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0194 MAIN ST./RTE 6A(W.BARN.)
-Z�l 9 a V! I II 1� it Owford® NO. 1.52 ORA ESSELTE 10% a _� _ x i :� .� �•` __ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map c y Parcel o z.y Permit-_ TG�C i 0. ; --,i? :S± tG Health Division �- bJ -S �/ Date Issued /a o 0 2 Conservation Division � , 2 z1D� �' ''? 2 ApplicatiorPFee //��-71 w Tax Collector U L i�f�/ate Permit Fee Treasurer 2 �/���7/0 _ __—��- �FC `� ?� STEM MU T BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board VM TITLE 5 ENVIRONMENTAL CODE ANL Historic-OKH Preservation/Hyannis a TOWN REGULATIONS rt Project Street Address I V-1 . u�� - ..�� ' ►Q.�. �� i,J�f (3a.c,-►-�,�.�� 02-4Gg ; : _s I�a,L�s-�,.Village Owner ��;,,,p,2oL Ce,l �,;��1� `�Crh�s�' Address 5 -ov.o_ as a o� Telephone So 8 - -11 S- 2 o Z °1 Permit Request Ott /Y) 0 R& /PO/L( W(?nA.A/p MdAY `9l4lV 3S-' So'11 4 PRO Ty LiN� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District_�E Flood Plain _k3 Groundwater Overlay ,� Project Valuation 4 a%Z Construction Type Lot Size 2.`L A-,t s Grandfathered: ❑Yes Q No If yes, attach supporting documentation. Dwelling Type: Single Family 12 Two Family ❑ Multi-Family(#units) Age of Existing Structure o Historic House: ❑Yes 5$No On Old King's Highway: ®Yes ❑No Basement Type: ®Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 300 Basement Unfinished Area(sq.ft) Zoo Number of Baths: Full: existing S new Half: existing new Number of Bedrooms: existing A+ new Total Room Count(not including baths): existing r 7- new First Floor Room Count Heat Type and Fuel: ®Gas ❑Oil ❑ Electric ❑Other Central Air: aYes Cl No Fireplaces: Existing 3 New Existing wood/coal stove: ❑Yes ®No Detached garage:Cl existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:®existing ❑new size zMyz,i Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes &No If yes, site plan review# Current Use Proposed Use c BUILDER INFORMATION Name \,\a,<h� es,�- Telephone Number 2, A (42',c 210) Address 2_��`i S�c� License# L' ���.c� � � Home Improvement Contractor# 1 Worker's Compensation# j�q UG` U-1 X I f CA,61 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO U L� SIGNATURE DATE _ 1211/ CTZ--• FOR OFFICIAL USE ONLY S ro PERMIT NO. DATE;ISSUED < MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION _I� Y D p FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH, FINAL 7 7t PLUMBING: ROUGK- °,� FINAL 1- y GAS: ROUGH' `T FINAL FINAL BUILDING ej e f r 4 4 .l•r'M �aG�.'f DATE CLOSED OUT ASSOCIATION PLAN NO. I A The Commonwealth of Massachusetts — = = Department of Industrial Accidents -- - Office 01///YBS0890//S _ t , 600 Washington Street --_=` Boston,Mass. 02111 Workers' Com usation Insurance Affidavit name ,��—1 01•�t,,��z. :.....location rs� _ Cl ci a (e �- D Z66 hone# - S - C 2_ 1 am a homeowner performing all wort myself. I am a sole r rietor and have no one worki>l in ca achy 'din workers' co ensation for ray employees worlQng.on•this.job.}}!:.:.:.!::.!:.}:{.!:?.}}::?::::: :::$::,::":wA:�:,:::y::`::; ,; :: Ism � :eons ................ .... ..::::...:::::::.::.:....:.:.;}....,,.. .. ........:::....... .... :{.�.;}.::..<.:;;;� .... :;•::'!:l�:::}::.:}}Y r:}i+:ii..::.:}:v:{+•:•?•}N:vy'}i;xw::v:•::?•}:••i}::.:!':.:iv::4};:.:v{{....::•••:: .......... r"+ -.4':i:^i}is?4!}:•'}}i`$$$}}:h:C.$}:�:::}':$.`•iii}:tv}>$$i$::?�!}!:??•S:t�:FiGii$:'v:$:L<•$':)i:;:$:'L$$:•i:};:::;;:�*::!:^.v%i::;:;::+:.::'::'r:L+:sti:;:<:isy�::;:<;:;:;:;:}:i::iii:yY:::::i::+::?i::::i::i:`::i:i�:G:iii:iv�i:ii::«:}}}}:: 4i}is}:•::.}ti:{.}:::L}:v:.::w::: ..... .. ..................:....:.�.:..::. :..:.::.>o-$iii}:•}:::::.,.r:::.:::::}:;�;:...F::r.,. .:.t:::.::. .:.. � �:.;:$ Cl •}'. .}•4:}}i:c;•}•{;•:}:.::.}}}ice:.::•.}•.:'::::::::.::.::.: .:::•.:.:>•::.::::.;:::};.;:•:::.:>':;::.::•::.;:<•:}:�}>:}:�}}}}>}:::•`::.: -;. I am a sole proprietor, general contractor,o homeowner circle one)and have hired the contractors listed below who have rs co ensation ohces: :::.:......: . ollowm w mP ..................:::::...............,....::.::.................................................. ....... of �Jf rLOn1D anv n a1II } n L t�' .}.'iii$'{{r:•r ::•::::::r4:h:6;J:4}}i:$}::i$•yF:{4:4}:t...n....•.;:::. ........... ........ ..........:::.::::::•..... :l.L•i}:^::::::.,.}:<^}!!? :}i}:: :::.::.::..v:.•.,::'.�}i;;$•:$'i}}}iii:?4}}:!J.:}}}i}:L.:'�u:$iii i:i�i$$:}:{ri: ..n...j L ,} W $:C 4 r..� 4 Y Y }w ss�' e r}i tit• .? } h.. LY}}/ :M•: r<• h .:w :4:'4:}}}i:::::!i}}:{4}}}}}:G:j.}}}}:?vr}x?•}}..n;�}?':n'{:r::.:r.++rv.+n.F;••. :....n^::::+ ... .............. ?4::'•}}:{^:}!>::•:}::iyh,it(7''i$:•.•�:.';•�:+':�$:�i}}::?::$i:�!$iii$ii4{>.vitY;:;:;):;:;{:$$$$::4:>;::<:::;,f::•:::;:x::y:',:$. . .n:...... v:.:.......•::::::::'v:... ::w:r.v::::: .. ......:v:vt. y. D 4 Fr'h,t4ii ... .... ......:�................:....v:.v. ....:::. r:n:.v.::n..n::::::::.::::.. ....,}}}:.... r::},:}}}•ij::{:•nJ.:}4:,?::} w'. r .. +.. .... ... ...... ... t{. y� :: ::.......:4:\:{.}:3:{{���..:' :.is�-.. .•}v.? f��"w r: rn....... ......}.. t.... ............... :..w............ -{•x.........•• .:•.:........::;: :. iii;, ...i; .::. i.v.:±!•.v...........r:?.:.v.:.....r....4C ,Y.•. r.:•:::- `::•:..................rr N:•:...,........:.:r++.........,..:::.: OLL .#... .. acne............... ............... ................... .................. ............... ........ .........................::::.•}:;•}}:.}::.:�:.}}:.:•:{.}•::.::........:..{:>$$:;:.:4:<•{x.w.,4v»+.;{w;.:{•.is `•z :> •�G:�•?:�:'i�:j}�:i>:Div?Y}::.:'�::::::::: '<�'�$i:::j�fi:.•:':i:::•:L:•i::A$:;:ui!�:�•,':.`}::tir?`i:'.:'.:!vi:iJi i:•}}ii$$j;:.�: �'^::•':!�!tit:•$::::is<:::;}x? .....::f.{{;w:::::n:n::.•::::::n:;: ,:::::v:.v.::::::.'.v v:n�.w:.•.•.'.::'v.v:.•.•:�.v:.::::':.}':.�::.�.•.':nvv::::::nw::re::::::n:v:v.; ...... ............. r...r......... ............ .................... +..4.....:..:+...::.v.:...:.,w,,.:::::{:::.::.}..: +r....v:run-... :.r.{4'.}i}:v.j;:�ji;:.-+::v:•::.. .....:.....••,v:::::';?•}:}:::::::�v::::::::::w:......................." r,vv::::::•:nv::::?•i}}:•"r•Ti%:$'r+: .\. ,...:•r.4i}:-:::•{•i{•i:{+:::::::4-.v.v:.w:;:}}:::::r::4:?<Gi}iii:4i}y::-}i}:•:4:r:$$Y.•:?.iii}:{h;4}}:G:;i}.,}.. .r}::.rr:::•:::� .....rr,ti.