HomeMy WebLinkAbout0082 JENKINS LANE 6
UPC 12534
No.2153LOR �
HASTINGS.M m
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TOWN OF BARNSTABLE
CERTIFICATE OF OCCUPANCY
PARCEL ID 128 004 010 GEOBASE ID 41153
ADDRESS 82 JENKINS LANE PHONE
W BARNSTABLE ZIP -
LOT 8 BLOCK LOT SIZE
.DBA DEVELOPMENT DISTRICT WB
PERMIT 35288 ' DESCRIPTIO3
PERMIT TYPE . BC00 . TITLE CERTIFICATE OF OCCUPANCY
Department of Health Safet' i
CONTRACTORS: Y ,
ARCHITECTS: ., and Environmental Services)
TOTAL FEES: TME
BOND $.00 '
CONSTRUCTION COSTS $.00 �► t
756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P §PABLE.
�MAS&
1639.
ED MA'I
BUILDI DIVIST
BY /
DATE ISSUED 12/10/1998 EXPIRATION DATE
r i
"TOWN OF BARNSTABL,E
BUILDING PERMIT'
PARCZ1,/TD 128 004 010 GEOBASE ID' 41153 �
ADDRESS'. 82 JENKINS LANE PHONE,�
W BARNSTABLE ZIP -
LOT 8 BLOCK LOT SIZE _ __
DBA DEVELOPMENT DLSTRTCT WB
I
PERMIT 25650 DESCRIPTION SINGLE FAMILY HOME ( SEW # 97-489 )
PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PVT CO-NTRACTORS: JON BRITTON Department of Health, Safety
AW,HITECTS: and Environmental Services
TOTAL, 'FEES: $308,26
BOND $.00
CONSTRUCTION COSTS $99,440.00
101 . SINGLE FAM..HOMF' DETACHED . 1. PR!VT1'F. P-
+ BARNSTABLE, •
t - MASS.
t•`\IER BRITTON, DOREEN 039
,!LESS 1503'
NEWTOWN ROAD BUILDING DIVISION
COTUIT.,MA.CT
BY
DATE ISSUED 09/15/1997/�y -EXPIRATI(O
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN-
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE
1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH-
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS.
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE.
4.FINAL INSPECTION BEFORE OCCUPANCY.
VISIBLEPOST THIS CARD SO IT IS
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
a�* 1_y_Vi5 - , P/,. .4
2 4r/q/aW0.12 2V1_ Gp�ye
�." In its , v� 2-07-9e
C /Z
133 1I2�S t j �� �1j_��'l Cf}j! t HEATING INSPECTION APPROVALS ENGINEERING DEPA THE
BOARD OF HEALTH
OTHER: SITE PLAN REVIEW APPROVAL
L�ESi. q}�NS/
�(l3v�S 6
Zi
FH
ORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
E INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
RIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
ON. NOTED ABOVE. TION.
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716
40 Engineering Dept. (3rd floor) Map / Parcel 19U /CJ Permit# 25(p 570
* Mouse# 41 �q� Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) / �� ��. �F Og,
VIC" -
Conservation Office(4th floor)(8:30-9:30/1:00-2:00)
Planning Dept. (1st floor/School Admin. Bldg.)
