HomeMy WebLinkAbout0038 WINTERGREEN CIRCLE ..�
J
a
- � � q ., �. ..,., � � - �..
,.
fi � ..,
o- �� .. - .. .. .. - �� �. � .�
,,
�. � � � �,
,.
,�
, �,
�.
�, �� �, °w �� ,.
M `
,,
,-
�4
��
o a
.,
',. .�
i o
.. � � .. U.
- � .. �. �„
�. � � i. ��
�. ,. o ��
�. ., u q
,.. .,
�� �. ..
�. � �, f ,
�....... .� fin.._ ....—tn-� u+�r+.+►^�
,_.._.r,s.,. .:_ter �..�. �...._.-- -.N
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map'_ 119 Parcel �V 1���C'C�ja��.. Permit# 9
Health Division q�� �3 7$h Z a i®1�C01Wp, Date Issued — � " 99
o ENVIIRp� T.H PrLe$ AiVC� 7 7 • S�
Conservation Division�� Gj .t®W -W C®�� Fee
Tax Collector 3'C REGULAPONS �p
Treasu �
-Kept. - . ,• • . �J .
Date-Baffff ive Plan Approved by Planning Board ` ` , ' K�6
440Ae6e--OKH Preservat�n_/H_y�nnis '
Project Street Address 3,8
Village 0,:�T6g_V I LLE ,
N nn
Owner��AA4 6sod 0A"&1)1 Address 3B f, ,A)Tz"o"Cew
Telephone
Permit Request 4,ici 4o eImlk Ac ��oa
Square feet: 1st floor:existing proposed 2nd floor:existing •7 7 7 proposed `�-1 Total new 7 6
Estimated Project Cost ZS�0`OO Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes 0 No If yes,attach supporting documentation.
Dwelling Type: Single Family Two Family 0 Multi-Family(#units)
Age of Existing Structure �yni Historic House: ❑Yes t(No On Old King's Highway: 0 Yes NLNo
Basement Type: III Full ❑Crawl O Walkout 0 Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing Z new `& t-40-457- Half: existing new W4 4�
Number of Bedrooms: existing 3 new vso
Total Room Count(not including baths): existing (-, new First Floor Room Count LxK�
Heat Type and Fuel: )0 Gas 0 Oil ❑Electric 0 Other
Central Air: UYes ❑No Fireplaces: Existing New Existing wood/coal stove: O Yes ho No
Detached garage:O existing ❑new size Pool:O existing ❑new size Barn:O existing O new size
Attached garage:04 existing ❑new size Shed:0 existing 0 new size Other:
i
Zoning Board of Appeals Authorization 0 Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name �Ueo 00-011- Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE a
FOR OFFICIAL USE ONLX '
PERMIT NO. -
DATE ISSUED ,:.
MAP/PARCEL NO. `
ADDRESS - *,. VILLAGE -
OWNER
F
DATE OF INSPECTION: -
FOUNDATION' � ;
FRAME '% _ - .•
INSULATION"^� ' C= - -
FIREPLACE''
:r,
ELECTRICAL: • ROUGH FINAL
a
PLUMBING: ROUGH FINAL'
GAS: ROUGH FINAL '
FINAL BUILDING,
r a .
DATE CLOSED OUT t. -
ASSOCIATION PLAN NO.
1
AD
log-•IL . .
GEG7"%.�iEO GLoi' 1-1-AA/
/ cF�riF•Y TN,g7- T.�/L� fcvNDAT/and .LOC.4T/O.V� .OST�✓/fit-; .
>�/OtdiVyE2E0.(/CGLt/PLYS,W/Tf/ SCALD
•�/�-s-'/.oE.0/.C/E laic/o SET8:4 C/G: . '
/'EQvi.�Eti/EN/.s of THE 7'owN�7F' .' p�`Ait/ �EF'E.�Eit/CE
.oca 7;--.,--> glypiry/.v� �T�///E/�.�'LoaaPG4/y p
?C' Br•,./76
,Bc4 XTE+2es
Tf//S P,c..<!�v/S NoT gASEO�N A_�f/, .CEG/S7-E.eEp .�,qv0 Scle}�Eyo
�NS7',C'UtilEit/T SU.E'YEY� THE AsT�C�Y�,C.,C�a NlASs.l�cr,�E•TS SyowySs/ouLp.�l07-g�.:
�SEO 7O OETE�i f/.(/E�oT /it/6S AO•��/G.4/�7` cNAe o r Ai iSaJ..5i9e6t�/T
4
ea ,
i,
A51 C24 C24 60XV8'
1°
CW14
New Addition New Addition New Addition c3a
Master Bedroom Family Room Dining Room m
CVV 14 C
ib
b
I i
MASTER BDRM LIVWG
KITCHEN
p
I � $
I I BATH 5,
CLOSET CLOSET
hull aoseT I °'
i
uP LAUNDRY A
tP MASTER BATH HH
tLl
I,�—da T• ee
ty
GARAGE
t
F
I
g
1stFW2 vAffi0c Raddition
211Q4 S7 39 i t9 6'
�
I
LA
Lj-
l,
.,� •6 TOWN OF BARNSTABLE
off^ o" BUILDING DEPARTMENT
TOWN OFFICE BUILDING
rua •�
HYANNIS, MASS. 02601
'�o rnr►• -
MEMO TO: Town Clerk
FROM: Building Department
DATE
An Occupancy Permit has been issued for the building authorized by
Building Permit #. / ».»»....._....»»... ....................
issued to� � o� - UAx( 101 .vr .............
ti.
4
Please release the performance bond.
J
M CMR Appendix 1y w
Table J3.2-1b(eondnaed)
Prueriptive Paekagm for One and Two-Family Residential Buildings Hated with Fossil Fade
MAXIMUM MINIMUM
Pie IGlazing Glazing Ceiling Wall Floor Bawnent Slab Heating/Cooling
Area'(%) U-value= R value' R-value' R value' Wall Perimeter Equipment Efficiency'
R value' R-valud
5701 to 6500 Hating Degree Days'
Q 12% 0.40 1 38 13 19 10 6 Normal
R 12% 0.52 30 19 19 10 6 Normal
S 12% 0.50 38 13 19 10 6 85 AFUE
T 15% 0.36 38 13 25 NIA N/A Nonnal
U 15% 0.46 38 19 19 10 6 Normal
V 15% 0.44 38 13 1 25 N/A N/A 85 AFUE
W 15% 0.52 30 19 19 10 6 85 AFUE
X 18% 032 38 13 25 NIA N/A Normal
_ _y - :18%-= .. - =38 .a 19 —25 _',N/A--= :.,N/A Normal
Z 19% i 38- 13 19 1 to 6 90 AFUE
AA 19% 0.50 30 19 19 -7 10 6 90 AFUE
o,33
1. ADDRESS OF PROPERTY: �� �1 ".ek►.) U��c
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 6Y0
3. SQUARE FOOTAGE OF ALL GLAZING: Z(j
4. %GLAZING AREA(#3 DIVIDED BY#2): R 6 v�
5. SELECT PACKAGE(Q—AA-see chart above): 7—
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-i980303a
780 CMR Appendix J
Footnotes to Table A2.1b:
' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall
area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 if of glazing area.
'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used.
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
'Wall R-values represent the sum of the wall cavity.insulation plus insulating sheathing (if used). Do not include
exterior siding,structural sheathing;and interior drywall: For example;an R-19'requirement could be met'EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements,
or garages).Floors over outside air must meet the ceiling requirements. .. .. • . -- .
`Tire entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
basements must..be. included.-with ihe_other_glazing,wBasement doors-must ,meet the the.door ,requirement
d.scribed in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building.utilizes eleetric resistance heating use-compliance approach 3,4, or 5. If you plan to install•more -
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day-requirements of the closest city or town see Table J5.2.1a
NOTES:
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
43
e Town of Barnstable
�OFtME t
° o Department of Health Safety and Environmental Services
Building Division
9� M " 367 Main Street,Hyannis MA 02601
ArFD MA't�
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: J y ?9� n
JOB LOCATION: J 0 �I IJ i EY:gJ&C ) V 12CL`t O STD 1
LLf
number street village
"•HOMEOWNER':�;zic-gA.ad' itgggET yZ`�lJ '925- —7
$ 190—Z3` 6—
name V home phone# work phone#
CURRENT MAILING ADDRESS: 3 S At rj Cl►e
C�-�.r��lwc ntA 6Z6s 5
city/town. state zip code
ing5 s .