}Xi......................:"}:{}:L;:,Yv}.y}rr w:: r..:.n.... ............+. .............. .......:. r ................. ......r..r........ r..2..;.......... :. ......::::: 4>:^:iii:}:%?Yt$ii::::�.v..,.�:•.:i. �'i'+tit::i,:+r:!'};iTi$i$:;$$;{j!;isii:•}is4:.}:•:':L:9:�:{4:C•}i::::•:•.?v::::::�'::::::::::::.::;::v::!•:'.!. �::fw:�4i::::::.:.:•{.n:;.v::,.:w?!:}::ii::+.'.::iv:.}::::{!ii:{.}:L$::%:::•i}}}}}}:::•!i;}}ii::::};hC':}}}:;:i:{.}}: #Whwe to secure coverage as required ender Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sne up to S1,500.o0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a 5ne of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify the pains and pen es of perjury that the information provided above is truo and correct Signature Date 1 I • 3 'D 2 • print name n _ official use only do not write in this area to be completed by city or town offidal city or town: perndVUcense# ❑Building Department ❑Licensing Board Selectmen's Office ❑checkif immediate response is required []gealfh Departrnent contact person phone#; �-- ❑Other OrAsed 9/95 PJA) J Information and- Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the fore oing;engaged in a joint enterprise, and including the legal representatives of a dece'ased'einployei;'or the receiver or .., g trustee of ari individual,partnership, association&other legal entity;employuig,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 i building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance'or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the event the Office of Investigations has to contact you regarding the applicant. Please affidavit for you to fill out in the be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retame3 Ln the Departmei 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 D aitnient's address;telephone and fax number: 1? . .•., '6.'. . � _i,,,,.,�;;:.�. ep The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I Town of Barnstable Regulatory Services r • BARNSTABLE, ' Thomas F.Geiler,Director atass. ��plE1 39. 16. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 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. Type of Work: 'l Estimated Cost Address of Work: Owner's Name: � I 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: "1 -2CO vZ ,� � cx 1 _2,7_9 3� Date 11 Contractor Name Registration No. J , � r (R- Date Owner's Name Q:forms:homeaffidav f t. + 2 1 + 1 . 14.7 i .r + 14.8 15. ;. 16.1 + 4.6 12. BDARD OF HEALTH 16.9 MA . 17.1 + 14 + 1 .6 + 17.6 0 ,yp + 1 + 1 .6 -1. 1 18.1 G L0' 4 100• 50' 9.4 18.9 A 129 334 SFf + 0 14. II ,, 1y 79 15,9 O V + 18.8 + .4 + 3 + .9 0 + 1 5 N6 �iS� 11,2 a 50.0 .8 + 3.2 + 8.3 + 3io. N m I + 1 .8 I y5 BENCHMARK - TOP OF 14.1 11.3 CONCRETE BOUND -- • LOT 3 EL. = 18.7'(NGVD) \ � ( 13.d- 12.2. �188 0 + t� 9 /f4f l �\ + 5 12. 10.6 zis N + 19.2 \ 12.0 10. 3.4 12.0 a + 3.2 •` � �� i� :., 'tip ` o. \. 13.9 + 17. �'' \ - + 13.7 A 24 . 25 1 + 14 1 7 PROP. DWELL. 7.3 TOP FNON =25.0' O ` ! + 1 163 _ O + 3 .6 14 ® I' + l .6 ROP. WELL 2 + 9.5 3 .5 +128.7 202 i GAR �. ° + 2�J.eo.8 + 1 89 ° `L 25 rV t3� #0 W 10.3 2 .9 + 21.4 x W r d :corder From NEBS CUST&M—Printing Service L8o0-8 1.6327 NESS.Inc.Peterborough.NH 03458 —eh5.com Rot.No:G 328800740 le PIN OR WOOD PRODUCTS jf J, 326 Yarmouth Rd. 259 Queen Anne Rd. Hyannis, MA 02601 Harwich, MA 02645 (508) 771-5007 (508) 430-2800 ~�P R OO 1-800-368-SHED OV �G SOLD BY DATE 2 2 20 0 NAME / El. ADDRESS PHONE S -LoL9 6qy-q 'CITY BUILT BY Q, CASH Q CHARGE 0 .MDSE; RET D•` ❑:C.0.D: Q„'PAID OUT, Q PD.'.ON ACCT: , // i DESCRIPTION AMOUNT SIZE �CT / LEFT GABLE RIGHT GABLE STYLE op N ; SHINGLE 7)ee-, � r z111*" OPTIONS � � G FRONT /ou DELIVERY PP PlIel j so &JO �O p?3 7 . � .� DIRECTIONS BACK TAX CUSTOMER SIGNATURE �j _IOTAL CHECK 4 1-1"dLIS t3ppuyvu vJ ..... ..... .....a.. rr••-. - .. - - - -. Department. There is a ten (10) day appeal period on approved plans, necessitating a fourteen(14) day waiting period before an applicant may pick up his/her approved application. This is necessary for each Certificate of Appropriateness and/or Certificate for Demolition issued by the Old King's Highway Committee. If the 14th day falls on a Saturday,your plans will be available the following Monday unless there is a holiday, in which case the plans will be available on the next business day. The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 9 / �'`� S/ �1l y"PSj number 7 �``-� street /village / "HOMEOWNER": 6. t 6a,4CL name a,,, home phone# work phone# CURRENT MAILING ADDRESS: s'ar city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFMTTION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building D ent m;n;mum inspection proce ures and requirements and that he/she will comply with said r� Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q.Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed•Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner.is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a forn/certification for use in your community. i Application to d)[b Ring`o �Eqigbtlap Regional -�ffqiotoric �Diotrict CLERK W STABLE, MASS. In the Town of Barnstable 210? DEC -2 A i0= 32 CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under�Sect on 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and ,o3 plans, drawings, or photographs accompanying this application for: - 1 CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ❑ New' ❑ Addition El Alteration ( —' Indicate type of building: ❑ House Garage ❑ Commercial ❑ Other 1 m El 2. Exterior Painting: ❑ I — '-'' 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole (.Other TYPE OR PRINT LEGIBLY: DATE R•23 •ot ADDRESS OF PROPOSED WORK ASSESSOR'S MAP NO. - 13 y— OWNER -� '� ASSESSOR'S LOT NO. b2N HOME ADDRESS 1`t�{ YA4.L S� ��-/i' L af�"S TELEPHONE NO. S S' - 1)4 2021 ot6Glr FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way: (Attach additional sheet if necessary.) �.{wJo.�� w�a.Lea �►J:S $`S /�1...�-a S4 .s�LU M A e>L6 6 Fi 1 \� Ni Lt kta) Zl C, Q...L�a ISO. "ICA— AGENT OR CONTRACTOR�i n ��\e l � �1�cti�'� �R��=����"�� TELEPHONE NO.