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0026 CARLSON LANE
oG e No.2 R HASTIHGS,MM Ill��� r T Town of Barnstable *Permit Expires 6 mondo from issue date Regulatory Services Fee KASEL*61 • �����ll„`i� �����`�.Scali,Director jUL l o Building Division �. Perry,CBO,Building Commissioner �' ' , �1M nStreet,Hyannis,MA 02601�' ( � t t i 1 t� I w�town.barnstable.ma.us Office: 508-8624038 Fax: &- 90-6230 EXPRESS aRAUT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press I rant Map/parcel Number /33 �� � , Property Address 6,AlW - #,�_ Residential Value of Work$ Minimum fee of$35.00 for wor nder$6000.00 Owner's Name&Address Cat' L04L4 Contractor's Name d G�ct 1-1 • k> Telephone Number Home Improvement Contractor Qense#(if applicable) t� ,' 01.., Email: t �� ; (� �.Q' ! ✓1 C;�' t�` Construction Supervisor's License#(if applicable) C-`-� /0 2Q( , ` Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Hom er fil I have Worker's C•mpensation Insurance f . Insurance Company Name 6 U�t-�0^ 0LI11-c-c+_ . Workman's Comp.Policy# LL 0 -,rS(2-10 Y ff Copy of Insurance Compliance Certificate must accompany each permit. Permit Fj6rt(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to a, ❑Re-roof(hurricane nailed)(not stripping. Going over existing'layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. °Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of a Home Improve ant C tractors License&Construction Supervisors License is required. . SIGNATURE: C:1Users\DecollikiAppDataXLoea1 icraso indowslTemporaryInternetfilesTontent.0utlookUP101DHRTMRESS.doc Revised 040215 MAU Town of Barnstable Regulatory Services Richard V.Scout Director Tbomos Ferry«Cgo BuitcTin��fimpicSsi4eer 2AA Main Street, Myannis.,NIA 01601 '%-Ww town.barnstnbTe tna.tfs Office- 50$-8624018 Fax: 509-790-6230 Property Omer Must Carn:plete and Sign This Section If Using A.Builder 1� A"lcr J, tt/� jrvs) a Owner of the subject property hereby authori to act on my behdf in aU iris re live to%ork autborized kv this bumn pem. R wpfic�ation for: 1 G Car�jcoN L N yVi �N�rus�+�/� (Address of Job) w Si ature ofo veer Date Claw e yrv$ Print Name 1f rvoP*rOY r is"ty^for perwo',.ph a c0ftpue ttw ton W*ers Z_itewe Exmptisats� on the nvexse sure. t` liSerstt cdttik4l=sp�}e1eJ«Ca11 vi�crosoflSWit�fcnvct tm�ptt+n intemet.Fi!aTCosst tl:UurtocicE2}�[(}IDItR Stt'Rt CS dor Revisoc!040Zti I Client#: 16665 2MEAGHERCO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06113/2018 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 8r O'Neil Insurance Agy PHONE 508 775-1620 FAX 5087781218 A/C No Ext: A/C No 973 lyannough Road E-MAIL P.O.Box 1990 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A Penn-America insurance Company 32859 INSURED INSURER B:Associated Employers Insurance Company 11104 Meagher Construction Inc. INSURER C Timothy Meagher INSURERD: 776 Main Street Osterville, MA 02655 INSURERE: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DDNYYY A GENERAL LIABILITY PAV0146331 10/16/2017 10/16/2018 EACH �OCCURRENCE $1 OOO 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrrence $50,000 CLAIMS-MADE 51 OCCUR MED EXP(Any one person) s5,000 X BI/PDDed:500 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 X POLICY PRO- RO LOC $ AUTOMOBILE LIABILITY COMBINEaacdEDdant SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS N PROPERTY DAMAGE HIRED AUTOS AUTOS $ AUTOS NON-OWNED Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WCC50050054422018A 6/2312018 06/231201 X WC STATU- OTTH. AND EMPLOYERS'LIABILITY IER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $100 000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) 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 IN Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S213066/M213065 RPSW1 The Conintornrealth of ilassachusettcs De varhirewit of Indushzal Accidents i Office of Investigations 600 Washington Street Boston,MA:02111 ' r►mv.rnas&gm,1dia Workers' Compensation Insurance A&davij: iter'slCQ7mti`attdts/O ttticians/Plumbers AlMlicant Information PieaPrint Leldb Name(Businra/Oraniaticavbdividual): C� Address: t� '�.• City/State/Zi � Are yoipm employer?Check the appropriate boa: r- Demolitionype of project(required): 1.Wo am a employer with 4. ❑ I am a general contractor and I ❑New construction employees(full and/or partfime)_-* have hired the sub-contractofs Remodeling ?.❑ Ian a sole.pwprietar arpartner- •ksted.,anatl;e att chid 3seet ❑ ship aadEcti�,no employees Tliese.sub cogtractors lie wod ring for me in any capacity. camp. 'e.1 ems` 9. ❑Bugg addition (No wodDm'comp.insurance e ain corporation I 10.❑Electrical repairs or additions required.] 5. ❑ file are a corporation and its 3.❑ I qu a homeowner doing all work officers have exeemised their 11.❑Plumbing repairs or additions fight.of exemption per MGL myself 12. Roof repairs insurance watkefs comp. c. 152,§1(4),and we have no ❑ repairsinsuranc .]T r employees.[No wotJcers' 13.0 Other comp.insurance fequire&l 'Rety agpliimii ahae ctteL%s bm#f"tikM aLdt fill am ftee.sec�lielotu&bowing vim•'co®p®msatiompa]icy ief°amate°°1 1 Nomeowaers who submit Ibis affidavit inammis they am doing all wa l and they here outside ce=ctm mast submit it new off darn odicatigg sack �Corrado That chech this bm must attached an addidanal sheet showing the name of the sub-cou=ctars and state Whether or not those eulities have empioY . Nate s,,bcanmct0M have employees.obey must pm d-their warkess'camp.policy number. I ant an employer t1lat is prosIdWg workL--;: ' s insurance for my enip�tow is Hie paliey fob site informadolL C°.; pt3licy or ins_tic.� r �� ExPirftion`I?ate:.s� � Job Site A City/State/7,ip: W Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to seem coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Sae up to$1,500.00 and/or ono year imprisonment,as well as ci%ail penalties in the form of a STOP WORK ORDER and a fine 9f u 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 DU for iWance coverage vii4ficatioj 16 hereby certifi+un4&e " s and penalties Par�n t iiie.irifi►rmotieKi°>oeide/H. 'e t►rr nd cen t Si lure: r ' o �y Phone#: Official use onit: Do not trite in this area,to be completed by city or hvntn officiaC .,Cih4rT*wn: PermitUcense 0 Issumg Authority(circle one): 1.Board.of Health 2.Building Department 3.City(rown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.dtfier Contact Person: Phone#• 6 I Massachusetts Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-102260 Restricted to: Unrestricted-Buildings of any use group which contain Construction Supervisor f less than 35,000 cubic feet(991 cubic meters)of enclosed space. MICHAEL S MEAGHER JR 97 EMERALD LANE MARSTONS MILLS MA 026M Failure to Expiration: possess a current edition of the Massachusetts Commissioner 11/06/2018 State Building Code is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOV/DPS rwr (/ruirinnnrorrr�/�r/�•I�rLJrrr�uJc//J Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Individual before the expiratlon date. if found return to: Aeoistudlon E i xplrat on Office of Consumer Affairs and Business Regulation 162938 04/26/2019 10 Park PI -Suite 5170 MEAGHER CONSTRUCTION,INC: Boston, 02116 MICHAEL MEAGHER JR: „_ 776 MAIN STREET U —`"""i/- /,, OSTERVILLE,MA 02655 - Undersecretary t valid without signature l f Building Performance Contracting,LLC V. �W /b� Nauset Insulation S P.O.Box 1044 N. Eastham,MA 02651 Phone(774)316.4464 Fax(774)316.4462 7j0 Date A 1 l RE: Insulation Permits Dear Mr Perry, This affidavit is to certify that all work completed for the insulation work at has been inspected by a certified Building Performance Institute(BPI)Inspector.All work performed meets or exceeds Federal and State requirements. Respectfully s mond CO � I r� Co rn I f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 0�v Historic - OKH _ Preservation / Hyannis Project Street Address 021� Village�il, T f�� ,� /�l (26266? Owner - 11,nj Zee, lftr,Y Aga Address 07(P 11y6Y7 Telephone ;5b?