Definitive Plan Approved by Planning Board "Y7 19 SEPTIC S NCE
�...� INSTABE
LLS �
TOWN OF BARN IA
W �� AND
N VIRONME
Pre-,
Building Permit^Application TOWN REGULATIONS
oject Stres Lo �1 g J We fpis L Ill QVillage 60ni_-4-ab
o
Owner t
I3 r 4+0 Address I o3 M p wnwto Pd �
Telephone `1J-B' 8 Lf S-B
Permit Request R 1VI I _V_
,7;
First Floor 10DA square feet Second Floor 80 0 square feet
Construction Type WOC kam Q p
Estimated Project Cost $
Zoning District Flood Plain _ Water Protection
Lot Size I . ®A I Grandfathered ❑Yes ❑No
Dwelling Type: Single Family , Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ANo On Old King's Highway ❑Yes No
Basement Type: '*0 Full ❑Crawl Walkout ❑Other p�
Basement Finished Area(sq.ft.) r J Q N Basement Unfinished Area(sq.ft) 10o
a
Number of Baths: Full: Existing New_ Half: Existing New
No.of Bedrooms: Existing New _ 3
Total Room Count(not including baths): Existing New 5— First Floor Room Count 3
Heat Type and Fuel: ❑Gas DfOil ❑Electric ❑Other
Central Air ❑Yes )�No Fireplaces: Existing New ( Existing wood/coal stove ❑Yes ANo
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
M Attached(size) - I b a -f ❑Barn(size)
vv❑��None Q Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes *No If yes, site plan review# -
Current Use Proposed Use
P-D
Builder Information Lf
Name I� r f Telephone Number
Address 0 Iv License# 00 l Q
I �
\ Home Improvement Contractor#
Worker's Compensation#
I
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IJCrti�I\IS
SIGNATURE DATE
BUILDING PE DENIED FOR THE FOLLOWING REASON(S)
r
FOR OFFICIAL USE ONLY
PERMIT'NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
. 4,D
OWNER
DATE•OF INSPECTION:
FOUNDATION to fC_
FRAME ' no
INSULATION ` S�
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING.'• ROUGH- FINAL
41 r
GAS: R06U(I,4 ' FINAL
" .
FINAL BUILDING
DATE-CLOSED OUT-'.' �.
ASSOCIATION PLAN NO.
FWE The Town of Barnstable
o�
BARMAR%- Department of Health Safety and.Environmental Services
t639' �0
Building Division
367 Main Street, Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection
Location �� � Permit Number
Owner J �.� Builder
One notice to remain on jobsite, one notice on file in Building Department.
The following
II items need correcting:
Please call: 50 - 90-6227 for re-inspection.
Inspected by R �q A
Date
`OFtHE TO The Town .of Barnstable
BARNSTABLE.� Department of Health Safety and Environmental Services
MASS.
1639, �0
'QED MAC Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice.
TI pe of Inspection
Location (??4"- ((.� ' Permit Number
Owner L ' Builder
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting: '
U LOCH&-
kk"\' L/V\,L 0--%, j ke-%." tj-��Q T4�jn:Ei
4
Please call: 508-790-6227 for re-inspection.
Inspected by �� A Z �
Date �, 2--
4
•�s
•tea
N/F LOT 8
TAISTO RANTA `L 52,744 SF
o�
s� moo.
PROPOSED
i 10g 24' X 24'
J GARAGE
( CONC.
FOUND
TF=51.1'
EDGE OF t
WETLAND y[
La
LOT 9
A=41.38;
OD
R=30..00 cp
'TEA'1CI1►rs ENE
JOB # 96-105
CERTIFIED PL 0 T PLAN
' LOCATION : 82 JENKINS LANE W. BARNSTABLE, MA
SCALE : 1" = 50' DATE : OCTOBER 16, 1997 PREPARED FOR:
-REFERENCE LOT 8 PB 475 PC 95
D OREEN BRI T T ON
I HEREBY CERTIFY THAT THE STRUCTURE � 1H OF
SHOWN ON THIS PLAN IS LOCATED ON THE
GROUND AS SHOWN HEREON. 30! MNE G
of.608-362-4541
fax 508 362-9880
JOWn cape engineering, inc.
CIVIL ENGINEERSL
LAND SURVEYORS .....
