_A�qCURATE AND IN ACCORDANCE Wl (fl IL V( I , I - \ I � , , I I I I � . ,, 01' , I � i, \ I,,, , I " ,,, .� I I I A.M. 163/025-002 � I I I. I I , , �An [L-1�1 ��[ I IBACKHOE: � � � I I-- \11, . I �1\1--,, I � I I I I I I I I I , CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE I � �, ) k� I - , I I I I I I � OSTERVILLE, MA. I 4__ , UPOLE I I I I I UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY � � I I I I � � I I I I � I I I . . I I I 1. I I MUST WITHSTAND H-20 LOADING. I 11 I I 11 DARREN MEYER, R.S., CERTIFIED S IOIL EVALUATOR I I i I I I 0 \"\kp, \ \11--,, - I I I 1 4. THE EXCAVATION CONTRACTOR SHALL VERIFY I THE-LOCATION I I - . 11 I I I I'll I � I I I I � � I I i I . � I \ �b\ I I I I I - I I I 1, I . i � I � � I I � � i � I 11 I � I I I 1�?h I OF ALL UTILITIES PRIOR TO ANY.EXCAVATION. ' � � � I I � \ 4-\ I I I I I � � � \-V� I � 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE I I � "I I I L I I 1 1 � i I I : I . I I I I DESIGN DATA: OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. . I I 1 ( $1 1 OCTOBER 11, 2013 � -12- \ l'\ I - - I TP#2 EL.= 1 4.2 i I � I I I I I I I � I I 1 6. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE , 11 I I I - 1/12/13 REV: 12/03/13 1 � ��, \'��\\ B/DH \ I I 11 1 5 MAIN HOUSE OVER THE S.A.S. AND DISTRIBU11ON BOX. I , TP#1 EL. 3.9 (PERC BOTTOM@ 66 , <2 MPI) -7 I-- \ \ \ . I 1. -_ ci/0�8/11 '1� 11� I NUMBER OF BEDROOMS.........L_ -_ I ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER . -_ I I I ; 1 7. SEPTIC TANK SANITARY TEES SHALL BE'CONSTRUCTED OF _X*A� .�' ,, I , � ��11 � / I I I I I I - 1 3 GUEST HOUSE , D SHALL EXTEND A MINIMUM OF 6" ABOVE 13.6 1 0'- 4" 0 ORGANIC I I N/A 1 13.7 0"- 6- 0 OFGANIC N/A t,lbl � � X�kA OF So :1 I - I .Y!AV':�,,��OF f�l,,-, 1, \ I I I I 1�\1 _�M. "I "I I THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND 11T12 1�T`��_ � I I I GARBAGE DISPOSAL.................___!42___ 1 -- 11 , I � ��N � I I NHOLES. , 12.7 4'- 14" 'A' LOAMY SAND 10YR4/1 : N/A _ 12.9 A LOAMY SAND 10YR4/1 A 1!6 -1 R (p � r `?" I __ 4 , .,.�tx \ I I TOTAL ESTIMATED FLOW � _ I ____�� 1, jr'vl�=,h"� -4 i I \ 1 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN 1 10.6 . 14"- 40" B , LOAMY SAND 10YR5/8 N/A 1 10.8 16"- 41" B 10YR5/8 1 4 �.�, ___1\ . � -Z - i / . 880 . . I I . . , . . I I .."t f I 0 � I (110 GAL./BR./DAY X 8 BR.) - 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT , -_ tj - i I I ELEVATION OF THE OUTLET PIPE I I I I COARS SAN ' I I I �,�tv Z�,ii�tj I I I STO -_ � � I 1 3.9 1 40"- 120" 1 C I MED. COARS SANDI 2.5Y6/4 I N/A 1 4.2 � 1 41"- 120" 1 C IMED. D , �� I �u_0 ' NSCT22�8 � I � I , j I � I 550GPD X 200% = 1100 GAL (MAIN HOUSE) A* MINIMUM COVER OF 9 INCHES. , I I 11 11 11 I % I ,� � � � � I I I H I I I I GAL (GUEST HOUSE) 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED NTH A GAS - I TER ENCOUNTERED . , ` -_ �po $1 � 9. THE SEPTIC TANK SHALL HAVE I NO GROUNDWATER EN I I . 10. �6, � I I I � I � I I I : I I I 11 I � 11 11 \ I �_ /,q IF-- I I , I I � I I 1 .6 - �� I � INSTALL (2) NEW 1500 GAL. SEPTIC TANKS BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. I I I I I � - /11`-�� I'll ; I I I I I I I I � ,� I I I I � I I I � I I I : e I . ,� - - jk I I I n L 10 ; I I 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND � I I I I � I I � I I . I � � I . ... '%, I - I I , ; I I � 11 � I I � I I 0 - in ) I IC.,,/,/ X�Q_I,�;,,�.