--375 —65L0 Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation sy ,c� 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 o Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/00 al stove ❑Ye_s ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑,existing C new`Size_ w ^J Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: = �y Zoning Board of Appeals Authorization ❑ Appeal # Recorded 0 ' Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Josh L",_J Telephone Numb ------ F r - /' �� Address Pd 60� rlJ�3 �/��� License # Home Improvement Contractor# Worker's Compensation # U)c V 00 7 ,:/L/dD ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO� l SIGNATURE DATE all FOR OFFICIAL USE ONLY APPLICATION# i DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE `w ELECTRICAL: ROUGH FINAL ' r PLUMBING: ROUGH FINAL GA • ROUGH FINAL S. OUG P . FINAL BUILDING f ' DATE CLOSEDIOUT ASSOCIATION PLANNQ ♦ f L ju c4xwwmpemM Of MAwaebmem DqmwbmmtofbrdmbWAcddmb 600 Washbgwa S&et Baal;MA 02M s�v,..a. r e.+..aa.cnrfann in _an A vi A � Please PrimtL Name 1�Lci I ��, � �-e ���_��'���►-� 3-3 QtYMa� ��-c.ro D2"�#:1 a� C�� �ofcx I.L"J isma W&S I�Imed �� 6` D shipamdbavcno These s. ❑Demote . wowing £arno in any y cu*o - 9- 0 Bo�'t�mg D 1Q uquim -l. 5_D We ate a aogaasmsadits Bled or addilio� 3.0 Iwnahmneownwdd-wgA armmsbavectemisedtmir U-a or MYNK fxo wadne > of perms- Roofta �- 12.D 1t GLSI,�It'IAandWenA 13`[]Odter emtd - _ =A�q►a �ae�t��mmca�O�3anc�seo�� �+rwoaoe�or�Y . tH�mooasas�em �'sit m �9��saflwmlca4dtmaana�tsoa� e adm*Ww oxmmaaum tedsm a 8��a e�o�a��di �aormtfl�e> Lage wooyam Htw bave ,ftYumtVVd&&* eamp.poftmmbcr- ` Taman dWjFpropiBagtames' jrroaae. bra*mW&yejL Bdawk&ep&5Wawdj#bante ice C=4y-mYNM= 0%r poficy#orSe>frin&> Job Sft Mess: Mb--toaopyef&ew+adms'=mPC=mfi=PGftdOdmmfiwr t th*ro9 SM&qf Iilobe} D' 6,r FaamotD=caecovemps$ SecfimL25Aof1MC.152caalea&jDgw afm,&a paa lfmofa f=MptDg1,500.00 sswailtascivil is&CftmefasffWWMXoRMandaffe GfjptDSMADadayagqbmtftvhAmftm Beadvisad6 aacopyoff ddmncutmybefimraa dledtotoOf5mof Investigs6oaas of�eDjAf� W- IdoherabyewOmM of deda�aes anda®rnert l �V/T11 Pltoms# , ff Lv// - CRy or Taw= # L Bowd 7- Dqmtment 3. Cb* 4. S.Phumgkmpedw 6.Qfber Coutodptrom r # m00 . 22 ? \� � qR k % � F 2 > O - 0 7 -■ \ f � . � �■ v . � _ ,. ■ � � �\« \ _ . g 2 - . I i NOTICE NOTICE TO o TO EMPLOYEES ,t EMPLOYEES M Sv• The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street- Suite 100, Boston, Massachusetts 02111 617-727-4900 - http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above-mentioned chapter by insuring with: Insurance Company: Atlantic Charter Insurance Company Policy Number: WCV00939901 Effective Dates: 11/23/2011 TO 11/23/2012 Insurance Agent: County Insurance Agency, Inc. 123 Sylvan Street Danvers MA 01923 Employer: Building Performance Contracting, LLC 50 Sunset Drive Beverly, MA 01915 Workplace: Building Performance Contracting, LLC 50 Sunset Drive Beverly, MA 01915 MEDICAL TREATMENT The.above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at-the NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER ` ' a� Ucen�or valid€or individul use Ogee of Consumer Affairs&B eas Regulation �don only HOME IMPROVEMENT CONTRACTOR before the expiration date, N found return to: Regbbatlon: 4462715 Type: Ofee of Consumer Affairs and Business Regulation iral3nn:_ 13 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 j WJEMC07IND ;, JOSH EMOND 't i 50 SUNSET DRiVE � E BEVERLY,MA 01915 bnderswxetu7 Not valid withoutsignature .r OWNER AUTHORIZATION FORM I. D©n a NJea ,MacS�a l� (Owner's Name) owner of the property located at 2 Cat[Snn CqA e (fie s { �,(P r►�a 2 � (Property Address) (Property Address) GO u C�G�C► -Q r)c hereby authorize n�— '�— (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. O ner's Signature Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel. D: Permit# 5-4 7/ Health D V-�sion �� �� =f ' Date Issued Conservation Division Application Fee .&q (� Tax Collector Permit Fee ` Treasurer son" Planning Dept. UA41M TO Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 2 f M1,f0NN� Village � Pjf�Q N 1 Owner &(CW9 MM/2,sAlpCL Address LfaN Z kvC Telephone w _ © _ Permit Request f/V1jl� ��1��'�/►'/ o Square feet 1 st flo_oo�'r: existin l m proposed 2nd floor: existing proposed Total new Zoning District ``© 1 Flood Plain Groundwater Overlay Project Valuation�/; 3U- 06 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family `d Two Family O Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes NI NO On Old King's Highway: Cl Yes ;no Basement Type: ❑Full O Crawl CWalkoo1ut Cl Other Basement Finished Area(sq.ft.) 606 Basement Unfinished Area(sq.ft) Number of.Baths: Full: existing . 3 new Half:existing / new Number of Bedrooms: existing_3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: O Gas 15irOil ❑ Electric ❑Other Central Air: O Yes '>[No Fireplaces: Existing New Existing wood/coal stove: O Yes ❑No Detached garage:O existing O new size Pool: O existing ❑new size Barn:O existing ❑new size Attached garage:O existing O new size Shed:O existing O new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use (4 TI L lry Proposed Use BUILDER INFORMATION Name U16V f COkA/i N 6 A0,41MlY '�zttf Telephone Number Address 014,0 IF(4 RN 10//(6- n, License# c4m 7?)/v , /hA 620,21 Home Improvement Contractor# / 3 7 FY 3 Worker's Compensation# W CZ —3IS—3 YY3r9-" 1J_ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0w6vf CCR/V I N 6 96o T119W 11 _ rT. 64,0;9 N AA 0'.2-02 i SIGNATURE IV4DATE 6 �� FOR OFFICIAL USE ONLY PERMIT NO. .�r. tr DATE ISSUED MAP/PARCEL-NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH s FINAL PLUMBING: ROUG D FINAL t- GAS: ROUGI FINAL _ A FINAL BUILDING P DATE CLOSED,OUT t ASSOCIATION PLAN NO. y i The Commonwealth of Massachusetts Department of Industrial Accidents Office of lnvestigations 600 Washington Stree4 24 Floor Boston,Mass. 02111 Workers' Com ens on Insuurance.Affidavit:BuildinvPlumbin lectrical Contractors- o name: 1`"�'►'�"p //t6Ttl�7t17y� address: 2 O city " ` fl/WbNJ N'1y`'"f state: /• V4 ziD: 026 tr shone# work site location(full addms : S ►9/I • ❑ I am a homeowner performing all work myself. Project Type: [:]New Construction emodel I am a sole pro rietor�cand have noone working in any capacity. ❑Building Addition +"n'.. ' '�1 .1r`�n `y d'�Ysxt'�°�' s wli"zx x birr ': "rear;: 7c}:vCn-i".Cry iy. l� I am,an employer providing workers'compensation for my employees working on this job. company name: address:' city phone#: Insurance co. wr, policy �d3s113intiKI =eneral�contr�act�oro' %omeowner(circle one) and have hired the contractors listed below who have Ro m company name: �C" IE�/C address: /^T 66' 7 - ,v�vn/ iAE 57. city: 02-021 phone#: 7�/'?12 t—cl d cQ i insurance co Ll Q /Tt/ /I'tCir-Vfil olicy# a✓2— ��S-3y�3-�9-ols p �'i✓ 5� r<n�•'9��c• t�R vLR.i�4�.cr PNS.F�r'�.