��`��i�(� -� �0 ADDRESS -SS q--CL � z �. ►'ti'�(� DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. r12. X . f Signed Owner-Contractor-Agent For Committee Use Only VF This Certificate is hereby 1 Date ' 1v pp / enled Committee Members' Signature Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION c+ ^v` lz SIDING TYPF -e COLOR CHIMNEY TYPE COLOR ROOF MATERIAL�)a COLOR PITCH WINDOW�t t�`�10 ! � COLOR SIZE ;Z Sv� �(LIB�l TRIM COLOR I DOORS �� Y COLORS SHUTTERS 4 COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS S�1 A COLORS SKYLIGHTS i� SIZE COLORS SIGNS COLORS FENCE `;�A� COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11198 r :corder From NEBS CUSTLM—pdnting service NEBS.Inc.Petertarough.NH 03458 m w.neds.c Ref.No:G 328800740 �.iA HAJZ4yO� P OR WOOD PRODUCTS r Jl 326 Yarmouth Rd. 259 Queen Anne Rd. ter..— �S^ ot! Hyannis, MA 02601 Harwich, MA 02645 (508) 771-5007 (508) 430-2800 �000 pRoa 1-800-368-SHED SOLD BY DATE - NAME '�� C,-/ I �z �Z_ 200- 20 6Ws a"-z S C. L") ADDRESS PHONE —ZCIZLqI 1 4t Lt CITY BUILT BY ' �fW� �y�•t�fl Q^ //�{A� � r �y�•.3�.�+5,�`�� �y� Q�.g`k.+�ARGE�4��;� L�'MDSE R�T�U�1� ��1�� +1��',F'��, +•�'�.C}'" ;�.� rs�y 'C-10 D t'�,L?'�`"•�s� s �PAlD�xOUT�ja���"t� v PD'ON A�eC� e,,�^'„+� a.'�'V �5� '�'t�`l �i�;F.�vt.,r+;.y.'._r.fir�5�.'t:a�f.��..�rt.-.�.,a<r:.�.,.,.,�.�..ri."5«..AaraA��.w�.�S„�._s x.-:fir.�..�.•.:v n��k.,v':t- 5.......,:� DESCRIPTION AMOUNT SIZE �OD / LEFT GABLE RIGHT GABLE STYLE y� N SHINGLE I O _ _ OPTIONS -7 O C FRONT � � s s � cn, DELIVERY /O P — � oN� o o137 . f � DIRECTIONS ' / C SO 22— 7 BACK TAX CUSTOMER SIGNATURE Al OTAL;.25 CHECK 0 A runs aYYivrcu vj - Department. There is a ten (10) day appeal period on approved plans, necessitating a fourteen(14) day waiting period before an applicant may pick up his/her approved application. This is necessary for each Certificate of Appropriateness and/or Certificate for Demolition issued by the Old King's Highway Committee. If the 14th day falls on a Saturday,Your laps will be available the followin Mon da unless there is a holiday in which case the laps will be available on the next business day. i �,�-=�- � '�we<ias.`�.L;-r,.-"�.,.s.++..-�-..e"�.��'�.�.u:x.d'i,�hwa'.''�.'�'�i7.,-.5L,-13c3: �a�.�,.' ``.x..,� �Fa`'� S. '�ti�_ �.ste..-•si;7'13-+i ,r-�_,..�L�'� .,xarci3?�o--`�-[Y .lr>:: r�3'=r.rr3.�,';' 3Xn_•:3+x�"''�.-�s�l'�: $f='+�-�.y1�..1a`4m"�s�`_.Yx�,'71:��xai:;. a*1'^��-s,.+�b' ty�mx.�±Y.'xa'�'. .��..,:.�'"�..,3','.}.'.•:�-�,.�'._ .�'�i'.:r4 ��"' 's.�"x#1 x'..�d - t"d�."1 Y f�+.� 'Y�,�n'1 ' ,lard Overhang 0' en'o side co�e -ON IRS re�d s oTa�e�is as A.K rr"�,�� ''Y,$a'l,F�` -�F" g�k,'�1��i+"+1.{^�^" �Cy�`+a"3.,Y;'�i7`� has theinsideFthe 30 overhangofftheback " ' '� ,� allows-for�firewood�kaAM yaks to be kem 0, ff :tAwl" making the entire shed$bigger The roofline� Mt�� z�r� n'-;'T`d.r'7+h �};c"aF•" i 'c '`'�-u & 's t.w v{ �t s `g aG" a� ti t. s < is also apgealmg for its Saltbox,looks ,Taus - desi Khas 71, roofu itch�� MOO .3."+ .r.^.s 1ON 'i4M C99immamROM W'K'.RVWq.,_S, Gy°;`a"'c r r k � sr€ ale stir W�as Z � * r >-M4 t lwl. D `wu A MPM IXIM r�s> mo $$$F111'248�.2430>e00 c-e �:2I11 OO2xxx,l11-r"b242 x, �g,'°'r'� 0x1 � 0OO 930 x1� gg 8x8 $2370 0QL'V'c3�Mo 0 00! ti 168�$ 0:Mali. OWN 2x7 r to 'Ry.•'t.rqr.,.y x � a � m �g12x16 � $32000Oy � � r ti Lar ersizes ava�lable� ` ` y I optional double door, shin le sidinf, & trim pack. r,���• �, bz �-t�,,�au -f,•e�, ��::,�,��,.+��.�,.u� +w,��,;t..�s � �Pnce_Is sub�gct to change without nonce<<Rnce does noJinclude 3%sales tax'-��a X 1A tx + 2 14.7 + 14.8 15. 16.1 + 4.6 12. + 16.9 HOARD OF HEALTH 17 MA + 14 c 17.1 + 1 .6 + 17.6 0 .yo + 1 .6 + 1 18.1 G L0' 4 100' Ste' 9.4 18.9 A 129 334 SFf 15.9 14.0 , ( 1 9 + 4 O + 3 + .9 .0 + 1 5 #6 50.0 �r�• 8 + 3.2 + 8.3 + .310 04 - m I + 1 .8 I #5 11.3 BENCHMARK - TOP OF 14.1 CONCRETE BOUND c,l LOT 3 EL. 18.7'(NGVD) ( 13 12.2 ll 4 �188 A rn + S 2. 106 e� + 19.2 =\ 12.0 11 ' 219, =\ 3.4 \♦ =' 12.0 \ S 5�_ 2 ? TH1 \\\ ♦\` �" + + 3.2 + 1 4 + 14 13.9 17, � \ * + 13.7 24 > + 14 7 25 �9 7.3 _ PROP. DWELL. CjO; .0O TOP FNDN =25.0' ♦ / + 1 163 f�31.4 �p +/3 .614 \ ya + 1 gad 1 \2 ® l. ` + 9.5 + 1 .6 \ ROP. WELL \ 41. . 3 .5 +1 28.7 � 202 + 2Qf.e0.8 + 1 89 0 0 ate. ,`��`L�. 25 ♦�,'�ytK 10.3 2 .9 + 21.4 ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel doh Permit# q 6 Health Division s f d a� - 3 Date Issued 5--,9 o9-0� a Conservation Division �s d3 s�-�` Application Fee 'D Aiv`Tf' � I Tax Collector Permit Fee //J 61D SEPTIC SYSTEM MUST EE Treasurer INSTALLED IN COMPLIANcE Planning Dept. -:9?7Ad1,CJ p bT -L o/ C.c.s- ' I WITH TITLE S D fCI-V a Definitive Plan!� roved by Board u" 9 Qd. 2� 5 �` s oal ENVIRONMENTAL CODE ANE PP Y 9 TOWN REGULk'1ONS Historic-OKH 41 Preservation/Hyannis N �.z1 a3 foul. >/0'4 Project Street Address 9 y M f4/,v c� Village &I &A1VJ 7W1RL/- /� Owner ElxcMI1 !S /�/i1d CiS��'L1S%/,Y!iC0_SW11L Address LVIWIC Telephone CU 3 6.2- Cn �Z of Permit Request I h IA4- C, �0 QWZ Co(if'" �-�7i�C �Cw '&42D Square feet: 1 st floor: proposed S-� qexisting. p p 2nd floor: existing proposed Total new Zoning District lc Flood Plain Groundwater Overlay Project Valuation d2��� DD O Construction Type Go V /,,", p L Lot Size oZ, 9'(oc 2lZ.I Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes XNo On Old King's Highway: XYes ❑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 O Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION , � �0T -Cl,77 Name TAS&Z Telephone Number S'y a2o2 Address 3S- 0/C L bt _eAzUl}C License# 06 9'_? 50",?, M1v7.L C? &0o 4 /W-�F 0/25'2- Home Improvement Contractor# /,2 3 4/®if Worker's Compensation# (� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO L F'NT oli-, .CITf' SIGNATURE DATE CS-1/- G. FOR OFFICIAL USE ONLY .1 s PERMIT NO. DATE'ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION �0�7 FRAME v INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH} ; ` FINAL ' FINAL BUILDING '„ �� S 'DATE CLOSED OUTS' ° - ASSOCIATION PLAN NO. a � R i YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerics Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: ` k .0b1i/ Fill in please: rAMF M. ev .. . ' APPLICANT'S YOUR NAME S '5T(AOa BUSINESS YOUR HOME ADDRESS: !PSI v� S TELEPHONE # Home Telephone Number � (oZ-Cnc 7.............E.:r�11S.