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less
and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
-.______._.---_"homeowner"" hall-submit:.to-the.Building_Official..on-a_form-acceptable-to-the.Building0fficial;:that he/she-shall-be.-_ -
responsible for all such work performed under the buildin_g3ermit (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
7e,*
,ment/s,.A
Signature of HomeovRer
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for
hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,
particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would
with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used
by several towns. You may care to amend and adopt such a form/certification for use in your community.
QYORM&EXEMPT
The Commonwealth of Massachusetts
........
� _ Department of Industrial Accidents
-_ -- Mace ollesestigatioos
600 Washington Sheet
Boston,Mass 02111
Workers' Compensation Insurance Affidavit
j`JC,4A9 � 3i�- t,) -
namer.location �Nja&O etis I'
6. T I LL6 1 M4 vhcme#5-6p_qZg"Q�1�p
I am a homeowner performing all work myself
/❑ aso or and have no oneany cap,
� ��/////////////////'/ ////0//%'/O///O/�D%/G/////O////%/%O//%///%/////%%//////l%///////////1J�.
----------------
❑ I am an employer providing workers' compensatioa:for my employees working on this job.::::
........... ................n..r. ..................r.............................:....... .::w::::::.w:::::::::::::::::w::::::nv:v::::::nv:•::•:v::::v::.v::::::::::::::::::.:.�::::::::}...,....}:::v::::::.v......?.}.....::::w:::::::::.;
:i':8:.i}:.:�.'.'•'.....i.::ryj:;`.?s:::};. ti!:!.i?:>; {:;:::y?;i:; :iiF:•:'2?'i':ii:i:;:;:}::?:`::'{i:C;:;:;::::j::C�>i::i� ;,;:;:F FF:v::?2:............iti::iiii i?ji:�ii:;iii:C�:;:,'v,:':i;:<:;i::ii:j....:.....?:;i'FF?2 is:i s?:;i:;:!;:;iii:..............................
. ..is is;:i::;:;}i
conpany
...............................................................................................................................
...................................................................................:..................................................
:.:::::::::.........................................r•::..:. .......::.::::::::::::::::
�a�'dre
:...vr:,•r:::.;.:r.:::::::::::.}:?.}:.;:.}}:.::.}::.::.;;}:t.}:.}}:.:?.;:.};}:.}:.;}}:.;:}: •::::}:;;t.:t.::.::.:t::•::}::h. }:•:t.}:;.F}:•}:.}:?•:{.:t.:.}:.}:.}:.};::;:}•.;;•}:::.}:.;;};}}}}}:;:.}:.}:;.}:.}};:;.:;-: :{.}}}}}}:.}}::::?;{... }:.}:.}}:t:};:::2:{.}};..}
:st<:;::::> i;: :::>.::: ::::i:::::;:;:y r: iS<:::;:t;:::: ?:2y:: :-::<: :: : :::: :2:::: ; :y;: ir .....;t:
inane'?{
':'F:iv:`{:j:::4i�F?XiF:ii1J}Y:i::!:iYiiiii:iiiii:i:i�ii ii:ii:};:;::i?i}!iiii:iii:;i F:+F:i::.::r
inseraII
I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have
the following workers'compensation polices.• - :::. .
........
r: :::::$2:•2:F:;::FF::FF;<:::<::::::;::;:}:::;F:%::Y;:;::::;:::r::::<;:F:::;:::;::F>::>:5:: ::::?S`:2
...................................................r±:?r±±xoxa.};.}:{?+.•:{,,;.;::.:;,:.:•{.::?•::::::2.r-:;;:•c;.±};_.;{.}:::;<?.:{.:{?.:{.}:{{.:{{..}:.}:.}:{.}:..}.;:>..:...±5::2:;:}r;:»;.:�}::F:2;:F;:;:>.::::::F;:;222t+::.>:;:-}:;.:{:t•:.;FF:::::::}F:{<.:.};;:?.:
comyanvname:....
.................. ....t....r...............r:.r.....,.,..r........,rr..:......{...r::........f...x.....r....
::.........................v..,..,r.............:.........,.:..............:.....:..,:.:.:.r.:........,.......,.....t..................................................,........................................................... :.:.;:.::r.}:t.}:.:t{:....
...: .........: ::::::::.v::::::::•:x::::::::.::.v:::::, .......... ..:..........r...{....k......r......}::•:•:'.•.v:::: .v:•:::•.v..v:::::;:?:? :.v:::::::•:•::•:::.........::::.,.....::..::::::•::vv::.v:.�::::::�::::..
:}Mw:±::v:.vvv:v:v:....x..v...........:...:.....................................:...::.v:.:n...:.::::...v................................
:. }}};p;•};t{;:;x•%0!4:{•}:•}}}}}};•}:;t•: iii:.TFFFF.'•}'.FFFFFFFF::i}:}i:::{{•}:•}:•}}:??::<}::......:..... :.}..::::::::••::::::.....:..:...............:.....:: :..:..........
address:......................:..................... ............. ...... .......
?•i3:4iG>'2:'ii'''i'tifi:
yr...................... ..r..vr�'f::r..I•.Lv.:r•...., w:.}}FF::•F:}rF:•'/.4:4::{:•, vx{:r::{•:iJ} .•}.JK<.}v:t}. {�...v }................ ::
................:::: '....:...r...................................................................... . r..{.L•::.{....2..,Y. / -- :..�:.: K,.,.r.
..... ..........................x... ..r....r....................r.........n.........v:.::vx:.v::.v:::.�.??4:::•}r...........w:nv.w:r...•.C<vnv::
::::.:.v:::::::::{?{{•y}}:•}}};?.}:•}:t{iK•}}}•.:}'r'}}:•,vv}:L}:•}xf:.i'•Y•}Y•}"v:{{4}}}}:•}:•}:4:J}Y: ......x..........::. r {v�C.. :::::v::w::::::nv:::•:v:::::•:v:::::::::v:::}::•:i}'
.nrvn.v.r.r........ vw:.: ...
hon
B:#•.
:•:t<•}F:vFF:i%v`•F.`.•'?}::F:aF:222F:ioi::F::::F::'F::F:::}::::}:;4:;F:;:F;F:F::::%FF:F: ::%F}:•F;;:•}:•FFF:F:}:;};..}}>}}>:?.:.:{•}:•}':.};:.:::{:.;
v:..............................,.::•:w:::x::.vw::::::::::::x::r.v::::::::x:::.v.v.v:.:.w.w::.......n:::x.x.n...,......}v ::m....v x:.}'{?•}�::::•::r:v:::::•:v:.•:::.v::::J:•F}:4i}i}:?'.:4:4iF:': }':}}i:•::}'{L:•}:•}}}}:?:4:t4}:•}:�i}:{•}:<{•}}::v:4}ii::
.........:.::.............. ....... .. v.....r...............r............ ...v..r x..{.f.vxx .v.... •.v::::.v::::r:v...........m:.v.v::.wx}:}::::n•.v:.v:x::::::::.vw::::v:::::.v::::w::.:�:.............nn.,::v•w::?•}i:n}:i}
•f.
.......................... :....::. •:{ ...,.::.w::::::.vnv1.:nv.v..?{:• }}:?:ry.::F:v. {•:f.4.}F!v::±:w::h..
...,, ...................if...:...}. ..,......:....., ... .. .. .F.2 .�:r •:•:.w3n•:.::::. •r.,•:r::•:::: .:.::.F::}•K?a:?•}2:•:??.}}:;.}},.,••} .:•}:<•;}r±:..}; �..: ,..,2•.t•
.: :v:::::::::. ......... ..:.............v.......}•:....v9n.r.....t•..v...........f.......n.........:;,v:.•:.�:::::�:.::.::.:.::.:.............. ::.::..v::::n:.:,........ .v,....•.v:::.n.