��'�ty��1�:�`�l'i1rr�L�".t�Y.. S+�A..{:�.:N.t.r� yn.r„�*�•k�'.YfaJ'y�il�ts.. r�4@t.�Gi`'.Y.r1�ryC{i°ji�.'.:•y4.'� 7)FF�� • �YC 'company name: address: city phone#:. insurance co. policy# s' if d 0 ` tl'_ rC�.brH �. ,' °� °_. .,% .... s.•7 ti .rr•, t .-. .1 .,.11:[..�a ...��_d3.. '���,'•. an�ai�. c. i ��t�'u�i�s�.' �'�.�ii§E�+�b�:�si✓�i `'�� ° Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition-of criminal penalties of a fine up to$1;500.00 and/or one years'Imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a- copy of this statement maybe forwarded to the Office of lnvestigations of the DIA for coverage verification. ' r do hereby certify under the pains andpenalties o perjury that the information provided above is true and correct. Signature DateJV �!•W 0`r Print name 1)kN� VI EL Phone# 92 OV 6Q official use only do not write in this area to be completed by city or town official city or town: permit/license# :03Selectmen's ing Department CO]check if immediate response Is required sing Board Officecontact person: phone# h Department(Mi=d sepe lo03) ' r. Information and Instructions Massachusetts General Laws-chapter 152 section 25 requires 0-employers to provideworkers' 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 writterl. 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 bean 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 requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that'applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that therapplication for the permit of 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. a,,�•fP ,z o;• z'.: �E r . .t.;7� :1 t /'g. �iN..9,ir;•.7'1� + �. a:: Z .�i tire} at City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference.number. The affidavits may be returned to the D•epaitment by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for.you cooperation and should you have any questions, please do not hesitate to give us a call. .The Department's address,telephone and fax number: - '•The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`s Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext. 406 . _ {,1•{�/ III LVI LVV�I �I �I..I tea'• �Au�. a..I V VL _ va'�V Liberty Mutual Group :i ]Liberty PO Banc 7202 Portsmouth,NH 03SM-7202 Mutual ' Telephone(800)653-7893 Fax(603)431-5693 May 20,2005 i I RE: Certificate of Workers Compensation Insurance Insured: OWENS CORNING FINISHED BASEMENT 960 TURNPIKE ST CANTON,MA 02021 Policy Number. W(2-31S-344359-015 ElTective: 5 242005 Expiration: 5 242006 Coverage afforded under Workers Compensation Law of the foIIawing state(s): MA Employers Liability' BodilylnjuryByAccident: $ 500,000 Each Accident iBodily Injury by Disease: $ -500.000 Each Person Bodily Injury by Disease: S 500,000 Policyumits As of this date,the above referenced policyholder is insured by IA-berty Mutual Fire Insurance Co under the policy fisted above. The insurance afforded by the listed policy is subject to all the terms,exclusions and conditions,and is not altered by any requirement,term cc condition of any at other documents with respect to which this certificate may be issued. This certificate is issued as a matter of information only and confers no right upon you,the certificate holder. This certificate is not an insurance policy and does not amend,extend,or alter the coverage afforded by the policy listed above. If this policy is cancelled before the slated expiration date,Liberty Mutual will endeavor to notify you of such cancellation. %.0 AUIHORtZJD ;RFPRESEWATIVE IBERTY MUTUAL INSURANCE GROUP This Cuiriak isooakd br LBERTY MMAL ntSORAME CR=as=pmh IN&i.smamw n is affmW by hose ampanim cc: Insured: Producer of Rocord: OWENS(DINING F NISHED 111ASEMEN17 ANDREW G t CORDON INC 960 TURNPEE ST P O BOX 299 CANTON,MA 02021 NORWELL,MA 02061 srur:aos � . • ' /1. �W // OWENS CORNING • ' � � C' A,rll/ !■■!!■!■!mom■!mom!■■EiE■■■■■■n!■■■!■mom!!!!■■11�• I - �!■■■!■!■! ■!■!■■!■■lnnF§■■■■■■!■■■■!■■■■■!■!!■Iy�iiiivii ■■■■■■■■ ■■■!■■!■■■■■[4■■■!■■�E■■■■■ !■!!! ■■■■■■■■■■■■■!!!■■■�i! ■■■ , ■!■■!!■■![[�*11`�i7■ Lia,l■!■!!! ■■!■■!!nn■!■■!■■ ■n s��►���i� lai!!■all" TIMES !■! !■■III■■■! I ■i MwMd!■■■!■■■■■llrli�'ii��i"i�®®®®®!®®i ■■[�iei��ii ®®■Eiiii It IMMIN!■�!■!■!!■■■!■!�■■!■■�� �oi�O■ ■ I�!!1 ■IIFEII! !■!E'+ ■E!■■!!■■■ '�1 !■■■■!!■■!!■!■■■■■\�.,■!■■ ,NER!■■11!■IH1 M��� ■■■■L!■!■■■■ `■■■ rl !."\■■■■■!ti■f�■■!!■■■ !!■� . i�lf1 �11 ■■I1�!■■!!■ ■■l1►�1■Ei■!■11��1\llr�11211�+\■■■!■E�!!■!■■ll���La■!■! 111L�i lE■■ SCINN■■■■■ ■■■■`a■■i�■■�� llVl�1l0r■■!!■�:11►i■I!■■■!w4FAV,!® ��Iti��i ■■ I/!■■!!! ME■■!i'��■■lrecs��i■�lf5■■■■MMm"i\ilk■■■!■�C�ll��(It:'�\■ l�F:■!I ■■ ,�■■■■■! NMI !!■1��!■E■!■lam !!■■�1■!■Ci■■!■■■Lil»U■■�■! ■i111`iEi�����1�� �������� l■■■lnn r���e�ne®nn■■of:�■l�•n■l�!!■■■■W!■■!■� w��....�__..__ �i■nnn�■■!!rEli!!MEMO■■■l!7■ �1n■■■!■!!�■■■■!■■ ■■■■■■Diu.�nCi®� �■i13�■■■■■ ■■■■l\11i1Y1�■!■!■lll■■!■■ .!■■■■!■n■ri���nll■ll■rein■■■■■�!!■■■■■■■ l !■!■■■l■■■ll����n■■■!■lal!■■■■■ No ■!■■!■A6il�Jl■■ll■■■■!!'■■ ■i■■l■■!■■■■■ISIi:9C�!■■!■1�11■■■■■■ ■l■■■liii i�lll�i■■�i` ii■■\\`■r■■!i■!!.©■■! !■■■!1!! l�E�!■!!■■■!■!w^!1►�!!�", ■!■■■■!�!■!!■�lii■!■■■■!!■■ U'TLr.1■■! NMI HIM �1l��P ` `■!■`i 1 ■r�: ■�i ! !!■■■■ mmmmp-■■■■■■ a� � �l= !!■■■■M "fr lmikm ■■\r■■■■F!(�1i�:I■lIl�tI l �irt�� ■ mommomm !■EiIL�IKE] M■■■■■!■■■■■!■■ , - i!■■!r1■�\���■■�,l► \!■■■■■!■■■■!!■■■■Es�i�llE�la�►�i:�li�r_ei■ MONSOON!!!■■■■l0�s�lEi®1■11��1■l�iiiGi■r( ttla�aA!■■■■!■!■■■N&ia !!■■!■!�'■� ■�1KNE _ ll:�■Eji! !Ell■■l■■■■■■■■■■l■!`n�t5l � �� i ■■���NNElolploolum..7 l■■■!■■■■■!■■■!■■ ■MENOMONEE ■!■so NONE M 0 �!\�r\�ii■ ■■■■■!!!s■■■■!■■■■!■■!■■■■■■■■■!■■!W■■!■■■■!e■■!!■RNOMMOMMON no ll������� • �i • CONT TTO INSTALL OWENS CORNING BASEMENT WALL FINISHING SYSTEM Bay State Basement Systems,LLC.d/b/a/Owens Corning Basement Finishing Systems of Boston(the contractor)hereby submits this pro- posal to.sell and install the Owens Coming Basement Wall Finishing System and related Items as described herein at the residential premises set forth trelow.This proposal shall not become a binding commitment unless and until it has been signed by the Contractor and the Customer. Contractor: Bay State Basement Systems,LLC.d/b/a Owens Corning Basement Systems of Boston 960 Turnpike Street,Canton,MA 02021 Telephone#(781)821-0060 e Facsimile#(781)821-8552 FedeNal Tax ID#14-1855297 Mass.Home rImprovvement Contractor Reg.#137943 Date CLL r c 4)0 Customer: Customer Name \ /U{C1 dl l A l�fa d'— ��• h[�/r O �� � Street Address City,Slate.Zip (� �d Telephone 1 J J r a 1 This is a contract between the Contractor and the above named Customer to sell and install the Owens Coming Basement Wall Finishing System and related items specified herein at the Customer's residential premises identified below: Installation Premises: Q Street Address Vr_L__ City,State,Zip Scope of Work: �N Are Sketches and/or speci fication sha9ts attachede,r' al eneehmema ere ineorvoreted Ono and becortie a ben m th!R lxrtra�t iT �xgta t t 4� ' c Descripti of Wotk/Specitications a 'fro :�'4 ems` ?zeiE'�-..YGi.