�! NAME OF CORPORATION: 'P 1-`tD L)Ceuinub eti. 1 It NAME OF NEW BUSINESS TYPE OF BUSINESS [.� IS THIS A HOME OCCUPATION? YES NO /1 _ I I ADDRESS OF BUSINESS �°� T, �— �J . CFG& MAP PARCEL NUMBER (314 O �`1� / (Assessing] When'-starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to malce sure you have the appropriate permits and licenses required to legally operate your business in this town. 1: BUILDING CO ISSIO ER'S OF ICE This individ al e n info d fan p mit requirements that pertain to this type of blffis-. COMPLY W17-H HOME S AND REGULATIONS. OCCUPATION Auk on Sigria e** COMPLY MAY FIESULT IN FINES'LURE TO COMMENT U'l 4 i 2. BOARD OF HEALTH This individual has been ,o been ��I f the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has ML o nfo t e licensing requirements that pertain to this type of business. �_ Authorized Signature** . COMMENTS: Town of Barnstable n. Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner s63¢ �0 '0 met 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 508-790-6230 Approved( Fee: 493s- 0-0 Permit#: (2), 0 1 HOME OCCUPATION REGISTRATION Date: Name:C C -1 1_ri Ali C__ CA Ii U C^_� Phone#: � ����%29� Address: ( [ ( V-'lAI/J 7/ • Vill 9/� U �•, / / age:wySl / �� Name of Business: Type of Bus uiess:�l��'tnit�liL(ley-leolvi- -Map/Lot:_ INTF1V'I': It is the iitent of this section to allow the residents of the Tomi of Barnstable to operate a home occupation mthni single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelhiig: there shall be no increase in noise or odor;no usual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no ircrease in ai r or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permarient resident of a single family residential dwelling unit,located within ttnat dwelling unit. • Such use occupies no more than 400 square feet of space. • Tlnere are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing die Customary Home Occupation,and not within the required fi-ont yard. • Tlnere is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet ii length and not to exceed 4 tires,parked on die same lot containing the Customary Home Occupation. • No sign sli<all be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,thee street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a per-manent resident of the dwe 'ng unit. I,the undersi n have r ad e 't the above restrictions for my home occupation I an registering. 7� Applicant• Date: Homeoc.doc Re%•.01/3/08 TOWN OF BARNSTABLE I� CERTIFICATE OF OCCUPANCY PARCEL ID 134 024 GEOBASE ID 7222 ADDRESS 194 MAIN STREET/RTE 6A ( PHONE W BARNSTABLE ZIP - i LOT 4 BLOCK LOT SIZE DBA' DEVELOPMENT DISTRICT WB PERMIT 66367 DESCRIPTION SINGLE FAM. 2/CAR GARAGE PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY i CONTRACTORS: Department of ARCHITECTS: Regulatory Services . TOTAL FEES: ,BOND _. - $:00 �.111E_ ' CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE . 01' * BARNSTABLE, MASS. isr 039. Al BUILPIAIG DFVISION BY _ A DATE ISSUED 01/13/2003 EXPIRATION DATE U I J 7 l• A �' v�j.-..,_ ram i Department of Health, Safety. and Environmental S&V1ceN '* BAMSTABM MASS.: . �� ED Mlr►I� BUILDING'DIVISION� 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 WELLgAS 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 F90M THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE.REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU, ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). FANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY.UWas I 01!&-jej k 2 myj m m IRA M m&I g a IBM G� I BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 0 2 2 . d 9_0 C) 2, 3 .I?- EJ 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 I cj, o- BOARD OF HEA TH Z�oI .'53 / %3 0aws 3 . (,d SITE PLAN REVIEW APPROVAL Z_ � � I I I WORK SHALL NO PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS I THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS. ' TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. • a , o. 1 ' y M a Application to ®[b Rinq'o Jbigbhiap Regional J�iotoric Miotrict Cbn> ng&' , 1 1 2 ,e In the Town of Barnstable ` CERTIFICATE OF APPROPRIATENESS �? Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriatenessnder 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. r- CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: New El Addition ❑ Alteration � N Indicate type of building: eHuse ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: El Fence El Wall ❑ Flagpole ❑Other TYPE OR PRINT LEGIBLY: DATE OAAq (O w l ADDRESS OF PROPOSED WORK �9y�i�y s'l_n �T,( li✓£s: ZAeW,,ASSESSOR'S MAP NO. {3y OWNER F--W" -ekt CWic> 1,-.e ASSESSOR'S LOT NO. Da HOME ADDRESS lZ 4Je1.4,, CVC Ce.. VL. <<f TELEPHONE NO. �6`ZQ29 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR Ct S CkLc LAk tl— TELEPHONE NO. ADDRESS iz ` je(y, C1vre(e , C'eLAQ�,4 4c tM+q OZ6 2 DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. /t/EG�J S//t/�LE ni�y �lsYl�d �i47rJ�'•��O v va - 44r evS e'er E. /�to0/itC.sylr�rr/, �trd L L J s t Goo SC��'r �G.�� Signed Owner-Contractor-Agent For Committee Use Only C ^ AA qp M &EWEThis Certificate is hereby �! ���,I� W Appr6V4& ied; MAY 16 2001 Co ittee Members' Signatures. OWN OF BARNSTAB E Town of Barnstable 2001 � 112 Old King's Highway Historic District Committee SPEC SHEET FOUNDATION Go 4 Ae K- i'rr, SIDING TYPE 64.G• d:'v41 N,Grli 47 COLOR "lb"VToLLr- CHIMNEY TYPE A.;ITUGriO COLOR �.{�'(� W V-V�Lk44e- ROOF MATERIAL AA?p�46A,-r (*9 � COLOR PITCH WINDOWS "(�J 5 blq lbVb uTS COLOR 4.RI-f r, SIZE TRIM COLOR DOORS COLORS- SHUTTERS— ky COLORS GUTTERS No6js COLORS DECKS jr."" �� �Ti'�.'1 MATERIALS Md1-�OGrd,�i� GARAGE DOORS (iLy2-L0j!ft Webb -COLORS " u m 1 11 SKYLIGHTS I�1�. . SIZE COLORS SIGNS ND.. COLORS MAY 1 001 F BARNSTABLE FENCE& rbOV gl V_W-. fit%�� COLOR TOWN- ,gon,q HIGHWP,Y NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 TOWN OF BARNSTABLE B ICATION Map ! lr { Parcel �� J��. $ 2 Permit# Health Division ��—S3 y Z Jf.� !� a 8X�'`.-`---.------------ Date Issued ; Conservation Division s LIP& L,4�'71/a I �7 p®A.1 7��A' C Fee Tax Collector A/ �� �•��✓�S_ tEPT1G SYSTE-5o f�UST 82 Treasurer - o INSTALLED IN COMPLIANCE Planning Dept. µ...'