COIIIDHII{F•718mei..::::::::::::•:::::•::::•:::::::::::::::::::::•:::•::::::•..:............ ................................... .. .....................,.::::::.::.:::::::•::::::±:•:.•:.:;;.
^.vv}..... {.}:{.!,::{•:2Fj:}isv:4:?{,v}}}};n};.r.}:{.};{•}}}:•};{•}is2}:{??O}:i}}F}F}:4}:^'^:^F}:•}:?{(!}:•ii}F}}}}:::::i;i F.:....:y;:;}?.:•}};:tF:•i}}}}:?i{:.}'.:•}}Y.?•}i:^:4:•nv.r
:?:j}::':?;i:•::{•:•}:?:::ii.;:?;:;:??4:•}Fi}:4:t???.:•::Si:•}%•}:?^?A.?.,'F:;:?.}::}:•}}}};::}}r;{•}:•:?{}:{{{•± F}?:v;}} i.;:;}:}F}+i;{??{:?h:q;.}}}:•{{F}i}}:4:i^........}}y}iF:?.}:�i±:}>:}:;}:;:i::h?}:•}}}}.. ...w.}.•,..•�.:i'i•i::4:•:
•:•:::::::.�:::.v::::.�::::::::•::.v:n...................
.�.
'S e�ii"':?}}}it+:iF }}}};<{2^F:}}F::}:•}:•i:G:.i:?{::{F2:;}:::::{?•{' ...... ..':{::?;}:;}<:F?FFJ:2:::....2•}}}:v:v}}ii:?•}}:?ii.}' ......... ....... .. .......
v:G}:......:?,:...:F;:?;:.i:}}:r}Frf.}:i:?.;•}:•}}±}}:{{•}:?{i:F;:j?}};?.$}:2•{:'{{:•:??i:;i}:.i::}ii:?;:FF??'Y:v:•:?.}}};..........;4}}i%?•:h}}:•:•i:.iF>::
:::::n�::::::w:::::.:• •x::::;.;..v:::::::n�::?.}}:v?::........:9:::.v::r::n:::v •.::::::n:::::.r:�jti?•{::.v•: ..
.........:::.. - n�i......::: ....:.......:..:................. L;,,.. f'w:m::::nv.v.v•::ti:{t{,.;{,...................:...::.:v:::•::.:..r..:.::.:.:.::.. .
... .............. ......... r f:r•:;:.:•.-•.;•_:{::.}v.::v.:::FF:2•FiFFF::•iv:i.�}:•}:}}:{:•.i:}}::•}:•}}'•}}:{{•}: is+•}.'{:vtiw.::•... ...................................................... ....... ........,......:.........
.:...rn.v x..... ..v.... ..r}...........v. .r. .. .... .......x::::::............................................................... :.v::.::.v::.:•}}::::v.v:.};.
............:...:. ... .......... .......................... ....n., }:.0............,...v::::.wn..:.
..............{v...................... ....................................v............ .. ........................ R•.:v.v:::::.v:::??v:;:{{{.}}::.�•::•.v::::•:::}:::;isJ:::i}}}iii}:•:{•.�}}:?.i}:•}}:{v:•}.:v}i:•.}FFFF}}:
"v>:}iiiFFFFFF:
�F:fit{:ii:4'F:yin::iiiFFFFFFFFFFFF:2iiFFFFFF:':;{:;tFF%�}FFFFFF:^F:t�iiFF:i[i�:4n:
.:::::::v.................................w::::::.........v.i{ti•.v::•::::::::n�:v.v::::::}:::.v::::::•}::tiv:}::. v......w:...iv}:•}?•}}:}:tit}:•}:•}:::v:v v}:•
v.�::•::.v:.v:v::v:::nv:::::w::.}}}}w::::::::nv:::x::::r:................:..t•};.vf':vn�nor:v vr;''::::::••::••::::iti•:tiw:::::::.v:.....::.::nv::::::::.v:v.v'w:}
v:::w:::::::::::::::...." .w::::fri:}x.:v::v.::. ::::.... }'^'•}}:{?:•}}}}}}};:{?ti•}:?.}v::::::::::::.v:::::::fw::
......................r.'1.•r.......nv.../.f.nvr..n..rr:n....r:...{../.....:.........n.........:.6......• .........r.... .xnv:v::•v.:v:::::::::v.v:..........::::::::.v:v::::•::•:•.v:w:w:..:v...::.......................... .......r.v:...........:::•:::.:�.......xwr:.. :: w.•r. •.x•:: ..........v::nv•.w:::.w: v•: .f.::.v.:?•:::. ....n...x.......::::::......:..r........................................... .....
.:::::•:}n�:-{...•v:v:::::.v........1fY..{ff.:....Y:..........rh•}x::::.v::......r............}..niv..:n. .. ��{..... .. ...... .....v:•:::r:::::.:..................x:::v:::::.vr.v.v.v:::::nvxi?f}:+±±:?:!!:t??{•
........ .. .....:r .,......... .S'.Y•.::Mn,vrv:•:......♦•:;:}r,.:•}:•.;}:•}.? ..:........ ..a::._:::::r::.•:.,.f:}}::�±}}}}}.......::•}}}}}:'•}:•:{'•}:•}:???t{•}:vw:::::.v.•..w:•
. ..�:::vv:Y.-;YA4.}?;N;..4?+±tv,/•.:.,y.m:....r....v................v. F•k'Y::.v.., vv:::;\........S...v....., ................4................v........ ..>.........
Failrn;e to secure coverage as required under Section 25A of MQ.1S2 can lead to the imposition of criminal penalties of a fine up to S1,400.00 and/or
one years'imprisonoment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this stateanent may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereh fy a airs and pwtaba of perjury that the information provided above it&w and correct
Signature -/zy/fy - -
c�
Print name�te-44 U Q�Q � Phone# 'ti�Z 8-Q7
official use only:donpotwr1b in this area to be completed by city or town official
city or town: permtt/license# ❑Building Department
❑Idcensing Board
❑eheekif imm required ❑Selectmen's Office
_ ❑Health Department
contact person: phone#, ❑Other
uevaed M PJN
Information and Instructions
Massachuscm General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract
of hire, express or implied,oral or written.
An employer is defined as an individual,partnership,association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a .
dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on,the grounds or
building appurtenant thereto shall not because of such employmcnt be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit*to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 regmrcmcnft of this chapter have been presented to the contracting
authority. _
Applicants
M Please fill in the workers'-compensation affidavit completely,by checking the box that applies to your situation and
supplying company names,address and phone numbers along with a certificate'of insurance as all affidavits maybe
suhinitted to the Department of-b.uh strial Acciidents for ca�atioa of insurance coverage: Also he sure to sign and
date the affidavit The affidavit should be r to the city or town that the application for the permit or license is
... -.-,.- -. , �.a-: , oP y
being requested,not the Department of Indiistcial Accideats'''Shauld you have any.questions. egaidiig the"Iaw" �if you
required to obtain a workers' compensation policy,please cad the Department at the number listed below.-
City or Towns y��_, _,;•..._.
�.-....✓. .- v��w\: ..w.�'.L!,-+n....v..t:..'wT-i'-t 9.: ._. ...1....\. '...P Y^�.,..- . .-.n?`!X•. +� .. a. -. ...�.s.-r'P' w'�..�..F' '.'Y. - .
=.-=;.Please.be sure that the affidavit is.complete and printed legibly...11WI)e
partment,has.provided a-space_at.the bottom ofTthe, _
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 p'ermit/fi c numbac which will be used is a reference'nComber. The affidavits maybe retie ,%
the Department by mafi or FAX unless other ;have been made.
The Office of Investigations would lice to thank you in advance for you cooperation and should you have any questions.
hesitate
please do not to give us a call.