�.9' �k ,�Q(i•.!//� 4c"" w ^4� . r Work Schedule": 4 Approximate Commencement Date Approximate Completion "The proposed work sched}rle is approxir�tate and gu�bJect to Change 22 e ; Contract Price: '`i rxr.z` 3.;E s i,i y, Total Contract Price: Deposit with order. $ 3'Z cro /' C ht -A?fir•.i. / QC? jQ Balance Due: Terms: O Cash O Finance " (Cash terms are 10%deposit,50%on commencement,40%on completion) 1" Due on C6mrot3ricement .,z�raa. $— 1 G 521 Due on Completion DO NOT SIGN THIS CONTRACT UNTIL ALL APPLICABLE BLANKS ARE COMPLETELY FILLED IN AND UNTIL YOU FIRST READ AND UNDERSTAND THE ENTIRE CONTRACT,INCLUDING ANY ADDENDUM ATTACHED HERETO,AS WELL AS ANY ATTACHED SKETCHES,MATERIAL LISTS OR THE LIKE,AND THE TERMS AND CONDITIONS ON THE BACK OF THIS CONTRACT DOCUMENT. YOU ARE ENTITLED TO A COMPLETE,FULLY EXECUTTEQ COPY OF THIS CONTRACT AT THE TIME OF EXECUTIONS Nitness d(s)and seal(s)below on this /1��((�^ day of_ Y 1'I,L_Lt• Chu S tractor/ rized Repres ve. iigneture np d Title � Y`C, k 'nnt Name )0 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES :u tom r Signature aa&ia 'rint Name r °FINE rq Town of Barnstable ° Regulatory Services r • ` Thomas F.Geiler,Director 1639. � 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. 326 0� Type of Work: /� rAll JN A4-rE/h��r Estimated Cost G Address of Work: 26 64/U OA/ Owner's Name: /A C�'r✓7'�"� r'T�'f L�— Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: CA/ � 0(,4AV-r ca/1IVIN6 �y3 Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 089307 B1rthdate:.'.-t9/30/1967 Expires: 09/30/2007 Tr.no: 89307 Restricted:-;.00 DANIEL F YELLE -? 481 CORONATION:DRIVE. G— FRANKLIN, MA 02036 Commissioner Board of Building Regulat ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 137943 Type: Supplement Card Expiration: 1/29/2007 OWENS CORNING BASEMENT FINISHING DANIEL YELLE 960 TURNPIKE ST. CANTON, MA 02021 Update Address and return card.Mark reason for Chang El Address Ej Renewal n Employment ElLost Card qPS-CA1 0 50M-04/04-G101216 ✓Te i�ovrvnwncueal!/ a�./�aaoac%uaella Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 137943 Board of Building Regulations and Standards Expiration: 1/29/2007 One Ashburton Place Rm 1301 Type: Supplement Card Boston,Ma.02108 OWENS CORNING BASEMENT FI 960 TURNPIKE ST. r! / L V,,V�4 CANTON,MA 02021 Administrator Not valid without sigiffture _ I a , ,a TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 1:33 062 GEOBASE ID A,31976 ADDRESS 26 CARLSON LANE PHONE W. Barnstable ZIP - LOT 7" BLOCS LOT SIZE DBA DEVELOPMENT DISTRICT WB PERMIT 11184, DESCRIPTION SINGLEIFAMILY--RESIDENCE PERMIT TYPE BC00 t TITLE CERTIFICATE OF OCMpifftffi ent of Health,;Safety CONTRACTORS' , and Environmental Services ARCHITECTS: , t i TOTAL FEES: �. BOND $.00 y _ CONSTRUCTION COSTS $_00 i I 753 MISC. NOT CODED ELSEWHERE - ' t HARI!igTABLE. ' f F MA88. OWNER ' MARSHALL, R.MAYNARD & DONNILEA ADDRESS 26 CARLSOU LANE WEST BARNSTABLE, MA BUILD G I r DATE ISSUED' 10/25/1995 EXPIRATION DATE BY <y � DIVISION APPROVALS FOR CERTIFICATE OF,OCCUPANCY TO BE SIGNED BY EACH DIVISION HEAD UPON COMPLETION ! BUILDING: DATE: COMMENTS: r PLUMBING:' �� ' M1 DATE: COMMENTS' ` ELECTRICAL: DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.:- DATE: COMMENTS: OTHER: DATE• COMMENTS: TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OFFS ARE COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE ISSUED AT THATTIME. _ _ - r __ r_..- �. .•:. «_�..c 1 ice: ,r:.s•..e.,, i�'.' •-'..aa:r^�j- TOWN OF BARNSTABLE, MASSACHUSETTS BUILDING -PERMIT DATE ii=q..66�.1.uf)�. )5 PERMIT NO. N9 37536 19 t APPLICANT 4 udGI,"rC j' SUry"' ADDRESS ''Y$QuO1L' cavwa , F. Fa mouuh UuU 2(NO.) (STREET) (CONTR'S LICENSE) PERMIT TO i,).1�iU '.:'n'f_'-L�_:!ti (_) STORY Single Z'Imily' res4 ,-nce NUMBER OF L DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) r :tY-'.G4a u -,T;c'_ (i.a(; i j �JuG t baY-n_-table 'ZONING RF ` AT (LOCATION) -" DISTRICT (NO.) (STREET) - BETWEEN AND + (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE S , li 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 FOUNDATION (TYPE) REMARKS: ?5.--4u6 ..)21.:iC1 AREA OR �;=, 270 000 PERMIT VOLUME ��'• ESTIMATED COST $ FEE (CUBIC/SQUARE FEET) f OWNER •`• drC. a -�CT.!.i:_ia_,� ,.iil":.ae l._ / e _'.)C .^:CCU ..� L:w`iJ) BUI �IF _ * ADDRESS _ B or THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, A"LLEYIOR jSIDEWALK OR ANYPART 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 THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE.THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ,T:. , •MINIMUM OF THREE CALL -APPROVED PLANS MUST 13E RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE.3. FINAL INSPECTION BEFORE ' OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 3 i HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 � OF HEALTH.. OTHER (!1ttz SITE PLAN REVIEW APPROVAL r WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF 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. A 1118� ' LOCUS IS A.M. 133, PARCEL 62. THE LOCUS SCALES IN FLOOD ZONE C ON FLOOD INSURANCE RATE MAP REVISED JULY 2, 1992. All �y 0 NOTE: LOT DIMENSIONS HAVE A Q' CLOSURE ERROR OF 0.19 FEET sg, S 36-15-02 E. THOSE OFFSET FIGURES WHICH COULD BE IM— m PACTED ARE SHOWN WITH A s ss. 0 5t2,,� u ,Y LOT 6 LOT 7 c 43832± SF o 00 CB/DH FN HELD EXISTING CONCRETE � FOUNDATION 2�$ GB/DH FIN HELD 32.0' ^�' ,15 S0.00 1 r l THIS PLAN IS A, VALID COPY ONLY PLAN PREPARED FOR IF IT BEARS AN ORIGINAL RED STAMP AN • ATURE. R. MA'YNARD & DONNILEA MARSHALL -\k\0Fss9 SCALE: 1" = 60' APRIL 10, 1995 RON ELD oN o CA RONALD J. CADILLAC, PLS 5 P. 0. BOX 258 WEST YARMOUTH, MA 02673 su (508) 775-9700 /6/9s _ Assessors office(1 Assessor's map an t Mn Conservation L w Board of Heal rd m f t� y�� BAR33TLELZ Sewage Perini mber ! c� `� T ya Engineering Department(3rd fl or• q SEPTIC SYSTEM AEU A3V•``.� House number r_ �) INSTALLED IN C®MPLI� �Y Definitive Plan App ved by Planning Boar e(p `� 3 -19 i"�ITI�I TITLE ill APPLICATION PROCE ED 8:30-9:30 A.M.and 1:00-2 00 P.M.Only rn� �` p• �� Syr r��-- ;rl are I�'► 17A,L CODE AND I TOWN OF BARNSTABLE �n4 � BUILDING DIVISION APPLICATION FOR PERMIT TO CONSTRUCT A 34X28 CAMBRELW/26x20 jog, 1OX16I'M RM 2 M 2CAR GARAC-E TYPE OF CONSTRUCTION NEW CONSTRUCTION CONCRI'7'F FO TND TION/ WOOD FRAME -J 2 G 6 *TARCY 20, 19 95 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location LCH 7� 26 C'ART.SC N T.Amp.., LEST BAR S ABLE NA Proposed Use SINGLF, FAMTT,Y RF.S Zoning District PE Fire District Name of Owner R' MAYNARD & DONNILEA MARSI3AT,T• Address BOX 3738, POCASSET, ^P_ 02559 Name of Builder LEONART) ,T_ gFmT-rq (CAPFcmvT.F) Address_623 pMIN CTg= , FATNrnrZU p4A n2r40 (457-1616) Name of ArchitectNOKPNSIDE DESIM A c;nrTA^F:S Address 141 MATN q'PRFFT� YARMOTITHP()RT, rm (36 —9805) Number of Rooms NTNR ROOMS (9) Foundation CONC PFTF mxgg, 7Hx7n,. 