.me . ���" 2oH i ES E6�yIF�ONMEP�TALCODE AND Date Definiti la Approved by Planning Board TOWN REGULATIONS Historic-OK Preservation/Hyannis Project Street Address 154 1AA t 5 `I - 6:�4 ' Village G, J ES i ��ZN ST�t-6 Owner Address Telephone Szrzl�_ 0001 Permit Request A)eui {- i"(&Lj Pov t F w i� A-rA 71 0 CA�,?- 6 A-;A 6 Square feet: 1st floor: existing proposed 3 00-f 2nd floor: existing . proposed t� Total new Valuation � � i Zoning District Flood Plain . ;43 Groundwater Overlay A Construction Type Lot Size 2• '/69 -kcye� Grandfathered: Cl Yes CV16'-If yes, attach supporting documentation. Dwelling Type: Single Family Y' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ICI o On Old King's Highway: 0<e-s ❑ No Basement Type: Trrull ❑Crawl ❑Walkout Other 530� (767A6F Basement Finished Area(sq.ft.) /U`�r Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new S Half: existing new Number of Bedrooms: existing new/(I Total Room Count (not including baths): existing new First Floor Room Count (P Heat Type and Fuel: Mas ❑Oil ❑ Electric ❑Other Central Air: J'-Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes t�lo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing fnew size �61 '�hed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ j Commercial ❑Yes 'I<Jo R If yes, site plan review# Current Use ✓A C,4 Ai Proposed Use BUILDER INFORMATION Name Q V,)�'� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCT ON DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE Q �� Q FOR OFFICIAL USE ONLY PERMIT.NO. DATE ISSUED MAP/PARCEL NO. y ADDRESS • VILLAGE f, OWNER DATE OF INSPECTION: ' FOUNDATION a FRAME INSULATION k'` Q�—C2 —Q ✓L ���' j FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: < ROUGH FINAL GAS: ROUGH FINAL " FINAL BUILDING �/ '�/ in DATE CLOSED OUT sa, ASSOCIATION PLAN NO. a 9 i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE / e, square feet x$96/sq.foot= 5/(J x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x W/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft, >120 sf-500 sf `` $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= 0PD (n�) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee / projcost FEE VALUE WORKSHEET LIVING SPACE (2000 sq ft or greater) "`S�square feet x$115/sq.foot= : — (less than 2000 sq ft) square feet.x$96/sq. foot= (affordable housing) square feet x$57/sq.foot= (40B or low income) —�1 r� -square feet x$25/s foot= GARAGE(UNFINISHED) 's m q q PORCH l square feet x$20/sq.foot= DECK square feet x$15/sq.foot= ALTERATIONS/RENOVATIONS OF EXISTING SPACE . . . . . . . cost= . . . . . . . . . . . . . . . . (,e 5-��� �z Total Project Fee Value Office Use Only 17 Permit Feer� ^ l � vv I projcost oFIHETpM� The Town of Barnstable BAR L6. MASS.ASS. a : Department of Health Safety and Environmental Services 9 a67q. �0 p�F039. Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 i� PLAN REVIEW Owner: 'F( r� ( _ Map/Parcel: .13 4(— o a 4 Project Address: ' _ Builder: The,following items were noted on reviewing: J i i I� Reviewed by: 1 AA Date: 1 I q:building:forms:review I ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YY) PRODUCER ISMOON5 10/2 9/01 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Kittredge Insurance Agency Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 276 W.Main St., P.O. Box 1129 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Northboro MA 01532 Phone: 5 0 8-3 9 3-7 7 4 4 INSURERS AFFORDING COVERAGE INSURED INSURERA: Transportation Insurance Co. INSURERB: Transcontinental Insurance Co. Desmond Well Drilling, Inc. INSURERC: 5 Rayber Road INsuRERD Orleans MA 02653 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSLTR TYPE OF INSURANCE POLICY NUMBER D TE MNWD Y) DATE M DD�O LIMITS GENERAL LIABILITY EACH OCCURRENCE $10 0 0 0 0 0 A X COMMERCIAL GENERAL LIABILITY 2050156923 08/27/01 08/27/02 -FIRE DAMAGE(Any onefire) $100000 CLAIMS MADE ❑X OCCUR MED EXP(Any one person) $10 0 0 0 PERSONAL BADVINJURY $1000000 GENERAL AGGREGATE $2 0 0 0 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 0 0 0 0 0 0 POLICY PECT LOC AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS SCHEDULED AUTOS (Per pe IN) $ (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY j EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND - I WC EMPLOYERS'LIABILITY TORY LIMITS FJ2 B 2026409888 08/27/01 08/27/02 E.L.EACH ACCIDENT $100000 E.L.DISEASE-EA EMPLOYEE,$10 0 0 0 0 OTHER E.L.DISEASE-POLICY LIMIT I$5 0 0 0 0 0 1ESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS ,ERTIFICATE HOLDER N AODmONAL INSURED;INSURER LETTER: CANCELLATION CALDWEL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Chri s t i ane Caldwell IMPOSE NO OBLIGATION OR LABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 12 Evelyn Circle REPRES Centerville MA 02632 I . CORD 25-S(7/97) ®AOORD _RA O 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNY) PRODUCER (5 0 8) FAXSUED 10/30/2001997-6061 (508)991-3283 AS A MATTE:R:1I-UKMATI01W- Southeastern Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 662 State Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 79398 N. Dartmouth, MA 02747 INSURERS AFFORDING COVERAGE INSURED Ron's Excavating Inc. INSURER A: Insurance Innovators Agy of New England PO Box 1167 INSURERS: Arbella Protection Insurance Mashpee, MA 02649 INSURERC: Guard Insurance Company INSURER D: INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MaK VLX-T STEM I in LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDIM DATE(MM/DD/YY) LIMITS GENERAL LIABILITY 4CC144307 09/16/2001 08/16/2002 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Arty one fire) $ 500,000 CLAIMS MADE OCCUR MED EXP(Any one person) $ S.000 A PERSONAL BADV INJURY o 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PEP PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY JECT LOC AUTOMOBILE LIABILITY 73574400001 08/16/2001 08/16/2002 COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY $ B (Per person) X HIRED AUTOS 1,000,000 X NON-OWNED AUTOS BODILY INJURY $ (Per accident) 1,000,000 PROPERTY DAMAGE $ (Per accident) 11000.000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ S WORKERS COMPENSATION AND TBD 10/11/2001 10/11/2002 TORY LIMITS ER EMPLOYERS'LIABILITY C EL EACH ACCIDENT $ 100,000 E.L.DISEASE-'EA EMPLOYEE $ 100,000 OTHER E.L.DISEASE-POLICY LIMIT $ S 00,000 I DESCRIPTION OFOPERATIONS/LOCATION S/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS :or any and all operations performed during policy period. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Chris Caldwell BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 12 Evelyn Circle OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Centerville, NA 02632 AUTHORIZJ=DREPRESENTATIVE Karen Bernier c - _ The Commonwealth of Massachusetts Department of Industrial Accidents 62 =;- � =='=� , -_� 011fcrallal�estlBatloas -- _ _- 600 Washington Street Boston,Mass 02111 `J Workers' Compensation Insurance Afridavit name: YV l� a el STl lia yC C�'f i�yJ LL location: r-_ r ,[ Ciri, uk�( � �JS Gr yL-�+ phone tl� a' �rJ�'7 ❑ I am a homeowner performing all work myscZ ❑ I am a sole nroflrietor and have no one workins'in aav caaacity ❑ I am an employer providing worl=' Compensation for my emniovees working on this job. name:.: ....::::..�:.:..::.:::: �'��;�::;;;:�::::..,;;.{;;::.;.,:?.:::.::?.:.:.YY:...::.}:a'•}:a:.}:�::.;::.:{.:}:•:;.:ail:;:{.:;.::::�:;;::�.;{•::•:::}} '.:::::.:..:..:.. ...:: :ax:::YYx•:: r Y}}: ........... ....... .... ...................... ....., .... ...... �..... :.:.;.♦.;.,»...;. ........ ..Y:•.{•Tsai :;}:;isi•:{{;:ii;:;:;}:.;:;:;{;;{•:;v:i•:;i.;;,:: Insea3tcee MTam a sole proprietor,general contractor, or homeowner(circle one)and have hired the comractots listed blow .w ban the following woricrsz' ensauon olicrs �P P .............::w:................. ::....:nv:::.............: .. .:.:. ....•...:..... .... ...w.:.v:::::.......... .......:::.:.. •-::• r:M ;xua'?{fi}>?:QY.wxY.•X;::.}:}}}:awr:.};w........: ..r...............:::4;:.v:::}•;{:i�::w:rw 4}::};:'r:{ {•:v.• ... ................ ..... ... .......rwv• ...., .. ...... .. ........ .........v:::�...•::... ..:•{.y::•...:.v•... v: : v•wv:a:4 { ..;,..;:•:.}t..�.w. ......................v::r::.v::n:, .:}.::{�:•:•:ii:�.i::i:::a::::t:::'.:• ..�::•:::.v:�.:................. .....:nv.:::.:v.;........: .:..:.:,.,v:v...v.:,{..; ...................... .........................v::•:.v::•:•}YY:•}Y:a.: ....v::::AJA..:. ..4....S+N+V:G:w.•::•.}x{•}:{i......... ,,...w:t•'!.{{ .........„•:.v::•T::.}..:..::.:•::•i::..:::.....:....}.:y. .r... ..,,............ �»:?Ls•::::.,•�•r:::.. . 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V • � 11 // •w.1./1 w• •1•l1• •w ' 11 1 I • / vim. wlw w• .• 11/1•. •w 1 // • ' 1•. .1✓. • a•1•.1-. . •. •••w. • •1 •) 11• • .•w .1• .•1 !Iw••w•1♦ • .mow• •IY. . .• • • . y . •11 • • • .• .11 • 1• . .11•• • •• •.• •�/ .1. .1• .11 • 1• • • / •U • •w • •1• 1 1 11 11 1 1 1 � •. 1 . •1 1 1 1 1 1 • 1 •. • 11 • 111 11 1 1 1 I all 0 I I MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I I I I I Checked by/Date I I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 7-17-2001 DATE OF PLANS: 7-18-01 PROJECT INFORMATION: Caldwell Residence 194 Old Kings Highway West Barnstable, MA 02668 COMPANY INFORMATION: Archi-Tech Associates, Inc. , 6 School Street Cotuit, MA 02635 COMPLIANCE: Passes Maximum UA = 1227 Your Home = 1110 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1108 30.0 0.0 39 CEILINGS: Raised Truss 2990 30.0 0.0 96 WALLS: Wood Frame, 16" O.C. 6185 19.0 0.0 371 GLAZING: Windows or Doors 1268 0.320 406 DOORS 53 0.290 15 FLOORS: Over Unconditioned Space 3883 19.0 0.0 183 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for thi building, and the cooling load if appropriate, has been determined usin the applicable Standard Design Conditions found in the Code. The HVAC e ipment selected to heat or cool the building shall be no greater than 25% of he design load as specified in Sections 780CMR 1310 d 1 Builder/Designer Date ' 1 The Town of Barnstable • BARNSTABLE. • MASS. ��� Regulatory Services ArE1 59. � Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: (9Z/ N S c e5 �number / street + village C �y "HOMEOWNER": W �• Cf}I�t� i L L ��' �����c / �(� LlY� ' name home phone ,#p work phone# CURRENT MAILING ADDRESS: CeL14Q� (le utiA 6z(0� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINMON OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner'certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and re uirements and that he/she will comply with said pr edu and ignature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35.000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors):provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors.Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case.our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities.many communities require,as part of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPM I �� � 67T il ` U SDI Effective Date: July 16, 2001 � 9 Western Surety Company e , e F � r e B e LICENSE AND PERMIT BOND KNOW ALL MEN BY THESE PRESENTS: BOND No. 69194880 " ` Thatwe, Christine and Edward Caldwell , il of the City of Centerville , State of Massachusetts , as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the State of 6 Massachusetts , as Surety, are held and firmly bound unto the n Town of Barnstable , State of Massachusetts , Obligee, in the penal sum of Five Hundred and 00/100 DOLLARS (_-$500.00 ) lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives,jointly and severally by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the said Principal has been licensed Road Contractor by the said Obligee. NOW THEREFORE, if the said Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in full force and effect until '`�' �� f 2002 , unless renewed by Continuation Certificate. . ;' •and m1$' oterminated at any time by the Surety upon sending notice in writing, by certified mail, to.171—cfro of�ythe P-'dy*cal Subdivision with whom this bond is filed and to the Principal, addressed to them at tl" b 11 Su '��D named herein, and at the expiration of thirty-five (35) days from the mailing of said no�,ic , his bond shill ISO facto terminate and the Surety shall thereupon be relieved from any liability for any a6A7t'*a i sic n' ,o£'k` "Principal subsequent to said date. 1• day of Jul y 200 `i�yrr itD i Principal