-----
f9 main 9L yormouth; ma 02675 DATE REG. LAND SURVEYOR
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Public Health Division
Town t
PO Box 534
Hyannis,MM tests 02601
Fax(508)M33441
Phone(508)790-6265
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p �a��YK ie�SICEIJG� ARCH1 -TECH ASS0(1, TES
z Lvr It BE�i<Zwr�E re'alu5 W.V-
1 o _war enteNsr�sB�_ ti-ra �s . a r c h I t e G t U r a d e s 19 ri
—+=Lva1? FLAIJ-i LiU I ell tower mall, 1600 route 28 (508) 771-3900
`+ Centerville, ma 02632 fax 778-0770
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• TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print. -
DATE
JOB LOCATION Lo ,- 8 ywi /�1 S L_a/,j kj&D+, 6C01U*-S.'*" :'
/
l.c
Number Street address Section of town
"HOMEOWNER" e. ���Iv n 4f-om
Name Home phone Work phone - -
PRESENT MAILING ADDRESS - •-
L C�2(,_-_�3 5�
City town State Zip code
The current exemption for "homeowners" was extended to include owner-occupier
dwellings of six units or less and to allow such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Persons) who owns a parcel of land on which he/she resides or intends to re-
side, on which there is, or is intended to be, a one or two family dwelling,
attached or detached structures accessory to such use and/or farm structures .
A person who constructs more than one home in a two-year period shall not be
considered a homeowner. Such "homeowner" shall submit to the Building Offic_
on a form acceptable to the Building Official, that he/she shall be responsih-
for all such work performed under the building permit. (Section 109.1. 1)
The undersigned !homeowner" assumes . responsibility for compliance with the St
Building Code a:hd other applicable codes, by-laws, rules and regulations.
The undersigned "homeowner" certifies that he/she understands ..the Town of
Barnstable Building De t�ment minimum inspection procedures and requirements
and that he/she will c m ly with procedures and requirements.
HOMEOWNER'S SIGNATURE
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.
Y
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner 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
Home Owner engages a person (s) for hire to do such work, that such Home Own',.,
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for . licensing Construction' Supervisors I Section 2. 15) . This lack of awarene:
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed Supervisor. The Home ''Owner' actir.
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, man
communities require, as part of the permit application, that the Home Owner
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.
'�orb- ��rr--r�s �1�� �!� � � � � � � � • -
. . . The Contntonivealth of Atasnachusctty
%':►! �--- Department of 111di ntrial Accidents
OffIC. l/nYOSfIgallans
600 !i'asl hz ton Street
` ' Bnstua. A1ass. 0 111
Workers' Compensation Insurance Affidavit
i li :in lrif rni itin• — . PI —P
/p/
n v
location. Lo 'f v
, A&4 �IQ s C4Aj
c t� +—�J - C)or l s 1.1C. 1 V ) - him
I am a homeowner performing all work myself.
r7 I am a sole proprietor and have no one working in any capacity
' .. ��_.v_. .....__ �'.lM.s.. wa�C T•"w.w.�'/,7r!�:iI't.w�.+w...�.�1�'..�r — Mw.,..�..__...,..
[1 I am an employer pro vidin` workers compensation for my employees working on this job.
corn ianv namLk,)e: v 0orsA(2hM
address: v N CAJOMIU &
city: V l nhnne t!• 17 I roae
insurance cn. I P Ot V L-)n e ` / fpiict #
F I I am a soie proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have
the follo%YML, workers' compensation polices:
cninmov name-
atidrevc•
i cin•: nhnne#•
insurance rn. nnticv t!
cnmpanv name:
addresc:
city: phone#�
insurance co Holier #
Attach additional sheet iCneccssar_. v__ — .:..� �,;;;_;L., ,.y___ __ �-•.--= _
Failure to secure cuvcraac as required under Section_SA of I%IGL 152 can lead to the imposition of criminal penalties of a line up to 51.500.00 andiur
une v ears' i r„nnment:is well as civii 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 thi. ata ctneut ma.'be forn•ardrd to the Oltce of Investigations of the DIA for coverage verification.