�, I . .1 11 I I � I � I I � �)�, � .U,�,�.I IzC � . , � - � I I I I I .�, I I I � � , I , � I UPOLE I I I INSTALL: 6-500 GAL. 'DRY WELLS (W/4' CRUSHED STONE I � I I I � '' I I � , I 11 � I I 11 � r 10. 4NITAR , - - I . I I T !,�- 4 - � FIRST TWO FEET OUT OF THE DISTRIBUTION BOX SHALL 11 , 11 I '. 11 z " I I I I I I � I 11 1. V_ -1-1--- . I . . . . I/Y � 'r- � ,I I � - t I � .1 � , . I "_ - I - I I I- � � I I ON THE SIDES, 4' ON THE ENDS) AND BACKFILL I BE LEVEL. � I I I 11 : , JP#3 EL. � 1 3.'9 � � TP#4 EL.= : 1 4.2 1 1 � , , � I � I I "I � I I I 1 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION I I I I I � --------_ 01" I --- ____ I I. I I � I 11 - I I � � . WITH CLEAN SAND FILL PER 310 CMR 15.255 1 TO MACDOUGALL SURVEY, INC. FOR B.O.H. AND DESIGN I , . - � 11 I I . I I 11 11 � I I I I I � I ELEV. DEPTH (IN.) HORIZON TEXTURE , COLOR MOTTLING OTHER ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER . I I ; � I ENGINEERS REVIEW AND APPROVAL., I I � I - a urveying � - � I I I SOIL CLASSIFICATION................- 1 1 13.6 0*- 4" 0 ORGANIC I I I I N/A , 13.8 � 0"- 5" 0 ORGANIC I N/A , MacDoug 11 S � � 13. LOT NOT IN ZONE 11 I ' � I � DESIGN PERCOLATION RATE......:!�_2___Mll U.-/LN- I I - 1 4 � � I 1 13.1 �4"- 10- A LOAMYSAND 10YR4/1 N/A 13.2 5"- 12'p A LOAMY SAND 10YR4/1 A - & Associates I � � I i I I � I , I ! I � I I EFFLUENT LOADING RATE.........--.74 . I I I . ___�� 1, � � ! . I � I I 1 CONSTRUCTION NOTES: . . 10.5 . 1 O"- 41" . B - .LOAMY SAND . 1 OYR5/8 . N/A I , 10.9 1 12"- 40" . B . LOAMY SAND . 10YR5/8 . . N/A I . , i i � REQUIRED LEACHING CAPACITY.....T------ I � I I I P. 0. Box 2428 i ; GRAPHIC SCALE � : I REQUIRED RESERVE CAPACITY......�82__Q L,/DAY 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 1 1.9 1 41"- 144" 1 C �MED. COARS SAND 12.5Y6/4 I N/A = 1 2.2 1� 40"- 144" 1 C IMED. COARS SANDI 2.5Y6/4 I N/A I � I 11 I -L � 1 30 0 15 30 1 60 120 1 1 1 1 1 LEACHING CAPACITY PROVIDED.....aa,L__QA DAY ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING I I � � NO GROUNDWATER ENCOUNTERED 11 I I NO GROUNDWA�,ER ENCOUNTERED � I . Mashpee, Ma. 02649 1 i I 1L WORK ON THE SITE. I I I ______ __ I I I I 1 . , � : 6" W., 1!� - - I � I I SIDEWAL ' 2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE I I I I I - i I PH. �508�419-1086 1 kmn� = 4 I I L:(13' + 68')x2x(2 SIDES)(.74)= 239.8 GAL/DAY 11 I I I I I � 1� I I I I I WE% rE2 I I I I BOTTOM: (13' x 68')(.74)= 654.2 GAL/DAY NTH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT , � I I I ; I I I I I fax 508 419-1087 ! � I I I - I IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. I I 11 � I . � I ( IN FEET ) I I � � I I I I I I I I I I � I I I email: . , : i : � I I I 1.3. ALL SYSTEM COMPONENTS SHALL BE MARKED NTH MAGNETIC MARKING - I m acdougallsu rvey@com cast.net : � I inch = 30 ft. I TAPE OR A COMPARABLE MEANS. I I I I I I , 11 I � I I ��- � :� `� - - �_��_�< " *'* , I (i /`�ql; , __�_ i $ i i -1, 111111'r I � �t � � - I 1� � z / 1� - : I 1 894 GPD PROVIDED -' 880 GPD REQUIRED = 14 GPD RESERVE I I I 11 I I � I I I I I I I I � I I J#-1492C I' . ,1 . 11, 11 I - I � I I � I , I ! I I I I I � . 1, - �____ , I I I I I - -- - I I ; I I I I . I ! I 1 S 11 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 - 11 � I I - I I . 1 I I 11 I I ," I I I I I . I I I ! I I . I I . 1 I 11 .1 � . . �_ , � I "I � I � I I I - � �_ .1 I I : � �I . 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