Principal Countersigned WESTERN U E T Y C O M N Y _ T By - - / By - - Resident Agent St hen T.Pate,President ACKNOWLEDGMENT OF SURETY (Corporate Officer) STATE OF SOUTH DAKOTA ss County of Minnehaha e On this 16th day of July 2001 ,before me, the undersigned officer, personally appeared Stephen T. Pate , who acknowledged himself to be the aforesaid e officer of WESTERN SURETY COMPANY, a corporation, and that he as such officer, being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the ; corporation by himself as such officer. F IN WITNESS WHEREOF, I have hereunto set my hand and official seal. B.TOMA edaaa446HOMA 0.1 1 S hggggggh+ 6 s ^ NOTARY PUBLIC ^ ; SEAL SEAL s Notary Public—South Dakota 0 sSOUTH DAKOTA s " Form 532-9-95 y My Commission Expires 6-2-2003 8 iyy4y�syy55wy�yh�y�yh4hwy+ RA ' F " u f ACKNOWLEDGMENT OF PRINCIPAL f (Individual or Partners) ' . c , F STATE OF P , s. a P County of , d c P o On this day of ,before me personally appeared d P P , 9 , n c p P J , - e , , v a known to me to be the individual— described in and. who executed the foregoing instrument and ' acknowledged to me that —he executed the same. My commission expires 1 Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) STATE OF ? t s County of On this day of ,before me personally appeared — ,who acknowledged himself to be the __— of _ ;a corporation, and that he as such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself as such officer. My commission expires Notary Public V CIO p \ i , F p p p P p � p p O N 6 P M1 c P U C ., a � p P rn4-1 p Ap ¢� ti a pq ° , zril e W Z 4 P � b F > a 1-0 0 > ' P , 324-027 66971 enn y 8?�(1 295 RICHARD L. TERRY( Trustee of. COTUIT ROAD TRUST, under Declaration of Trust `dated--May 8. 1985, and recorded with Barnstable County Registry of Deeds in Book 4530, Page 157, of 18 Punkhorn Point Road, Mashpee, Barnstable County;Massachusetts in consideration of ONE HUNDRED SIXTY THOUSAND and 00/100 ($160,000.00) DOLLARS --- grant to EDWARD F. CALDWELL and_CHRISTINE G.,_CALDWELL, ,husband and wife, as tenantis by_the—entirety, of 64 Harbor Road, Ilyannis, MA 02601 with quitclaim eobetutnte the land in West. Barnstable, Barnstable County, Massachusetts, bounded and described as follows: 1.0T 4 contnini.ng 2.969 acres, more or less, located on Route 6A, as shown on-a-a duly surveyed plan entitled "Plan of. Land in West Barnstable, Massa- chusetts, prepared for Harold and FCLeds Spivack dated April 28, 1981. Down Cape Engineering: Scale 1" - 40', recorded In Barnstable County Registry of Deeds in Plan Book 356, Page 59. Subject to and with the benefit of all rights, restrictions, easements and rights of way of record insofar as the same are now in force and applicable. i For title. see deed dated 'December 18, 1986, recorded with Barnstable County Registry of Deeds In Book 5497, Page 11. t "V��1,.trt /W,nlU ar L)��Q�� I Executed as a scaled instrument this 29th day of October, t9 92. COTUIT ROAD TRUSTBY Richard L. Terry, 41tustee t4c ldontmontvcalth of Paseachuedts Barnstable, BS October 29, 19 92 Then personally appeared the above named Richard L. Terry, as Trustee aforesaid, i and acknowledged the foregoing instrument to be hi free iia and ,/ �''• I Bejure me. � 7 aC M �`� •°Nutary Public •� � , �af;Q4YidGXa�XAGX248dGXX I My commission'expjre•- r 19 �;•.,lir,ll.i;OCT 30 92 BARNSTABLE COUNTY REGISTRY OF DEEDS A TRUE COPY,ATTEST ;�N F.MEADS,REGISTER NOV-05-2001 12:29 ROGERS 8 GRAY,HYANNIS 15087904212 P.01i01 suosm rr4ouam THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 4,14 rltO 1Tt iladY flls. AY/lrCr� NO ONLY AND NO RIt3HTS UPON THE CERTIFICATE HOLAEA. THISIS CERTIFICATE DO E$ N07 AMEND, EXTEND QA '. 0. Solt >IROt s0uTo Onmum KA 02GM46W INSURERS AFFQRDING COVERME a3ANp� Cadbudaftnbo INSURER B COtN1AJWAL UNIOM ingunam 40r � »a � 9 a NraAnr. MA Amsf s THE FQLICIES OF INSURANCE LT9TED BELOW HAVE MEN MUED TD THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REMNIE TENT,TERM OR CONDITION OF ANY CONTRACT OR 01MEA DOCUMENT WITH MVECT TO WHICH THIS WMRCATE MAY BE ISSUED OR MAY PMAML THE WSURANGE AFFORDED Tiy THE POLICIES DBORM HUMN IS SuwEC'T TO ALL THE TB MB.EXCLUSK NS AND CONDITIONS of SUCH TTPP OF Fmw PCLICY L1(fI9 am OCCIlRlog f 300,000 a Guam Lmwff NLM92480 04/16/02 04/16/03 Fm 100,000 x Col"MC I OD Eit6l.11A9 m NO DAlAAL9r O f CLA9A4 MADE ❑Z CCmUR IAEU E79P DV i 50000 PERSDNN.6 A 9ifIRY i 500,000 OITa& IE i 6000000 GO&AOLFEOATE LIAR APRJE PER PRODUCM_ Aflt1 i 600,000 POLICY m Eloc [SATE 8 OMt089E LIA�Y CB�26919 04/20/01 04/10/02 �y �IUR i ANY AUTO ALL OWNED AM Py� i 250,000 ow Y3090tLED AUM x NM MAO6 i 500,000 x NOtK�MR�AUTOS i 100,000 ow wcx" AUTO ONLY-5A ACCIDENT f [1AilAtIE LUIBEDY EA ACC ANY AUTO oym THAN AUTO Owyll AV 6 EXCESS LUSUff EACH g9offlng s owm CLAM MADE A00FWAM i i DEMPOTIME AM F£IBNTION f WC ETA a6 0Y6�Weems WC01 657193 06/30/01 06/30/02 i 500,000 FA. DOM EAEWLOV% i 500,000 F-L OMM-POLICY LUff S 500,000 OTNISL DEMMMOLN OF ADDED BY PaoNRIOIs It�a0latiun iLNetalLtivn. pax 508-773-5079 AODNf10 m ABUTTED:few LETM 9N01!<D ANY OF THE ABODE 11 M POLICES W CANCaUn BODE TILE:E VATM QAIB Tlig=F 7W tlB1 M 9011M WILL 0WA"TO W DAYS WR M W 12 awe" oft* NCflCE TC THE C6rt1FiCAtE NOtJ>BN NAM TO TTE LET,DINT FA9aJRE TQ DO SO SNAIL !R'06E NO OITUO 7=OR LlA9L11Y OF ANY WND UPON THE .rm AOI3NTy OR fYsbwllEs MA R iTATNES. AIRNa+aw 13 E(C G 'IIISURA C�AGBi3+vY,i C. ACMD ZSS (ZAP) 0�7Y TOTAL P.01 11/07/2001 10:38 5083982224 PL&B PACE 02/02 +------------ ----------------------------------------------------------------------------------------- CERTIFICATE OF INSURANCE ( DATE 11-07-01 (MM/DD/YY) ---»------------------------------------------+---. ----------------------------------------------+--------.r-----------------� I-------------------------------------------------------- PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS I UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PASSARO LEVERONE & BUCKLEY INS. +- ----------------------------------------------------------------------- -------j 239ROUTE28 - BOX160 COMPANIES AFFORDING COVERAGE + ---------------------------------------------------------------------------------+ DENNISPORT MA 02639-01601 COMPANY