I do perch cc r untler the pal • nd pert /tics of perjurr that the information provided above is true and correct. �]
Signature Date
Print name 1 bL 1 Phone* ( /. -9 Q/IVI
' offcial use unly do not write in this area to be completed by city or town official w
City or town: permit/license# r•ttluiiding Department
C3Ucensing Board
Check if immediate response is required OSeieetmen's Office ►_
C3I1c2lth Department
phone#:
contact person: —Other s:
information and Instructions i
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tl
employees. As quoted loom the an etnpinree is defined as every person in the service of another under any
contract of hire. express or implied. oral or written.
An rmple rer is defined as an individual. partnership, association. corporation or other legal entity•, or any two or in(
the forc�goin�g cnuaucd in a joint enterprise. and including the le-al representatives of a deceased emplover, or the
rccciver or trustee of an individual . partnership. association or other legal entity, employing; employees. However
owner of a dwelling house haying not more than three apartments and who resides therein. or the occupant of the
d%%cllin`, house of another who cnnploys persons to do maintenance , construction or repair work on such dwelling f,
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an empio%
MGL chapter 152 scetirnn _5 also states that even' state or local licensing agency sliall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the contmonvealth 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
been presented to the contracting authority.
Applicants
Please fill in tine workc;'s"coml;etjsation affidax it completely, by checking the box that applies to your situation anc
Supplying company names. address and phone numbers as all affidavits nnay be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. Tlne
affidavit should be returned to tine cite or town that the application for the permit or license is being requested.
not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are require
to obtain a workers* compensation policy: please call the Department at tine number listed below.
City- or ,towns
Please be sure that tine affidavit is complete and printed -legibly. The Department has provided a space at the bottom
the affidavit for you to fill out in tine event the Office of Investigations has to contact you regarding the applicant. P1
be sure to fill in tine permit/license number which will be used as a reference number. The affidavits may be returnee
the Department by mail or FAX unless other arrangements have been made.
Tite Office of Inyesti=atioils would like to thank you in advance for you cooperation and should you have any questic
please do not'hesitate to _give us a", 11.
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts °1
246
Department of Industrial Accidents f-:
Office of Investigations
600 «'ashington Street
Boston, Ma. 02111
fax #: (617) 727-7749
phone L: (617) 727-4900 ext. 406, 409 or 375
Insurance Company of North America
agCIGNA Company
CIGNA
LICENSE AND/OR PERMIT BOND
Bond No: K05109176
KNOW ALL MEN BY THESE PRESENTS:
That we, Jonathan Britton as Principal and Insurance Company of North America, incorporated under the laws of the State of
Pennsylvania, with principal office in Philadelphia, as Surety, are held and firmly bound unto Town of Barnstable as Obligee,
in penal sum of Two Thousand Dollars ($2,000), 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 Street
Opening Permit for 81 Jenkins Lane, West Barnstable, MA 02668; and the term of said license or permit is as indicated
opposite the block checked below:
Beginning the 15th day of Au ust, 1997; and ending the 15th day of August, 1998.
WHEREAS, The Principal is required by law to file with Town of Barnstable,Town Hall, Main Street, Hyannis, MA
02601 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 perrnittee 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 the Surety shall so elect, this bond may be canceled by the Surety as to subsequent liability by
giving thirty(30)days notice in writing to said Obligee.
Signed, sealed and dated the 15th day of August, 1997 .
Jonath Britto
By: (SEAL)
(Witness) (Principal)
Insurance Company of North America
J_J_J (] C12 By: � (SEAL)
OOOCG002 (Witness) Jul tA. Attorney-In-Fact
r
ow r of INSURANCE COMPANY OF NORTH AMERICA 719186
Attorney
CIGNA
Know all men by these presents:That INSURANCE COMPANY OF NORTH AMERICA,a corporation of the Commonwealth of Pennsylvania,having.