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
..Department of Industrial Accidents
ma of I68=1I08tlons
600 Washington street
Boston,Ma. 02111
fax#: (617) 727-7749
hone#: 61 7274900 eat. 406 409 or 375
•_-__.-_ i"/• = yam,
pEst6u -PATA
BELQa�Ms- ' o
-5196l-.E FAMtLI
PAIL-{'FUW
SePrt c i AuIL j-cb 4 \
DtWMAL I-/>'006AL�L,57bA/E F r< 4. i # �+ /R
51DEWALL AR{�
y
. 'ISd'SFX 2S �h5�`�t'CS I� fi tv,
Add
'TOrAt: DAILY 100
pE¢GaLATION ATE`=.�'I Ild�iNlhl/LESS ra I� s ' r LZueu.Wb��� n✓ 22f �l
r�
m II : r � t♦Qf.�q,�� ij4i:c arA..rtbif �o ��N �
� r N
;JSuulvAN_I
Emxrm , 1 i + No 29733 + l
OgAL'
' ..._ ' "f:'i��'` .� v}S •`� (OD'� "AtY!L.i_^t�e�..__ �—e.-f'vm-f,_,r�_.._
S h-
p .+ ytl'IA'li�?l►2�,1,1 GI P..c:.LE=
Io11000 u ISOi.
Sur,oEc, sA.L- 9dB
16 `+ uV $ f q&L 4 TIC M1
io`dt7 lavt asz TNe
z
92 r i,r 4y k 1 � �' wt 1•t_
1
yCazn-FIED ptdT' P[AIJ
G6VELopEll ?fit l h 3 Y ,E L'o IoN osrEl-/I Li-IS
' F s / \
FLB � a r ; r {{ ttyc �sLltLl7i ��I-4C$
-
I10 wAfFn �/£Lx� }, E1fy' Fdjxap ;;* x' {� PLAN Ret ERDJCE
slloww.Attv.15...4 "TOItM :�3afsilsrael fi Lot-
0T
10
- 3 Fb VLf ReQ;!tF 4910
\
otdT�i u/ utfl' £ Ftoav LeI{1t .• •AWIE F. ceos9
8dx'CHz .4 +JYtr ING
t I r '..k ri t i r. i I:PPO�i$/Dlld(.'�dlhb Sv /GQS
TiliS" FLdsl l IS:,_NOri 18 ® IJ yltJS?>ZiaNEUT 7: I aSI ,:I si.iiL_ 4 E+JUNEF>Z5
.gufLvEy,'ArJ17�THEr�F�FSE'f I'S ts�,uu(','I3E , i yit,ioSS�*/ICLE � MA54 ,
USCU ,Ta ESTAB1-15�{ PRo�EYzT ' `latle5 k iArt k
dPPL1z4�iT',:Qrudn �Avso , 4A¢ tr.
WE r�
The Town of Barnstable
• a�iaKs-rAAt r
9� Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL a 142A requires that the "reconstruction, alterations, renovation, repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements.
• Type of Work: MCI,r-;D,) /p JX rsntj Llwe: Est.Cost 2 DOO
Address.of Work: 6�)r OTt"&e-6 GacuL i L(-E
Owner's Name"Z—i AA-d QP60-r
Date of Permit Application: /Z'Yf 99
1 hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner.
Date Contractor Name Registration No. -
OR 1
.� 12,4111
Date Owner's Name .
SRAM I NG SECTION
ALL DIMENSION LUMBER SHALL
BE KID SPF N0.2 OR BETTER.
x COLLAR TIE @ 4b" O.G.
2 x ja RAFTER @ 16' O.G.
2 x CEILING ;JOISTs84 16"" O.C. HINGLE
W�IS I.S.8 FELT
i
rIx PINE FACIA
R-30 KRAFT FACED F G BATrS /J
R- UNFACED FG BATTS - SOFFIT VENT
W/6-MIL POLY VAPOR BARRIER PINE SOFFIT
(I at 1 2No FLOOR)
-77
2x IUFLOOR SOIST @ i Z"O.C. _
(isr * FLOOR)
n
u u
S!!L
i
I 0 �
ANCNDR BOLT
SILL SEAL
@ 6*-0` O.G.
e, ~CONCRETE
'. a FOUNDATION WALL
L
�FroMING
�)EGT ION
- - - - - ALL DIMENSION LUMBER SHALL
BE KD SPF No.2 (IR BETTER.
x COLLAR TIE @ 48" O.C.
2 x I0 RAFTER @ 16' O.C.
N5�keu�.T SHINGLE
2 x 6 CEILING TOIST ® 16" O.C. W/IS LB. FELT
I , •
Ir OPINE FACIA
R-30 XRAFT FACED FG BATS
R-i3UNFACED FG BATTS SOFFIT VENT
W/(6•MIL POLY VAPOR BARRIER —
(1 et 1 2No FLOOR) `l PINE SOFFIT
S
I
1 I
1
I
I
I
7
2 x 10 FL00R JOIST @ 12"o.G.
(isT FLOOR)
h
C�
Z..
1
I
I
I
• I , � --- '--. .� a ��— ;;ILL
I 0 1
SILL SEAL Awo'OR BOLT
@ 6,-0' O.G.
-CONCRETE
�' FOUNDATION WALL
IT MOST, '
rr nL V4 .701!
7 A IIrIT[0 IA Ii�[lSal►
TW NXWJ7 M COMPMMES
sNcr .sa
M.C.H.C.- N y l4 to (S NAME R 1 Qt4 4<.� SA-1PGvt f
MANIFOLD ADDRESS
SALESMAN LQ 42e�. TEL.97S.5 .
JOB LOCATION
8 �.:
Pt4tr
i r4' ZB�
Z ua 1=L 3 o e- L L L = . 3o' pk
�2r,1 way loo�c.i - 8 X 3 o = Z40
f2aoT= 3 o t_ - ! e4 6C 3 O 1E-ZO
Lo 0 7c
. �L - l . 34 � 10 - 14 .
8 K Zo = i rloo
Go
tit 64 51
Sv+ c> LOADS 146 14c34vG
L L = -7o
D c. -- S1 4
2ND FLOOR BEAM A
5.25" x 11.875" 2.0E Parallam® PSL
TJ-BeamT"' v5.42. Serial Number:709054347
BEAMIJAA 1111 6/7/99 12:03:05 PM
Page 1 of 1 Build Code:104
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED
a; ;a
b 13'
Product Diagram is Conceptual.
LOADS:
Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 14'
Loads(psf):30 Live at 100%duration, 10 Dead, 0 Partition,and:
TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT
Uniform(plf) Floor(1.00) 701 514 0 to 13' Replaces
SUPPORTS: INPUT BEARING REACTIONS(lbs.)
WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER
1 2x4 Plate 3.50" 3.596" Left Face 4557/3468/8024 Detail A3 1.25"LSL Rim
2 2x4 Plate 3.50" 3.596" Right Face 4557/3468/8024 Detail A3 1.25"LSL Rim
-See TJM SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3.
-Bearing length requirement exceeds input at support(s) 1,2. Supplemental hardware is required to satisfy bearing requirements.
DESIGN CONTROLS:
MAXIMUM DESIGN CONTROL CONTROL LOCATION
Shear(lb) 7818 6443 12053 Passed(53%) Lt.end Span 1 under Floor loading
Moment(ft-lb) 24758 24758 29854 Passed(83%) MID Span 1 under Floor loading
Live Defl.(in) 0.303 0.422 Passed(U502) MID Span 1 under Floor loading
Total Defl.(in) 0.534 0.633 Passed(U285) MID Span 1 under Floor loading
-Deflection Criteria:STANDARD(LL: U360,TL:U240).
-Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and
positioning of lateral bracing is required to achieve member stability.
ADDITIONAL NOTES:
-IMPORTANT! The analysis presented is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of its
products by this software will be accomplished in accordance with TJM product design criteria and code accepted design values. The
specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not
been reviewed by a TJM Associate.
-Not all products are readily available. Check with your supplier or TJM technical representative for product availability.
-THIS ANALYSIS FOR TRUS JOIST MacMILLAN PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Allowable Stress Design methodology was used for Code NER analyzing the TJM Residential product listed above.