1 nwl(; 24x24 C'ARj1C-E ExteriorIA700D, 4" RPn C7- nAR CZ-APROARDS Roofing pim c=AR SCNjb=gS Floors 3/4 T&G PLYb= Interior Heating OTT, FTRF.T) cv q� H(7M km=R Plumbing�2A= A T� Fireplace Th70 BRICK Approximate Cost 970 nnn pn Area Diagram of Lot and Building with Dimensions Fee i I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. d Name LEONARD SEPVIS Home Imrpovement Contractor Registration# Construction Supervisor's License# 000425 /22/95 375-3.6 133. 62 No Permit For 3' Location 26 Carlson Lane (Lot 7) West Barnstable o Owner "R. .Maynard & Donnilea Marshall Type of Construction s Plot Lot „ 6� low Date of Inspection 19 Date Completed �/40, < 19 r_V a r 3zk rtt 'COMMONWEALTtl 01.,4 1 PAl1TMENTOFPUBLICSAFETY Q I V 1 "I`11 t: i` "-:Ir1I•oI �f OF i tlr,.erutcb.•...!• .'...,t./rycllll!�4 E ASHBORTON PLACE' p + 1;odm le 1.::.,;,:;or for000rlow MASSACHUSETTS BOSTON,MA 02108 f I� oI Ulla llr.:rnon. LICENSE I� EXPIRATION DATE CONSTR. SUPERVISOR i� CAUTION 10/24/1995 ` RESTRICTIONS EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST NONE 106/30/199,3" 000425 ii THEFT, PUT RIGHT THUMB 6 e 1 PRINT IN APPROPRIATE i:PLEONARD J ,SERVIS ? L BOX ON LICENSE. SS N 029-42-8717 €EASTNFALMOUTH�MAYU253G '? ATINCOP`EiiIi&S MUST INCLUDE PO. i PHOTO(BLASTING OPR ONLY) 1' Ro.on Jul 1 5 1993' NO VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY III HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER !I DOB: L�� 10/24/1952 _ a I.i--L THIS DOCUMENT MUSF B* �'-•� ,/�•-fi, CAIInIFDON II IE PEnSONOF SIG N I « SIGN NAME IIJ FULL AUOVE SIGNAIUIIE LINF IIIE IIOLDFR WIIEN EN 1 OHIERS•BIOTA THUMB PIIINI GAOEDIN IIIISOCCUPAIIOPI MISSIO1,BR 1. I I 1 i ,r /J a COPY,nwnWea& ��nn of i'Vlamac4ujetb a!J¢,varfinent o1 ndujfria[._/`dccidenfj '. 600 VVa.ekn9fon Street James J:Campbell v.?oeton, /i'/a iachuietb 02111 Commissioner Workers' Compensation Insurance Affidavit 1, LEONARD J. SERVIS 000425 (CAPESTYLE BUILDERS) (Ucensee/pertnitcee) with a principal place of business at: 683 MAIN STREET FALMOUTH MA 02540 (acy/State/ZJp) do hereby certify under the pains and penalties of perjury, that: 1 am an employer providing workers' compensation coverage for my employees working on this job. EASTERN CASUALITY INSURANCE CCMPANY VJCP 0005519 11/23/94-11-23-95 Insurance Company Policy.Number () 1 am a sole proprietor and have no one working for me in any capacity. () 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: SITVA FOUND CO EASTERN CASUALITY INS p0006557 Contractor Insurance Company/Policy Number TART. nA1rngSA NQRTHLAND INS CCMPA.NY 77 14870 94 0 Contractor Insurance Company/Policy Number S&G CONSTUCTICN FIDELITY & CASUALTY 28c888597794 Contractor Insurance Company/Policy Number O 1 am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure coverage as required under Section 25A of MGL 1 S2 can lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine.of S 100.00 a day against me. Signed this J day of 19 p� Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617.-727.4900 X403, 404, 405, 409, 375 �%A Bond # 30541457 Fidelityd Deposit Company and HOME OFFICE of MARYLAND BALTIMORE, MD. 21203 License and/or Permit Bond KNOW ALL MEN BY THESE PRESENTS: Leonard Servis 10 Binnacle Road, E. Falmouth, Ma. 02536 That we, -•------------• .............�._.......-•.--•-----•--......--•---..._............--. ...................... --------........... , as Principal, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, incorporated under the laws of the State of Maryland, with principal office in Baltimore, Maryland, as Surety, are held and firmly bound unto Town of Barnstable -----------•--•--.....-----•-------------------•--•--•-••---••---------•-----•-----------•--------------•---...-----.......-•---------------------------- as Obligee, in penal sum of-.Ong__Thousand_-and_O0/100----_--_--------- _----'-------------- Dollars, lawful money of the United States, for which payment,well and truly to be made,we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly, by these presents. WHEREAS, the above bounden Principal has obtained or is about to obtain from the said Obligee a license or permit for..new dwelling - Lot 7 26 Carlson Lane, West Barnstable, Ma. ............................................................................................: and the term of said license or permit is as indicated opposite the block checked below: ❑ Beginning the........................................day of................................................19------. and endingthe........................................day of..............................-.................19......... r-vl Continuous, beginning theZlst------------------------------day of.........March 19 Town of Barnstable WHEREAS, the Principal is required by law to file with-___............................................................................... -------------•--------------------------------•-----------•---------•-••--........-----------------------------•-----------------------•-------------------•-•--------••---••------------------- a bond for the above indicated term and conditioned as hereinafter set forth. NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, That if the above bounden Principal as such licensee or permittee shall indemnify said Obligee against all loss, costs, expenses or damage to it caused by said Principal's non-compliance with or breach of any laws, statutes, ordinances, rules or regulations pertaining to such license or permit issued to the Principal, which said breach or non- compliance shall occur during the term of this bond, then this obligation shall be void, otherwise to remain in full force and effect. PROVIDED, that if this bond is for a fixed term, it may be continued by Certificate executed by the Surety hereon; and PROVIDED FURTHER, that regardless of the number of years this bond shall continue or be continued in force and of the number of premiums that shall be payable or paid the Surety shall not be liable hereunder for a larger amount, in the aggregate, than the amount of this bond, and PROVIDED FURTHER, that if this is a continuous bond and the Surety shall so elect, this bond may be cancelled by the Surety as to subsequent liability by giving thirty (30) days notice in writing to said Obligee. Signed, sealed and dated the.........21st Y March 95 da of -•------- 19....._.. Principal BY..................................•--•--------------....--------------......_...------ FIDELITY AND DEPOSS COMPANY OF ,ARYLAND r' BY /;- ...... tornn-F'�ct . 