its prmcipat office in the City of Philadelphia,Pennsylvania,pursuant to the following Resolution,adopted by the Board of Directors of the said Company on December 5,
1983,to vrd:
,RESOLVED,Tim pursoaat to Articles 3.18 and 5.1 of the By-Laws,the following Rich rhall govern the a maroon for the Company of bonds,uoderhkings,recognizance,,contracts and other writings in the mamma thereof;
(1) That the Ptaidatt,any Senior Yta President,any Vice President ad Assistant Via Prttidea�or stay Aetorney-in-Fact,may execute for and on behalf of the Company any and all bonds,undertakings,feoogruzances
con0erls and other writings in the aatura thereof,the same to be altesmd when mecessay by the Corporate Setvaary,or any Asaistmt Corporate Soactary.and the sal of the Company affixed therm;and that the President.
any Senior Vtee Reidam,any Vice President or any Assistant Via President may apyoiatand•udtmlce my other Officer(elected or appointed)of the Company.am Attoroays.ln-Fact to so eaeane or atust to the exeaniwl
of all such waiting,on behalf of the Company and to affix the seal of the Company
thaao
(2) Any such writing www ed in accordance widt these Ruin shelf be as binding ap04 the Company in any ama as tbough signed by the President and attested to by the Corporate Secretary.
(3) The s{gsatrmc of this President.or a Sarin Vice President,or a Vice Prnidem,of an Assistant Vice President and the seal of the Company may be affixed by facsimile on of attorney granted puewant to this
Raotntioo the o as certifying OfFury and the seal of the Company may bee axed by facsimile to any certificate of any rich power,and any such power or tcate bearing such faaum Swaume and seal
shift be valid and bindmil;on
(4) S&uch
of her Officers of the a of dear duties Company,and Amreeys-fn-Faa shall have authoritylomdty or verify copies of this Resobmion,the By-Laws of the Company,and any affidavit or record of the Company necessary to the
(5) The passage of this Raohnion does not revoke any other authority granted by Resofutiot s of the(bard of Directors adopted on)we 9,1953,May 28,1975,and March 23,1977.•
does hereby nominate,constitute and appoint THOMAS A.LITTLEFIELD,LINDA H.NEEL,GINA M.SEMONELLE,JULIE A.WATKINS,
MICHELLE R.RASH,VALERIE S.OZER and ANTOINETTE DAVIS all of the City of Wilmington,State of Delaware,each
individually if there be more than one named,its true and lawful attonfey-in-fact,to make,execute,seal and deliver on its behalf,and as its act and deed any and
all bonds,undertakings,recognizances,contracts and other writings in the nature thereof And the execution of such writings in purstumce of these presents shall
�---t be as binding upon said Company,as fully and amply as if they had been duly executed and ackowledged by the regularly elected officers of the Company at its
principal office.
aINSURANCE IN WITNESS WHEREOF,tSe said William Jungreis,Via-Prrsldcet,has hereunto subs:rbad his name and Mixed th eal e corpo:a:c s of the said
N COMPANY OF NORTH AMERICA this 6th day of May 1997.
INSURANCE COMPANY OF NORTH AMERICA
C �
C
Y = `
William Jungrets,Vice President
U COMMONWEALTH OF PENNSYLVANIA
0 3 1 COUNTY OF PHILADELPHIA SS.
of � On This 6th day of May,A.D.1997,before me,a Notary Public of the Commonwealth of Pennsylvania in and for the County of Philadelphia came
a a-N William Jungmis,Vice-President of the INSURANCE COMPANY OF NORTH AMERICA to me personally known to be the individual and officer who
=_ . executed the preceding instrument,and he acknowledged that he executed the same,and that the seal affixed to the preceding instrument is the corporate seal of
N M said Company;that the said corporate seal and his signature were duly affixed by the authority and direction of the said corporation,and that Resolution,adoptpo
u— by the Board of Directors of said Company,referred to in the preceding instrument,is now in force.
-p
aM'N ; IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed my official seal at the City of Philadelphia the day and year first above written.