PROJECT INFORMATION OPERATOR INFORMATION:
RICHARD SARGENT MID-CAPE HOME CENTERS
BILL RUBEL
P O BOX 1418
DENNIS, MA 02660
508-398-6071 X390
508-398-4559
Copyright O 1999 by Trus Joist MacMillan,a limited partnership,Boise,Idaho,USA. TJ-ProTM and TJ-BeamTM are trademarks of Trus Joist MacMillan.
Parallam®is a registered trademark of Trus Joist MacMillan.
C 2ND FLOOR BEAM B
_TJM-Bela_mf v5.42, SeririallN'u�mber..709054347 5.2J„ x 14 2.0E Parallam® PSL
BEAMU,SA 1111 6!7199 12:08:19 PM
Page 1 of 1 Build Code:104
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN CONTROLS FOR THE APPLICATION AND LOADS LISTED
i
d 16'
Product Diagram is Conceptual.
LOADS:
Analysis for Beam Member Supporting FLOOR-RES.Application. Tributary Load Width: 14'
Loads(psf):30 Live at 100%duration, 10 Dead, 0 Partition,and:
TYPE CLASS LIVE DEAD LOCATION APPLICATION COMMENT
Uniform(plf) Floor(1.00) 701 514 0 to 16' Replaces
SUPPORTS: INPUT BEARING REACTIONS(lbs.)
WIDTH LENGTH JUSTIFICATION LIVE/DEAD/TOTAL DETAIL OTHER
1 2x4 Plate 3.50" 4.439" Left Face 5608/4296/9904 Detail A3 1.25"LSL Rim
2 2x4 Plate 3.50" 4.439" Right Face 5608/4296/9904 Detail A3 1.25"LSL Rim
-See TJM SPECIFIER'S/BUILDER'S GUIDES for detail(s):A3.
-Bearing length requirement exceeds input at support(s) 1,2. Supplemental hardware is required to satisfy bearing requirements.
DESIGN CONTROLS:
MAXIMUM DESIGN CONTROL CONTROL LOCATION
Shear(lb) 9698 8098 14210 Passed(57%) Lt.end Span 1 under Floor loading
Moment(ft-lb) 37982 37982 40742 Passed(93%) MID Span 1 under Floor loading
Live Defl.(in) 0.429 0.522 Passed(U438) MID Span 1 under Floor loading
Total Defl.(in) 0.758 0.783 Passed(U248) MID Span 1 under Floor loading
-Deflection Criteria:STANDARD(LL: U360,TL:U240).
-Bracing(Lu):All compression edges(top and bottom)must be braced at 2'8"o/c unless detailed otherwise. Proper attachment and
positioning of lateral bracing is required to achieve member stability.
ADDITIONAL NOTES:
-IMPORTANT! The analysis presented is output from software developed by Trus Joist MacMillan(TJM). TJM warrants the sizing of its
products by this software will be accomplished in accordance with TJM product design criteria and code accepted design values. The
specific product application, input design loads, and stated dimensions have been provided by the software user. This output has not
been reviewed by a TJM Associate.
-Not all products are readily available. Check with your supplier or TJM technical representative for product availability.
-THIS ANALYSIS FOR TRUS JOIST MacMILLAN PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Allowable Stress Design methodology was used for Code NER analyzing the TJM Residential product listed above.
PROJECT INFORMATION OPERATOR INFORMATION:
RICHARD SARGENT MID-CAPE HOME CENTERS
BILL RUBEL
P O BOX 1418
DENNIS, MA 02660
508-398-6071 X390
508-398-4559
Copyright O 1999 by Trus Joist MacMillan,a limited partnership,Boise,Idaho,USA. TJ-ProTM and TJ-BeamTM are trademarks'of Trus Joist MacMillan.
Parallam®is a registered trademark of Trus Joist MacMillan.
,�S;�A�:,.p„wo-�^.�^c.. y.,.r::.,...+o.-•-• •.-.a—^'-'r-*wv--�:.. «-,x,�.,ky,.r�,;��_......w;:.,..a.�:.,oy.,�.� .••e,�;�,vw�...zw..�.,,.v.� ti,..-.v..�..irr.s,.+.-.'. "`....�-..._:�..�,.-.r+aY,:—•-....w,,,;
,,1Mf TOWN OF BARNSTABLE Permit No. ..36922
BUILDING DEPARTMENT
I ' I Cash
TOWN OFFICE BUILDING
,Ml V
.67V• X
moo+' HYANNIS.MASS`02601 Bond ................
CERTIFICATE OF USE AND OCCUPANCY
Issued to Richard & Alison Sargent
Address 38 Wintergreen Circle (Lot 10)
Osterville, MA
USE GROUP FIRE GRADING OCCUPANCY LOAD
i
THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
February 8 95
19................. ............... ....... ...................
Building Inspector ;
'TOWN OF BAR NSTAPE, 'MASSACHUSETTS gUILD190 PERMIT
G.
� -aa� 3�922
DATE `;Ud' ' 19 `4 � PERMIT NO. NQ
APPLICANT 1Gllar( h,isOi: Sarg,::':L ADDRESS 9V5t=� 1�'��.:J ' :7Z:, osterviZl(:
(NO.) IS,TREET) ICONTR'S LICENSEI
PERMIT TO Build dwesl9 it (�� ) STORY aS.ngle tamii-`y d %iing NUMBER`.'OF
DWELLING UNITS
(TYPE OF IMPROVEMENT) NO. (PROPOSED USE)
�- AT (LOCATION) 38' Wintergreen Circle, -loth #10, Osterviile ZONING PC
(NO.) (STREET) i DISTRICT
�' ;�f.
BETWEEN:ri' t
AND '
(CROSS STREET) (CROSS STREET)
SUBDIVISION T LOT
LO �BLOCK SIZE '
}
BUILDING IS TO BE FT. WIDE BY FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION
TO.tYPE 'USE GROUP BASEMENT WALLS OR F'OUNDAT,ION
•
(TYPE) -
REMARKS:
.iL wc:i;E 494-3 i 8 �
AREA OR 15tisq. IL• �" 'YESTI�ATED COST $ FEE
115,`000 MIT a 326. 75
VOLUME y. D
(CUBIC/SQUARE FEET)
OWNER hicharu & AlisoIi Sargent ,) �' .
'ADDRESS �yuoft mairl .~it, Stt 1 V111E BBYILDING DEPT:� 4�
THISIPERMIT COtJVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY* PART THEREOF. EITHER TEMPORARILY OR
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP-
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED
FROM THEOEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS
YOF ANY APPL B SUBDIVISION RESTRICTIONS. it .
MINIMUM O 'j-1� „CALL -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
ALL CONSTRUCTION
FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
- ALL CONSTRU�C,T ION ORK:
±' ELECTRICAL, PLUMBING AND
1. FOUNOAT'D`4S'OR FOOTINGS. MADE. WHERE A CERTIFICATE OF,•OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
2. PRIOR TO'Cbv-eRt.NG STRUCTURAL QUIREO,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL i
MINAL INSPECTION
TI TO BEFORE
FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTI N APPROVALS ,Q PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
�a� 11-�/7
v2 7 �� �� i 47i u rr /"V,, , G�..�� 2
ING INSPECTIOI :•.PPROVALS ENGINEERING DEPARTMENT
1 ,
` BOARD OF EAL
OJT SITE P N EVIEW APPROVAL
c-6 diA-k_ -
IA'ORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
',;HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION
Assessor's office(1st Floor): , , 6, SEPTIC SYSTEM M
Assessor's ma and lot num _ INSTALLED IN CO
Conservation(4th Floor): WITH o.