3519— Power of Attorney FIDELITY AND DEPOSIT COMPANY OF MARYLAND HOME OFFICE,BALTIMORE,MD KNOW ALL MEN BY THESE PRESENTS:That the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, a corporation of the State of Maryland, by R. W. BUDDENBOHN , Vice-President, and M. J. SCHNEBELEN , Assistant Secretary, in pursuance of authority granted by Article VI, Section 2, of the By-Laws of said Company, which are set forth on the reverse side hereof and are hereby certified to be in full f rce and effect n the date hereof, does hereby nominate, constitute and appoint Noel J. Almeida, Fred W. Fay, lie B Gift and Kenneth R. 0 Forster, all of Sandwich, Massachusetts, E its true and lawful agent and Attorney-in-Fact,to make,execute, deliver,f on its behalf as surety,and as its act and deers: any and all bonds and undertakings, eac � a pen not to exceed the sum of ONE HUNDRED THOUSAND DOLLARS ($100,000). . . . . . . . . . . . . . . . . . And e execution o such bonds or undertakings in p of these ts, shall be as binding upon said Company, as fully and amply, to all intents and purposes, as if they had ° duly exec d acknowledged by the regularly elected officers of the Company at its office in Baltimore, Md., in th proper ns•This power of attorney revokes that issued on behalf of Noel J. Alme' etal, ed, October 19, 1988. The said Assistant Secretary does hereby ce t eect�t forth on the reverse side hereof is a true copy of Article VI, Section 2, of the By-Laws of said Company d is noIN WITNESS WHEREOF,the said Vice- ent an Secretary have hereunto subscribed their names and affixed the Corporate Seal of the said FIDELITY AI� POSIT OF MARYLAND, this 26th day of July , A.D. 19 9 1 Q FIDELITY AND IT COMPANY OF MARYLAND ATTEST: Asais t tary Vice-President STATE OF MARYLAND CrrY OF BALTIMORE ( ' On this 26th day of July , A.D. 1991 , before the subscriber, a Notary Public of the State of Maryland,in and for the City of Baltimore,duly commissioned and qualified,came the above-named Vice-President and Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND,to me personally known to be the individuals and officers described in and who executed the preceding instrument, and they each acknowledged the execution of the same, and being by me duly sworn, severally and each for himself deposeth and saith, that they are the said officers of the Company aforesaid, and that the seal affixed to the preceding instrument is the Corporate Seal of said Company,and that the said Corporate Seal and their signatures as such officers were duly affixed and subscribed to the said instrument by the authority and direction of the said Corporation. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal, at the City of Baltimore, the.day and year first above written. u�001A OL J «� + Notary lic Co Expires Au Qu s t 1 , 19 9 2 CERTIFICATE I, the undersigned, Assistant Secretary of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the original Power of Attorney of which the foregoing is a full, true and correct copy, is in full force and effect on the date of this certificate;and I do further certify that the Vice-President who executed the said Power of Attorney was one of the additional Vice- Presidents specially authorized by the Board of Directors to appoint any Attorney-in-Fact as provided in Article VI,Section 2, of the By-Laws of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND. This Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the 16th day of July, 1%9. RESOLVED:"That the facsimile or mechanically reproduced signature of any Assistant Secretary of the Company,whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed." IN TESTIMONY WHEREOF,I have hereunto subscribed my name and affixed the corporate seal of the said Company,this 21 s t day ofx;arG, 19_•9 5 063-3678 Aaai Cant Secretary _ r EXTRACT FROM BY-LAWS OF FIDELITY AND DEPOSIT COMPANY OF MARYLAND "Article VI, Section 2. The Chairman of the Board, or the President, or any Executive Vice-President, or any of the Senior Vice- Presidents or Vice-Presidents specially authorized so to do by the Board of Directors or by the Executive Committee,shall have power, by and with the concurrence of the Secretary or any one of the Assistant Secretaries, to appoint Resident Vice-Presidents, Assistant Vice-Presidents and Attorneys-in-Fact as the business of the Company may require, or to authorize any person or persons to execute on behalf of the Company any bonds, undertakings, recognizances, stipulations, policies, contracts, agreements, deeds, and releases and assignments of judgements,decrees,mortgages and instruments in the nature of mortgages,...and to affix the seal of the Company thereto." i 1 i i i f i f Application to *995 0 I �PPN �eMgtt PYGN Y ; Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereb I made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves )f Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this ; pplication for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building ( onstruction: ® New Building ❑ Addition ❑ Alteration Indicate type of building: ® House ❑x Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards. ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fei ce ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE January`9 , 1995 ADDRESS OF PROPOSED WORK 26 Carlson Rd. W. Barnstable ASSESSORS-MAP NO. 1 33 OWNER Mr and. Mrs Maynard Marshall ASSESSORS LOT NO. 7 10 Wheeler Rd, Pocasett MA 02559 HOME ADDRESSMai1ing: P 0 Box' 3738, Pocasett 'Ma. 02559TEL. NO.508-564-5485 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attac-) additional sheet if necessary). See Attached sheet AGENT OR CONTRi\CTOR Gordon Clark, TEL. NO. 508-362-2210 ADDRESS141 Main Street Yarmouthnort , MA 02675 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8,other side),including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). New 3 bedroom with 2 car attached garage. O Signe Owner-Cori tractor-Agent Space below lint for Corimittee use. V by "D�IJ U ��The ificate is I reby Date 91995 11 e �. T 1NN OF BARNSTABLE - r.ttvv tl1RVA Approved ❑ IMPORTA eT If Certificat kisapproved, approval is subject to the 10 day appeal period provided in the Act. Disaooroved ❑ DS & RH MAR: HALL TEL NO .508-564-5485 Jan 06 ,95 17 :38 P ..01 2W7� ABUTTER'S OF VACANT LOT AT 26 CARLSON LANE, WEST BARNSTABLL MA 1. Lot 30 Kenneth F. and Anita L Ledoux 11 Carlson Lane West Barnstable MA 02668 2. Lot 64 Basil and Sophia 0. Dorras 2 Meadowbrook Rd. Dover MA 02030 3, Lot 65 peter M, Locscher Sr. 4 Juniper Circle Walpole MA 02081 4, Lot 76 Louis A and Mary Gay Piper 87 Carlson lane West Barnstable MA 02668 5. 110-37 Michael R and Valerie Brown 76 Carlson, Lane West Barnstable MA 02668 6. Lot 63 John J and Ann R Burchill PO Box 9162 Boston MA 02114 7, Lot 61. Bruce J annd Donna A Hegarty PO Box 651 West Barnstable MA 02668 8, Lot 28-1 William A arid-Adeline Ricci' 70 High Street West Barnstable MA 02668 9. Lot 28-2 John A and Patricia R Ross 40 High Street West Barnstable MA 02668 Town of Barnstable 'd Old King's Highway Historic District Comm-zL` SPEC SHEET FOUNDATION Poured concrete SIDING TYPE Red Cedar Clap Board COLOR Light grey CHIMNEY TYPE Red Brick COLOR Red ROOF MATERIAL Red Cedar Shingles COLOR Natural PITCH 12/12 or as noted WINDOW Double Hung & casement SIZE see plan TRIM COLOR Light grey DOORS steel with wood batten front COLOR brick red SHUTTE .:S N/A GUTTER: Aluminium DECK P T Wood GARAGE DOORS Steel COLOR light grey NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when applicable. Plot plan need not be "Certified", but should show all structures on the lot to D scale. 