0
Of a-
�' •r 6A i r 00TAN&SISAL
M 4) = a x; = MARY E COLUNS.Not PubgC
' to a>' . — �y /
''C,? * .�0 OF
t•. * dry d Phihdelphla,PhIIL Ctry Notary Public
My Ceeaaksl M E1tpIM JUM 2Z 16W
X. Pe (j
P
_ cts
//'''f�AlRY SON"IitO�\
M C ' I,the undersigned Secretary of INSURANCE COMPANY OF NORTH AMERICA,,do hereby certify that the original POWER OF ATTORNEY,of
> which the foregoing is a substantially true and correct copy,Is in full force and effec L
i+ • L i
rZ � � In witAess9w Se{eof,I have 9reyltb3 subscribed my s1alm.as Sectetary,and affixed the corporate sea]of the Corporation,this 15t�y of
Debi,H.Paziora,
THIS POWER OF ATTORNEY MAY NQT'BE USED TO EXECUTE Al BOND WITH AP*eEEMON DATE AFTER May 6,19".
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2. MUNICIPAL WATER IS _t °"f ,a,./o.► t �E
I MINIMUM PIPE PITCH TO BE 1./8' PER 'FOOT.
4. DESIGN LOADING FOR ALL PRECAST UNITS TO: SE -AASHO—HST:
5. PIPE JOINTS TO BE MADE WATERTIGHT
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE.WITH MASS. '
ENVIRONMENTAL CODE TITLE V. `. • 4. ;
7. THIS PLAN IS FOR PROPOSED .WORK ONLY. AND NOT TO BE
USED FOR LOT LINE STAKING:
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-47 PVC..
;• 12
9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED-,WITHOUT: "• - a, 1
INSPECTION BY BOARD OF HEALTH AND PERMISSION 4QTAlNED a ;
FROM BOARD OF HEALTH. s
SITE AND SEWAGE PLAN
IN THE TOWN OF:
PREPARED FOR: r E
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t-
SCALE: _DATE:
��„ OF t MAY .2 8 .1995.
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NOTES:
1 ;DATUM IS
--------------------
2. MUNICIPAL WATER IS r4�!j L F�
SEPTIC, DESIGN: OSER IS
(GARBAGE DfSP 12
4-
3. MINIMUM PIPE PITCH TO BE f 8" PER TOOT.
DESV�l FLOW: BEDROOMS lo GPD) GPD AS - BE AASHO-H Cl
T UNITS TO
GPL 4. DESIGN LOADING FOR ALL PREC
00 us
4M, 1 I I
E DESIGN FLOW.
GPD GALLONS
5. PIPE JOINTS TO BE MADE' WATERTI
SEPTICi
TANK:
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
"US ENVIRONMENTAL CODE TITLE V.
E A( GAI LON SEPTIC TANK
-PLAN IS FOR -PROPOSED WORK ONLY AND NOT TO Br
7.' THIS
LEACH ING:,
USED FOR LOT LINE STAKING.
SID
ES GPD
8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC..
BOTTO�: .4
GPD
9. COMPONENTS NOT TO BE BACKFILI ED OR CONCEALED ITHOUT
TO
S.F. GPD
RD OF HEALTH AND PERMISSION OBTAINED
TA'
It:�4..&A
dF BOARD- OF HEALTH.
FROM
-7
L
o-;"4
6t
LAN , . -OF
.........
SITE AND SEWAGE P
4�
.cx�
IN THE �TOWN OF:
BOARD OF HMTH L
�JIFIPARED FOR:
APPROYED DATE
�4%L 0
Feet
40�
DATE:
SCAM
t;9v
0 f
doR-n capo engineering, in c. Of
MAY .2
.8 1996
ARNE Ii.
ENGINEERS
C IVIL
OJALA
IAN D SURVEYORS
CIVIL
No.
PHONE 508_�362 454 1
62-9880
FAX 508�3
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