Board of Health(3rd floel
M 4 ENVIRONMENTAL
Sewage Permit numbs DT'7/ /iJ ' J
Engineering Department(3 floor �y TOWN REG UL��
House number ( �S l
Definitive Plan ppro d UrPlAning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1:00-2:00 P.M.only
`�°� `� � tTOWN ' OF 'BARNSTABLE _ ��
0
BUILDING INSPECTOR o�� � �� (-
APPLICATION FOR PERMIT TO QtO
TYPE OF CONSTRUCTION
iC jury ►( 1994
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location 38 GJ�,�Trrcg,� C-� (Lor /o) 01--& /Ut
IJ
Proposed Use NC z_E
Zoning District j. Fire District
Name of Owner2iCw*Arc&4-Absoio 3AagF0T Address ��81� �,J S�. (3sm .J/ca
Name of Builder`" -' �re,f/�rtD S'aigE•.rr Address
Name of Architect 7 bV_IDSI4 A-11rOC- Address CA f v, %mil o'_ r Knopgc
Number of Rooms U Foundation
Exterior V�)acd—� lskvq� Roofing A<A-AW'
Floors T���I�7ewd 1E40tr- Interior !�6_111 zc�-
Heatin Lo toe T Plumbing 2((z_ 6Tf4
Fireplace Yi2! - Approximate Cost 116",00t0
Area
Diagram of Lot and Building with Dimensions Fee
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name6tEiRMik 2Ie.I OZ]Al'zqgNrl
Construction Sr ipervisor's License
SARGENT, RICHARD & ALISON
4$C.2017
N 6 Permit For BUILD DWELLING
_ I
lz story single family dwelling
Location � ts �are`g=�nle_ J`"
Osterville .
Owner Alison -SAr-gant
Type of Construction
Plot Lot
Permit Granted July 28 , 19 94
Date of Inspection,
Frame D 19
Insulation !9 19
Fireplace 19
Date Completed 19InE
a
S s f_b t
I,.
r
TOWN OF BKRNSTABLE BUILDING, PERMIT #....
-: COMMONWEALTH OF AWSACHUSIFtTTS
�• «F DErAIt 1�1EN'T OF LNDUSTRI Ji.ACCIDENTI S '
L
600 WASHINGTON STREET
fames-* (;ar laaei: BOSTON, MASSACHUSEITS 02111
or:mussone.
WORKERS'.COMPENSMON IKSURANCE'AFFID T- �=v,
.AVT
' (iiacLssoJputaictee) -
wirlr a principal place of businc s/icsidcnoc
1-z W,
a
do hereby zf.r..under the pains and 1e=of .�
-
j] I am an employer providing the following workers'eomperiation coverage for my cmployeC7 wooing on this
job.
r - '
Insurance Company Policy Numbs
1 am a sole proprietor and have no one woridng for me
j] 1 am a sole proprietor,general contmaor or homeowner(tirde one)and have hired the eontnaors listed below
who have the following workers'compensation insurance politics: - --
Name of Contmaor Insurance Company/Policy Number
Dame of Contmaot Insurance Company/Policy Number
Name of Contraaor Insurance Company/Policy Number
Q l :m: homeowner performing all the work:myscl£
NOM.Please be aware iat while 150raeo•-acrs wbo employ persoas to Zo eaiatenancc.eonstruet;oo or repair•Oork on a
dwcliint o(noi raorc 6zc z rcc Laiu is whit'✓ tic I,or__co-mcr aiso resiccs or oc t c rrouacs appurtenant ibcrcto arc not rcocratJv
eonsicerce to be emalovers =4icr tLc Corkers'Cor-vc satioa Ac-fGL C 152,sec 10l).appliutioa by a 15oraeowoer for a Iieease
or permit rnov eviccace tie lcfaJ Sums of an erL•alover uader the C'orkcrs'Cor--?cessdoa Act ,
I -cc-;��c i� : t:.•C:t_!s;:;;-c-: w'V be fo:w�c;C to �::✓=�:-c.i c::-c s::i IAcodcnts' Ofncc orrnsur= C: for Govc:%tc
C ;-•, ,,,SCCL':C C�^^�C-St S,: iCCI:::<C L'LCCC �CC_G:��.'.C: tSC_ ��_ Cam,1C1C LO L:,L t:::�OS1 ClOn Or Q7:'L'7�pCf.�.�L-
CC.^.!1!::-C CI : t:-c C. CC tG 1 5�'C'-Gil :..:GAO: IC: 1:0-^L^.t O: c' IO CLC\•cam"C C\:: Ju L-i &-c corm of z Stop Work OrOc:S.-C :
fine Of S I00-OG a cav q--ins:mc.
Sltncc this 3�h d;v or t 19 9
VJ
nsorrr:rr:r— -
f .
ALGER & SCHILLING
ATTORNEYS AT LAW
886 MAIN STREET
P. O. BOX 449
OSTERVILLE, MASS. 02655-0449
TELEPHONE 428-8594
JOHN R. ALGER AREA CODE 508
THEODORE A. SCHILLING TELECOPIER 420-3162
July 13, 1994
I
i
Building Inspector
Town of Barnstable
367 Main Street
Hyannis, MA 02601
Re: Land of Richard P. Sargent, et ux
50 Wintergreen Circle, Osterville, MA
Assessor's Map 119 Parcel 49
Gentlemen:
The above parcel of land was conveyed by the developer Annie F.
Cross to Albert Smith, Jr. and June B. Smith on April 20, 1963 at
which time the parcel complied with the building and zoning laws of
the Town of Barnstable. From that day to the present the parcel has
been individually held, first by Mr. and Mrs. Smith and more recently
by their daughter and son-in-law, none of whom owned any adjoining
land. Therefore, it is my opinion that this lot is buildable under
the zoning laws of the Town of Barnstable and Commonwealth of
Massachusetts.
Very truly yours,
?/t4,L-
JRA/db
Signed as Dictated
But Not Reviewed
f
9 0
3S '�
k
Y
.1bSA ate �d a• 4, 1 ¢DeS'
�`.( °s-•'-Ytw• Vie' �� n� �� y . y `� � o
' �'� �:�% ___- ��%� � it Itl ���•.•Z a _�yY� .d 1� �'^�6"
Be IIQ�_ Fla-•j<�y�_
�
ilk.
dl�
p _ �_
r YAFOSHIS pArEs.INr-
fC
' �M.an .YA u3B19 I
• i
yq2b"��•(995�
n ^
-- ----'------'- -'-----=-----.._................_....: ...... . . ------•'-------..----._--'--- . ..-------_.._. ....___.�_.�. - — - - —• -------- ' it
THE FOLLOWING �
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
IMA��J I
DATA
i
. . 1
I
RE
..........................................
THESE PLANS MAY NOT BE NOTICEIII
REPRODUCED IN WHOLE OR PART; TO BUILDING OFFICIALS !
UNDER ANY CIRCUMSTANCES °,,,1E 1D°�'"'^�•eve��caors.•• ®...o
rzwas arn.urce aw wi.s wn w�co.wwcE
' vle,ama.0 a a m r...ne orb .�w�.ww�.rrtn nor .e�n am a
wsma wn•eu:n..c man urtn�. •�
OlB9Tq mvm AYo�W� Yuhpm uo. �Aseowrt.eronor++cE eonu wE.u.•aEaa 2� �. i
YARO_H-. :IAM
I.
I
.---..-__—�.-�--s'_�.re_=_�' r.�� .r •1 ,•.ram �--�.''-.x H' � _ n.oao
1 . :� __ -, ; +i —++ecr>an..u.+. c> ���a w:,:•e o `7• . _...._._ -• it __- Ij ___- __ .._. __— . I
twll ��; �=_— _ I' t ^� ewes e.>`• /•-
1
Fri
lit w
IZ .=.:.-;+ -� I/' + i .•'-: ., _ .. ,I ;F., it
I !� w �� `�I — v •I—�.� i.la,`_- ��ir:? I u.Y m,. I � .� �. I,__'�L._' ._ 1 � _.� _ •. (
I I
i
Itoa IS4 vY,
".1' .�.
I I i � _i_1-� �4 c.^♦1 L ']:n0 4M1 0,/•...,{:j 5i: I I - , - �:i'• I 1 i i �� I IJ -I
� weYj.� c.♦L.Fyy r.�-.-r 1 I �.' 11 Iy _I_�[�.,„�_1 I I
1 - - _ ._._V-`�__•_... !,'.-/L4 a^(o+cF - 1 - ^il "ice: i I I •�'
77
• y
Al r1 �1 vJ r-._ _.--__ Ir--f__. .;h 6s-W9��fl we'd•� 1 - - �- � I•
Lj
' J. � : I j �� �\�•� I I NNH�2ySME?.;,N4.