6 Q D r Application.,to ^ N Old King's Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition $3 Alteration Indicate type of building: ® House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE 5-30-95 ADDRESS OF PROPOSED WORK 26 Carlson Rd. W. Barnstable ASSESSORS MAP N0. OWNER Mr and Mrs Maynard Marshall ASSESSORS LOT NO. 2h 10 Wheeler Rd, Pocasett, 'MA 02559 HOME ADDRESS Mailing: P 0 Box 3738, Pocasett , MA 02559 TEL. No. 508-564-5485 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). See Attached list . y, I AGENT OR CONTRACTOR Northside Design Associ at-Ps TEL. NO. 51L-369-993 n Gordon Clark III ADDRESS 141 Main Street , Yarmouthport , MA 02675 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Addition of (4) shed window dormers , see plan revis ' date 5-3.0-95 . Signe Owner-Con tractor-Agent nano Iwlnw lino fo pl,Llplit:tve use. G-11d y Dti.Date 01 he Certific is hereb � (=4Z /�'2��vlrbate MAY 3 0 1995 1 ,,,�,�, Y Time TOVYN OF BARNSTABLE i B�ji.t7 INIr.'S 1111,SHWAY i Approved �/ IMPORT T: If ertific rtes approved, approval is subject to the 10 day appeal period provided in the Act. nisannroved 711 ' Town of Barnstable 1 , Old King's Highway Historic District Comm:ss:;�: I SPEC SHEET FOUNDATION Poured concrete SIDING TYPE Red Cedar Clap Board COLOR Light grey CHIMNEY TYPE Red Brick COLOR Red ' ROOF MATERIAL Red Cedar Shingles. COLOR Natural PITCH 12/12 or as noted WINDOW Double Hung & casement SIZE see plan TRIM COLOR Light grey DOORS Steel with wood batten front COLOR brick red SHUTTE RS N/A GUTTERS Aluminium DECK P T Wood GARAGE DOORS Steel COLOR light grey NOTES: Fill 'out completely, including measurements and materials/colors to be used. Three copies'. of this form are required for submittal of an application, along with three copies each of the plot plan, landscape plan. and elevation ' plans, when applicable. Plot plan need not be "Certified", but should show all structures on the lot to scale. � DDD • •. . D DS & RM MARSHALL TEL N0 .508-564-5485 Jan 06 ,95 17 :38 P .01 l ABUTTERS OF VACANT LOT AT 26 CARLSON LANE, WEST BARNSTABLE MA 1. Lot 30 Kenneth F, and Anita L Ledoux 11 Carlson Lane West Barnstable MA 02668 2. Lot 64 Basil and Sophia 0. Dorras 2 Meadowbrook Rd. Dover MA 02030 3, Lot 65 ?deter M. Locscher Sr. .4 Juniper Cit�cle Walpole MA 02081 4. Lot 76 Louis A and Mary Gay Piper. 87 Carlson lane West Barnstable MA 02668 S. 110-37 Michael R and Valerie Brown ;76 Carlson bane West Barnstable MA 02668 6. Lot 63 John J and Ann R Burchill PO Box 9162 Boston MA 02114 7. Lot 61. Bruce J annd Donna A Hegarty PO Box 651 West Barnstable MA 02668 8. Lot 28-1 William A and Adeline Ricci 70 High Street West Barnstable MA 02668 9. Lot 28.2 John A and Patricia R Ross 40 High Street West Barnstable MA 02668 DEOE File No. SE3-2845 (To be provided by DEOE� v !! Cily•Town Barnstable 2AU1 L ( Appiicent Marshall ,► aqua �6Jq. Certif(cate of Compl lance TOWN OF BARNSTABLE ORDINANCES, ARTICLE XXVII From Barnstable Conservation CQMigg fon Issuing Authority To R. Maynard & Donnilea Marshall P.O: BOX 3938, Pocasset; -ba 02559 (Name) (Address) Date of Issuance October 20, 1995 This Certificate is issued for work regulated by an Order of Conditions issued to R- Maynard & nnnn i 1 ea Marshall dated Feb. 2411995 and Issued by the Barnstable Conservation Commission it is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. 2. C It is hereby certified that only the following portions of the work regulated by the above-refer- enced Order of Conditions have been satisfactorily completed: (if the Certificate of Compliance does not include the entire project, specify what portions are included.) 3. It is hereby certified that the work regulated by the abovo•referenced Order of Conditions was never commenced.The Order of Conditions has lapsed and Is therefore no longer valid. No future work subject to regulation under the Act may be commenced without filing a new Notice of Intent and receiving a new Order of Conditions. .................................. ................ . . . ILeave space Blank) M _ 8.1 Effective 11/10/69 - i , r 1. 4. This certificate shall be recorded in the Registry of Deeds or the Land Court for the district in which the land is located. The Order was originally recorded on March 16, 1995 (date) at the Registry of Deeds Book 9590 Page�2 4.._, r 5. - The following conditions of the Order shall continue: (Set forth any conditions contained in the Final Order, such as maintenance or monitoring, which are to continue for a longer period.) Issued by Barnat ab.1_e nearvation ssion Signature(s) When issued by the Conservation Commision this Certificate must be signed by a majority of is members. On this day of �c.�C . 19 before me personally appeared 1%& . to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as hisiher free act.and deed, April 12, 2002 Notary Public My commission expires Detach on dotted line and submit to the Barnstable Conservation Commission ......................................................................................................................................................................................................:. To B&=nt abAa Cans rva 1_nn,�_nmmnI amen Issuing Authority Please be advisea that the Certificate of Compliance for the project at 26 Carlson Lane, West Barnstable File Number SE3-2845 has been recorded at the Registry of naada In HArns*abla and has been noted in the chain of title of the affected property on 19 If recorded land.the instrument number which identities this transaction is If registered land.the document number which identifies this transaction is - Signature Applicant i3.2 + 'Ai , �'• ` T; 1. ' ' V `~ ' nt f;,Neib srit iol fiuoO bnAJ exit is ebeeO to VtiV'afI,*rit ni beblooeied-11srle et6oilifiso sidT `4- (etsb� aee i ♦at ricxnM no bebioosi YNsnlgho esOiabiO eriT;'betaooi ei bnsl evil goldw �..i?s eua9, QegQ,Aooe,_ to rfeiges slit is 1 ,a srif ni benistnoo arioitlbnoo yn'B ritiol fs2) •eunitnoo Ilsris iebiO add-to"knoitibnoo gniwollot eriT -a (,boiisq iegnoi s iol eunifnoo of eia rioitiw,gniigllnom io sonenetniern is r1au2,iebiO'lanil; • • ' N1 1, , 0�n3 Nd boueal ' ��IaN�G (21e5ytanpi2 f 7, vedmem al to ytho(ism s yd bongla ad feum efsolhhoO sirit noielmmo0 noltsvzsenoO evil yd beuesi nerIW am woted , -fP et , 410 to yab - eirif nO sdied of nwonA am of, � �}..r �t_SI _ beiseggs YIlsnoatea befuoexe erir3led fart begbelwon-±os bna fnemuifeni gniogsiol alit betuoexe oft bns ni bschoesb noveq besb bns fog 991t terl�eiri es emse erlf • SOOS ,S.i tlYga eeiigxe noleeimmoo yM 011du9 YtatoN tt0l8e QplfAYttAIktCOJ' otdai0l!=a8 adj of tlmdua bne evil bottob no Aostoo .. •..,.Yb.rr..,...r.r.,..r..m...i.n....+..,..r...........................r..H.....n......................1rN1.H...w..........1........./..............,..'a..................4...............I...r.,, yriiodluA pKiiall ..1.1<F1L IM"M:) ao -4bXiQ ffQ:j a(Aronc=a o t QJ CIAO BrixA$ j 89Pt 9fIA�I n0'�Lxa fa Jooiolo gry tot oonaiEginOo to etD3111neci Ort Jarit1o41vpe ed etsoict E�sL�t3II.tt1ELQ Jlb•E?"a . to ytteipoA eMl to bob�osa�rteod afan ledmuA gal Q r, no yfieooiq botoelts grit to eltd to n'.00 ors ni betor,need ear bee sl noltoesnailtwil yeilitnebi dwiw Vdmun inerruilant smi,bnal oobi000i ii .� at nolosanatl Ol asiiilrrebi 030w"dniun Jnemuoob etil.brim oelewcot it tna31i40A �•tl SYSTEM PROFILE HORIZONTAL SCALE: 1 " = 41f VERTICAL SCALE: 1 " = 41± NOTE:- INVERT_ ,ELEVATIONS,- EXISTING & PROPOSED - - - - - - - - - _ - - - - - _ _ - - - - - _ _ PROPOSED GRADE - - - - GRADES,- RADES, AND FOUNDATION SCALE CORRECTLY, zo FACE OF RIP-RAP * ON SEPTIC COMPONENTS WRITTEN DIMENSIONS HOLD. 68 ELEV. Q WALL foundation �z I design by others - � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CONSTRUCTION NOTES I o0 i 64 z - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - top basement 0 BUILD UP CHIMNEY WITH slab = 62.3' - v MORTOR TO WITHIN 1' OF GRADE. IF UNSUITABLE SOILS, OR SOILS � 62 DIFFERING FROM THE SOIL LOG ARE FOUND, CONTACT THE 60 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 60 BOARD OF HEALTH AND 4" sch 40 pvc 4' MAX. R. J. CADILLAC. 58 - - - - COVER - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - �_2" MIN.77 6„ iT� S=.02 56 - - - - - - - - - - - - - - 11,0" 14" - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - AAM ALL CONSTRUCTION TO MEET 54 INVER-T 57.18 - - - - - - - - - - - -4' -0"- 5'- 8" - - - - - - .4" -sch 40 pvc - - - - - - - - - - - - - - - - - - - - - STATE SANITARY CODE AND EXISTING GROUND TOWN OF BARNSTABLE BOARD 52 - - - - - -INVERT 56.80 - - i.�� - - - - w OF HEALTH REGULATIONS. r 10' 6" ` 50 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INVERT 56.55 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 50 - S�S 19' ° - H--20 D-BOX -.a_- BUILD UP CHIMNEY W1ITH PROVIDE SANITARY TEE MORTOR TO WITHIN 1" OF GRADE. 46 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -& WATER- TEST -D-BOX - - - - - - - - - H- 10 1500 GALLON SEPTIC TANK 44 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I CLEAN WA SHED PE S- 2" MIN.DEIPTH OF $ONE 2" 42 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -INVERT 43.95 2' MIN. Off CLEAN WASHED INVERT 43.78 3/4" TO '1 1/2" STONE a- r. 4'* (SEE SITE PLAN FOR LEACH AREA SHAPE) 40 - INVERT 43.70 25' 2'level 38 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - � - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10'* � BOTTOM 39.7 THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN 36 4.0' - _ _ - 34 ORIGINAL STAMP AND SIGNATURE. BOTTOM TEST HOLE 2 H-20 LEACH PITS �F4;14ss� RO?!4LD °S �" RO1ALD JA!'FS JAMES m CADILLAC + o CADILLAC o ; v 35779 #1060 a SOIL LOG �o �o¢ sN,S'T soF T A TEST DATE: DEC. 20, 1994 PERFORMED BY: RON CADILLAC WITNESSED BY: EDWARD BARRY PERC RATE: < 2 MIN./IN Soils qualified by perc are shaded TEST HOLE 1 TEST HOLE 2 WATER TABLE: NOT ENCOUNTERED DETAIL PLAN DEPTH EL. DEPTH EL. FOR 0 TOPSOIL 54.0 0 51 .7 TOPSOIL 2.0 SUBSOIL 52.0 2.0 SUBSOIL 49.7 DESIGN DATA R . MAYNARD & DONNILEA MARSHALL TIGHT TIGHT AT SILTY SAND SILTY SAND NUMBER OF BEDROOMS: 3 6.5 - - - - -- - 47.5 8.0 ____________________ 43.7 GARBAGE GRINDER: NO LOT 71 26 �CARLSON LANE , WEST BARNSTABLE , MA _-=-=------ == --- - REQUIRED CAPACITY: 330 GPD 110 BR -_ MEDIUM SAND SEPTIC TANK SIZE: 1500 GALLON JANUARY 11 , 1995 SCALE : AS SHOWN PERC = MEDIUM SAND MED SOME SILT = SOME SILT BOTTOM LEACHING AREA: 176.5 SF 8.0 =-_ CIRCLE-3.14 X (5'x5')= 78.5 SF REVISED JANUARY 25, 1995 12.0 42.0 11.0 __ 40.7 RECT.-9.8' X 10'= 98 SF SIDE LEACHING AREA: 204 SF REVISED FEBRUARY 17, 1995 _= MEDIUM SAND MEDIUM SAND (3.14 X 10') + (2 X 9.8) (4')= 204 SF DESIGN CAPACITY: 686 GPD RONALD J. CADILLAC, PLS, RS 16.0 ---------====--=-== --== ======--= 38.0 16.0 ==_ =__ _ _===_ _-__ ====_== 35.7 BOTTOM-176.5 SF(1 GPD/SF) = 176.5 GPD PROFESSIONIAL LAND SURVEYOR & REGISTERED SANITARIAN SIDE-204 SF(2.5 GPD/SF) = 510 GPD P. O. BOX 258 HEALTH AGENT APPROVAL DATE WEST YARM OU TH, MA 02673(508) 775- 9700 SHEET 2 OF 2 _ _ x 53.4 / LEGEND 52.9 �'s WVELL / 1�? 51.2 PROPOSED CONTOUR ` s S \ • 72 - EXISTING CONTOUR 39'xF 2.3 P UNDERGROUND PHONE WIRES NO E a UNDERGROUND ELECTRIC WIRES / ` 49.5 x 51. / x .o ASBUILOTN CARD M C UNDERGROUND CATV WIRES x 4 x 8.50 x 69.3 EXISTING GRADE PROPOSED GRADE ('x' MARKS SPOT) 5 47.7 15 I , s 0BOULDER ` /. �� x 4 .1 �6 x 9 r LOT 6 x 45.5 �/ x 42.9 E - 42.3 \ 4E6.245.7 ! UTILITY TY POLE x t U 7.5` I 44.0 -_ _ NHS PROPOSED G LEACH PIT } TH1 TEST HOLE AND NUMBER (SEE SHEET 2) N _____ \ WELL \ I I I __ _ � 70 ' \ PROPOSED RIP-RAP WALL �� 0 TE 42.1 S _ _ _ x g N 150 I I I = STANDING WATER I 7" �\0 41. 4 .3 PROPOSED LANDSCAPE TIE WALL 39 N 12/29/94 x �25 • I I .1 x 4 1 -___- _= x 45 052 I WELL I I / � x 39.3 - I \ - 40_ _j - 44. - 51. � I I - _ x= 40. 2 x 47.0� 43.8� =_- -_ x 46.8 x .6 / t 40 NOTES .�h '� r Q x 4 .n / // / 44.9 0.3 38.4 co �, D I / 1 . LOCUS IS ASSESSORS MAP 133, PARCEL 62. ` �,`' �'.2 \ \ 44.4 / / Nl� / x 36.4 2. ELEVATIONS ARE NATIONAL GEODETIC VERTICAL x 6j. / �� h I L\O T \7 / / / 01 x 7.2o x 49.9 / / 36.9 DATUM 1929. 1` 67 x 4.7 STAKED HAYS WORK LIMIT LINE/ r /j �0 - 3. LOCUS IS IN FLOOD ZONE C ON FIRM FLOOD 36.9 0`1' �� ���, / / x INSURANCE RATE MAP DATED JULY 2, 1992. / co � ` / 4 / PROPOSED WELL WATERI-8.6 / / / x 36.4 _ STAKED HAYBALE WORK LIMIT TO BE SET IN x 73.d o CO x 58 4 \ / SUP L LINE /// / / \ /P // f 38.6 4. S � / PLACE PRIOR TO ANY CONSTRUCTION, AND �`v / .3 / / TILL LANDSCAPING IS WELL / 6 x 5 1 x 49.9 / 7 7 LEFT IN PLACE LL � 62 2 � �/ / / / � x 6.4 ESTABLISHED. / 8 / 5. THE LOCUS APPEARS TO BE IN AND RF ZONING x 75.9 �46.2 x 49 DISTRICT. APPARENT YARDS ARE: I ' oo x 49.9 / x 4 / .2 FRONT YARD 30' 73.2 / x 5 / x 7 / / x 4 .4 0.5 SIDE YARD 15' x 69 6 0 / WELL REAR YARD 15' ACTUAL ZONING DETERMINATIONS MUST BE = 2 ' MADE BY TOWN ZONING OFFICAL G tip . 56.4 _ 54. N x 7 5.5 2- Fj ��Z �,� 43.3 -- - - x 4.7 x 73 3 7.0.0 `9p. O�'G ` 10' x 49.5 iZ ) • 71.8 72 - x .8 x 49.9 \. 6 .��� 45.1 2 70� �77 0.4 -� _ s / THIS PLAN IS A VALID COPY- ONLY IF 'IT BEARS AN Cox !74.0 S• - D OX R x 47.2 P x 45 ORIGINAL STAMP AND SICNATU0t, \ = '7 O 6 6 .7 = 0 Q OTC I I Q- 24, -7 - _= OCr 0 x » �v QJ ''� Q`, "�_- 0 5 .7 x 49.4 x R0'VA Ss�' ✓ OF 6 LOBALD 70 sctia � S. 1 �• x 64.� _ _ ' � - �F 7.4� LOCATION FROM ��� - _ .. � #35779 � � 9 91060 �.y 1, _ -.6 / 4 0.1 O ASBUILT CARD �� :, F LEACH PIT �4n�oo` , gNiTAR`P x 6 g sr _ x .8 suffix 4,Fy 67.8 x 6 7.5 6 6 7.9 __ p. -� 1 O. x 1.4 ., �o �. z l /C/_s \ 6 x 55. 66.4 0 ) 52 52.5 REVISION NOTES: x 65. 30' 00� ��53 3.0 X 6.2 by .j'� x 52.5 1/25/95 - HOUSE FOOTPRINT SHRINKS 65 lb x G 53.1 1.9 TOP SOUTH CORNER OF CONC. 65.7 \ 64.7 SHEETS I & 2 REVISED 2/17/95 - WATER SUPPLY LINE & WORK LIMIT 7 ` 4 , x j.5 SHEET 1 ONLY REVISED SITE P L A N BOUND - 67.65 NGVD 1929 0`S �9.7 STONE x 62.7 .7 g.0 x 61.4 FOR55.6 20 ,:: -5 ` Yx 63.8 .3 6° x .7 DETAIL AIL 1 -„_ 201 R . MAYNARD & DONNILEA MARSHALL 0.4 9.8' 0:2 I 5.5 AT lX 57.9 INSTALL 2_6' X 4' DEEP LEACH PITS 9.8 FEET ON CENTER 62. WITH 2' OF STONE ALL AROUND. (SEE ABOVE DETAIL) LOT 71 26 CARLSON LANE , WEST BARN STABLE , MA 62. _ JANUARY 11 lc) 05 SCALE : 1 " = 20" TOP OF PK NAIL IN PAVEMENT x 61.7 INSTALL AN H 10 1500 GALLON SEPTIC TANK 7 x 59.2 ELEV.= 62.54' NGVD 1929 \ 8.6 REMISED JANUARY 25, 1995 x 61.3 PROPOSED RETAINNING WALL PER NORTHSIDE DESIGN SITE GRADING PLAN DATED JAN. 6, 1995. R E VIES ED FE B R U A R Y 17, 1995 62. 1 RONALD J. GADILAC, PLS, RS PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN x 62 5 I P. O. BOX 258 2.2 I WEST YARM QU TH, MA 02673 WELL 150' HEALTH AGENT APPROVAL DATE (508) 775-r- 9700 • SHEET 1 OF 2