- S Z,
,t ' •. - ti _
LL
�, ---
:'DSA ASSOUCM IN •'- ti .-_ L_'�,.
stT..e'
/ •'f.-.fl.r'Ss Cam£ �- ��
J
i ..__ I I I_�1 � I j• I I
� r�wr• � � '-------- --s---ter
I
cf
r
_._. .____-___ _ /� __ �• J"- - _ _.� YAYOSX ASSOCIATE:,ING i -._. -__•-�,.•_ I
ti gyp, :
ri
000.o:l
YN:r.Y10f6�i •
rsne.n�r:
U
I
i
I
j I
I
i
' I I
r. I i , \�� �I �-• I �-�l A.4+ i I I IG�I`• I �II �+ '=- "I � C
. �:' I I r,j
+II II I�-I�FI _< =--�' 1�P. •
I I I r
.I ii :_• ri
.�•.�,
..._.._.J� t_s _. E.o_ � I .. ti•�..A' ..��i' .i I[ � II .-�' I�i� .�erii -• .Go- -..I' _ _
1 � +
7-7
f
VAROBM ASSOCJATFS RiG
- Nanee...m msao
' d�_..:d m.Win„f aRDe•„J]
_ _ SUGGESTED SPECIFICATIONS Et[..n J tow D•�r r-w x-.ti.]n wr.m Df.n[t n,w wm rt d4 r E
PLEASE NOTE NO UN?IRECi$OPERN9ON ON THIS NtQ1ER saK✓:uiU.Sru
i t 4rne.[eves r•q w Or.rfeerro Jew n . . ..r e..«..•�.^✓frr<M�Or'w•Swcturoro.<D.+rvmm b.•rr•m. E • [rr.[_.r rr. v:....,:_arxnn. .n...nr �m w ua
. w Oww Can.ero•vr••,n•w rVe
.��.v -�.+.-��=:e r ow r n._.. rr mro+ )•'w...rm - wti.eu.,r.<v u[rJ w•nrw.n.rm,w wr[•c m. -
_ d�urw:et G Csrrnar,b n ru.r me.am e s,4 a..rw}w•rr v..• Ea:a pm .
farr'tld m r•rvdas•r.•..ugrmee b e]imrrr,se,.an m✓e�r,sro eh eta.a•re d 6 um Brr.•ee vu.w•
' •]m4,b �Ce+rw•wr�vv w�b w Urs>•q ., �'r'v •-r. .h rWet' ra Ms -
ro • vtirpa rm•[awf a•ry. s�b•ve• n s a m >an+, l v Omr a mMa •�
11,5C R,re • a,!n aanmea taSi✓♦•H .•S'v._ _
mmEsmo ea. -✓[] wm B:cmm . t.[t� .[ wrcx r.'cF1[SttJ1 ..
' B Tmerp•v rm'm errs n rr •n ror w•.w0,nsr RmsrV w. eer✓m VrNnW+,e K gmRperrypw�roe - ..
. n,ssaa^0.��ab w�v eerw C BrnnO a: - :Crew a e r•�^Chv }Pwr Rs '
•am .M1wcvu%e s. rw r M��A _ o^v+c me M _ • emOre rrtpM - •.
• qa,9^••e..at•r,u[e new D}rrn,m+ . ee:mv v� �i+rr*✓we • B R � ••rnr q rmw wv
c^•'mn n e Yb mrrvr•ro b rncun •_u e. m•o.p 4•c r
�r vdretw
. -- �Wmred•read+nvt m i.Y _' � .awr tanrtu
. ror1•wi,a•n e�te v J rmn.mme•m.r..s n O Rwb fm•ww n w J t'[qe U+na t. �n .
ee.rp e>+rcc�K ws aep.pR MrmN wnr a.m ue s}r F rss S D.�.ms Fwe w nsu]C ren n 4,:m v+Rw.w pwnr.. ... .
vvm �Eon New�.n�..•eve n fr ervn e R n•pr n M a'rep. 1 2. >vt•.�s
1 tti W VY m•— •c es ne.r p1••mrwrM.ry O�.w w slams Y wa n w • rw w m c[ _ '.n vd }r uceo viwnn
j m.rbm m :3 1�i""� w fa,ne •r�err San.+
•agaLv.d r 1!� ._ecwcj �R•t0`C.[ m.Om S.-6ir
�Y.� -.• w U+r+m a B .r Smme•♦JSn^V'ua_T-.eW S.[7•>•-t�V.me1Pe✓Ona n t � vw�'.an .
• Y m�v0,n.1
r'. >�caner.•d��asr rn�u/�tryr 4v.wmr+r�av mr.� L�ro'+Wnamr YumnT.rw�•.�,d•� tnr • u�w p+mda sw w t aff my nu•e war•maa r eve 4rm. . _
11 A !: qR a. Jno— ro 4 my B ar vw•m•s 1 S n m
D�A�>wo r.eoeau:rmsvr. •"•Opr}m.tnlrw D n mgdm m ,:Dbm•5�.4 9,u ••tK>
c u r•m users l.na C•mvs r W V r:.] Ga[uwr rn m isa:.v�vr'A mr wNw:uo"✓•nn C.G.•p•md..rw i.cv.o:.a•V
• .. rnq•sWn]4 O••rnv mw•Eiv.o•r'o rrtw wqr�r D NJ•meiaNnwC: p v and ec]v AeeVY r.w .. ,
r✓rm hen•^Y va 6o n E.pw✓e.. 1•'••'Srrp.r.[bd N.I])Y Caro em nnbp D imcb cJnrOr ..va-K w rt roan mn,ero K n aea✓•s M tH d V'aeep JN
. ..t mrlrtme� m Y w]®t w�nwm^m.wo.[. ; � ,.�D�•w• o Weem mtuN q M Lmrnevr %�v ew••s.m d�1���n R,c•,.: :.
r E �.�OrvA .r]^]rprnl m•.mn mnr•vd•va.d•r eM E •• K.OY,Ea.[, �.rrgnNn.Tv:eO t Wes: aa'J:.QaSiOB_sG>R•D[iww'EriISS(s=n_•6\ - ='J' _
.c nmrrn.dr[s e••['� vq.a o-rr.[rm.ry.em car d no w.c w .•�m�aw w✓.o a �� � w+mn pd a[r d.er[.v rma 4 w.•e•e..,,o,cdm,®r. '
' a.e co-.r. u. t u.em,c n e]rts•-m rmr.r. ..�.: �•...na,.,+<f:we+ew,w o...ro m�gtms n,nt '
.ew...e'.rerm.n. m,n.eep,r..a✓.,w a gd.nrm•ror p�m[avb e[e..e.ar_a�r m .•,w T. v , m w _ .. _ i
1 A oar mm r,a�VvaYas in wv✓ro w d`un.c c.0.vr.m tOJ.d r vCtw� _ _-��'••�r• m T B kn.cm prr+• ,u4^m•r+c..-tiTa,dts n[w.v+.m}
1 �ibbrm Drnemr.u a•omsvem )mw pr G Ew q.robe � w�.rr-�...._ •.yr E reKrua r;µ b nsu�11 m a.dew.•ero.m mn.a u .
_ qs+K'm• u YC Yr }carp^.•`mr: r w1 ee>e[4•.r :0 ••♦u � P�f/mrpe�n rvMe[eM�aJS 4m�.:.n w Drevsce wv[
' B Bevrns Y Arnim m •vaesen q•4 0•Mv trims0 � n Jr e _rm r pens•m ! raa•q• w•}:acorn.
I N�rar ,prrrmm eevmq]a mwr b� a �sv� Fr:tl�esrsVr[�.�D•vuvwsp�.,e.mab Ms` ). � ra •w rm ma'.M+a�p. n d gas , e] .
C •te•ga.r`.r�hpvdw� b w{pa rro is IS N � rt P^ry y{.+acr d srVra
0 U w T eYvmr k t or •So+_es >.p-•r.ea•� B mptnvrp d r�
Orem n.nr� I b[arm N p•c c m we�n•m W NI Il�tm•n m r'wrote
E tr.ra On .• ..avfnp+a.m ry _ __T_n;e•ym.1 ten .
- e_.._.'•h b_ }vw• � O.Pn,soS w s•.rO�r sws+q.dw '
.Ed o•avv ;'III b orwmK en•cot er mvpwp w✓p-ev L ,e ,m e+u[..0 m.ee _ Or rrsM .-a ru.r•rro a,<r.ew.•r..,n a.•rM r
j -_._ _ - +c•�c.a.q..e e,se nas.re.m.>-.e E" rtr _ ws u•_ �- ren rn..�.p_�.e.. -' S✓:�>f..[.a'D:.n[•:�::�`- -
r'marc ry 7tD].tN a•rran,W OJ•_ Drc•n x fvK ��pray,re' _
ee•mvf•v ew _ �1 _ [rest s w Ito'•.n Yr+6rJ'C Lwa. '
M Ors.o a n ...n hmrc w r Ow+.•c mr•arwe• O S.m,.v oe V+au....»rs n w.cnw•v t.rr..n s nr rNu'•rm S..L1^'�7._ w•�r:am rr.- 2w:.r m
n ••vmt0 �}rror,erq pm ti em� fqa�r c<r[•.4`r•n..c.c nWu.cn e V re 2 w.n+. .
an SnOma J.Vam m•mrnnnarr E] car b rtva.,o n_• ..d.Yr•rp m�E .,.t _ ^ n
' r) �L4—v anent e.u.r•em•a rt .n.:h^ro.M-'•. e .n won.m.,rnwrpt...,au�n �
a aer},ro.vpypr wr�m•.rwrarn u.qn d J.p00 vSJ r , .
rr ki' ` . +u rvmy.pe.rrr
o[: w..siJ,),J..: .s•u•rss ...r,w�a rtr ••++4 w•m.ehrx..w>.,.[Mrr<..,.d.m• Y AROSH iHi F 4550CS.INC
.r ..,..<r.p, .e .,..p. e.p rm e,....p . . � ..rc a deJ.r✓,w-lrt.°..) .� f'— ..... .. _.. -..
D..'�..:..��.s,�.An m w m..v e.a.eeq,a m..rt ,my-' n.ar.a..[>o e>:��..n..✓,n_w r .,n,r t.• � ,.�.. ___..__ M �—�.
..h.r.w a-•..rr.,._, e _ e_�. .. _ ,., a .m.. ..e..e:.- '" i SPECIFICATIONS .r
1
ZJ�SI6 N -PATA
5106L E FAG1P( 3 $E1 VWAAS 9e \o 0 o d >!
/�o r 6Ar�3A(sE 'GRIIJvvEtZ..._ ^. -
SEPTIC TANV-
12 3�x�/�j •d 95
lei?oSQL Ell /-1a0o'dA4.1 :smNE
. 51DEWALL APeA =I So'SFLn US
\ A IP
1307TOM A264 = "6n
.. - ..op
t1• r
MA
w°+
PE¢�ac.ATioN -i:¢� I►J .�i�AtN ; . . � � :��
A Of Aj ; , to �: i COF
R
_, V4 .7 `�•._:
BAXTER
uw !. ; . E . ; , •�
OIfAC �. i -� P 1 •I
to
� 'tp° {� � —wipe -- •�— ,_pv.•>,�- �` -
ALew
�IPct�
R v•�.
SiL 1 : �t7r: 1600 iw►! y9•o
l3ccoc B�. ,�� STrIC,
Iodri' iav aaz TNIC
GAL.' �� ;:.. ,
wa496 ';� TU44 a''DW
�". �T'oNE - -F-92-�sr�acL •aE N-2.o • - . . ;
CezTInED Pam• P[AIJ
VAITC
I:�..i.:l: :;�•tll' '� _.. .. PLAN P-2F�RQ•1C.E
. � :a� �'t�lE}'fDN�N=pF;B�Ct as'�►6(•�:-
aD ly �:ot„QT vV uI ! �Caoo. Yl A11.( - ;
id t_ i4iJf/.li/mot F. cCCRosg
t 1.J.� {..Y
i ; • �_.i. I r--� .�.�..{.:; ._� ., _ �,� it
I-
.4. ;p iSlorJdC.' LdtJD °Su `/arcs
' .
. :IBIS.: : �J IS.�:Noi" SAS f1:}I�lSTL't�GtEUT' . {.i. {_ t�:.i t_ �' E+1e N EELS
ti . `
.1..1: 1 .._� ,
bt�sets-f•��w,:�_�urJ1'�it3�..:;•, , �..I �05��/lciE - : : �MA'SS .
user :ro- aBus ; : ;. :, .;.� i..�
... - : , •SST �TY�la�t�5 �I� ; f
;1
_.
di'PL1cQNT:��I III �r15o A¢6�1T'
f
I YI
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please-"print.
DATE Tit I i Z �q
r
JOB LOCATION
Number Street Address Section 'Of Town
"HOMEOWNER" /-�1�15p1� JA 4,NT �?.H�1S
Name Home Phone Work P one
PRESENT MAILING ADDRESS 1 ��j$ NA W
S'►�YLV�Cksc �'Yl�d �z b�.
City/Town State Zip Code
The current exemption for "homeowners" was extended to include..ownes-.
occupied dwellings of six units or less and to allow such 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 to six family
dwelling, attached or detached structures accessory to such use and/or farm
structures. A person who constructs more than one home in a two-year
period shall not be considered a homeowner. Such "homeowner" shall submit
to the Building Official on a form acceptable to the Building Official,
that he/she shall be responsible for all such work performed under the
building permit. (Section 109.1.1)
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes, by-laws, rules and
regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department n' um inspection procedures and
requirements
HOMEOWNER'S SIGNATURE LJ
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35,000 cubic feet, or 'larger, will be
required to comply with State Building Code Section 127.0, Construction
Control.
NISCS
y
I Y
HOME OWNER'S EXEMPTION
The code states that: "Any Home Owner performing work for
Permit. is required shall be exempt. from the provisions of this ection
which s a building
r (Section I09. 1.1. - Licensing of Construction Supervisors
... Home Owner engages a persons) for hire to do such work
s
Owner shall act as supervisor. ' � : provided that if
, that such Home
Many Home Owners who use this exemption are unaware that the
e. assuming
the responsibilities of a supervisor (see Appendix
for Licensing Construction Supervisors, Section 2. 1Q' .Rules and rRegulations
awareness often results in serious problems ) This lack of
-Owner hires unlicensed persons. In this case pour 1Board lcannot when the Home
proceed
against the unlicensed person as it would with licensed su a
Home .Owner acting as supervisor is ultimately responsible.
p rvisor. The
To ensure that the Home Owner is fully aware of his/her res
many communities require, as part of the permit a ponsibilities,
Owner certify that he/she understands the res PPlication, that the Home
On the last page . of this issue is a form currentlyb used lbs sf a supervisor.
You may care to amend and adopt such a form/certification fo
community. Y evral towns.
r use in your
i
r _
` o.00
1� SnV. ..
_ t �
_
i
zq +_ 1 .
For' E
f
, l
\klI INEeG2rC jJ n za
4 4wl
; y ,
T/-/,4T 7-,44 DATiO�! LaC<1T/OTC/ OS7�2�/��,L `
>;�/c�h/N h�E.eEO.0 CO/t'Ii�?L YS GI//Tfi� �SCA L G—�-' I��,�,D ,..: ., ,�,t,•r, . . : i
•�/� s/oE.0/.c/� A//O SETBA Cl---;
8A �1sTg r31. givo X-T AOT '
o cA TE1:) fy/Thi/N ?',_5�� .-LocraPG4/y, ... .
7�y/s o,C�1w/S �(/o�- IXT.E,P_
BASE"O Oic/.4�f/ �2EG/S7"E,e�!> :C�c,/O;SIJ.eY6y!ar�
�NST,eUiy.��t/T,$'U.2YE}i�, Ty�•> - ,
.4P.�,L/C,QiVT12
}:i