A ZURICH INSURANCE CJMPANY + + INSURED -------------------------------------i COMPANY-------_--------------------------------------------------- ------- B 11 PATRICK K. ORCUTT OBA COMPANY--- - ------ -------------------------------------- --+ P & S CONCRETE C 17 DIXON DRIVE +------------------------------------- ------------------------------------ -----+ MASHPEE MA 02649-3192I COMP0ANY I -----------------------------------------------+-----------------------------------------------------------------------------------+ COV RAGES IS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED B OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FoR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR C ITION OF ANY CONTRACT OR-OTHER DOCUMENT WITH RESPECT TO WHICH T}IS C TI. EXXCLUSIONS. A BE ND CONDITIONSOF SAUCH POLICIES. LIMITSFSSHO N MAYYHAAVE BEENCREDDUCCEDBYBPAID AIMS IS. SUBJECT TO ALL THE I---+---------------------------------+------------------+----------------+-----------------+-------------------------------------- ILCoI I IPOL.ICY EFFECTIVEIPOLICY-EXPIRATIONI TYPE OF INSURANCE -POLICY-NUMBER DATE (MM/DD/YY) OATE (MM/DD/YY) LIMITS +---+------------- ----+- ---- ---+-----•---------- +-----•---------------- +-----------+ GENERAL LIABILITY GENERAL AGGREGATE $ 600,000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ '600.000 A I [ I CLAIMS MADE EXI OCCUR SCP 311545Q 03.21-01 03-21-02 PERSONAL & ADV INJURY $ 300,000 OWNER'S & CCU PROT EACH 8 CURRENCE $ 300.000 FIRE (Arty one fire) $ 30D.000 ¢---+-- MED EXP (Any one person) $ 10,000 -------------------------------+---- ------+----------------+---- AUTOMOBILE LIABILITY --+--- -------� [ I ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS per HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) $ +__-+ ------- -- --------------+----- .---------- -------------- --- - PROPERTY DAMAGE--- $ [C AE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONppLYY�:TT [ AG REGATE S +---+- --------------------------- ---------- ------- +-------------- -----------..-------------+-----------+ EXCESS LIABILITY --- EACH OCCURRENCEMELLA FORM $ 3 OTHER THAN UMBRELLA FORM I ( I 1 $ -------------------------------------- -------------------+--- +---------- +----------- WORKER'S COMPENSATION MO r i STATUTORY LIMITS EMPLOYER'S LIABILITY EACH ACCIDENT $ 100.000 A THE PROPRIETOR/PAR RS/ [ I INCL WC 557b0542 03-21-01 03-21-02 DIS E-POLICY LIMIT $ 5DO.000 EXECUTIVE OFFICERS ARE: [ I EXCL DISEE-EACH EMPLOYEE $ 100.000 --------------------------------------+------ ------ --+- OTHER ------------- ----------------+--------------------------+------- ---+ ---+---�-�-----------------------------+------------------+----------------+-- ---- -------- +-----..---------------- --------------- I N TE COION OF UCTION ONS/LOCATIONS/VEHICLES/SPECIAL ITEMS J.CERTIFICATE-HOLDER-- CANCELLATION------------ ---------------------------------------'I -----------------------------------------+-------------------------------------------------------------------+ SHOULD ANY F THE A80VE DESCRIBED POLICIES BE CANCELLED DCfOR[ THE EXPIRATIQIt DATE THEREOF, 1NE ISSUING COMPANY WILL ENDEAVOR CHRIS COLDWELL TO MAIL 10 Dr1Y5 WRITTEN NOTICE TO THE CERTIFICATE HOLD NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IM�E NO 12 EVELYN CIRCLE OBLIGATION OR LIABILITY OF ANY KIND UPON THE C ANY. ITS CENTERVILLE MA 02632 AGENTS OR REPRESENTATIVES. ---------------------------------.,.--------------------•-----------+ {AUTHORIZED REPRESENTATIVE I-- ------------------------- ---------------------------------I+------------ e---- ------- ---------------------+ ------------------------------------------- -- - --------------------------------------------------------------------------- - --� MOV-08-01 15.56 FROM: ID=5087900557 PAGE 1/1 CERT T F' = CATE Off' I NS�L7RAD4GE Issue date: 11/08/01 --- --- -- —__..�_�.� --------- ------------------.� W_�___.-------_--_---_---- Producer: ( 'this certificate is issued as a tatter of inforeation only and confers I no rights upon the certificate holder. This certificate does not anead, SMITIIEASTERN INS AGCY I extend or after the coverage afforded by the policies below. PO BOX 2610 1-------------------- �r._.------------- �-r------- 641 RAIN ST 1 COMPANIES AFFORDING COVERAGE HYANNIS KA 02601 i-------- -- --------------------------_-_---__.,-- Code: Sub-code: I Co Ltr A: CHA INS ------ ------------�------------------- �. --- ---- Insured:-- --_———- - i Co Ltr B' PRiNO PLASTERING (----------------------------------------------------------------- P 0 BOX 1493 1 Cc Ltr D: EASTERN CASUALTY MARSTONS DULLS HA 07648 I—--------------------------------------.._--. __�---- ( Co Ltr E: COVERAGW This is to certify that policies of insurance listed below have been issued to the insured named above for the policyy Period indicated, notvithstanding any requirement, term or condition of any contract or other document with respect to which this certificate say be issued or mar pertain, the insurance afforded by the policies described herein is sablect to all the terns, exclusions, and conditions of such policies. Limits shown say have been reduced by paid claims. Co 1 1 I Policy I Policy I Ltrl Type of Insurance i Policy nanber )effective date (expiration date! All limits in thousands A IEENERAL LIABILITY 1 1063035349 1 1/75/00 1 12/31/01 I6eneral aggregate: I Coteercial general liability i I I (Products-comp/ops aggreg: 1 ( Claims Lade (X) Occur I I I iPersonal/advertising inj: ( ner's 8 contractor's Prot I I I (Each occurrence: I I l f (Fire damage: 100 ( I ( I 1Medical expense: 10 -------------------------------------------------------------------------------_---------- IAUTOMOBILE LIABILITY l i i )Combined --~--------- l� I Any auto I [ 1 Single limit: I l All owned autos I I I Bodily injury I I Scheduled autos I ( I l�Per person): I i Hired autos I I I ! odily injuryy l ff Hon-owned autos I 1 I ((Per acciient): I i Earage liability l ! ( I 1 if I (Property damage: 1 I 1� 55 LIABILITY I I Occurrence Aggregate Other than anbrel is form 1 4 l I I D 1 VORI RR'S COtiQENSATli I (JCV0024535 1 7/09/01 [ 7109/02 fStatater I---------------�'---' 1 too Each accident) I EXPLOYERSS'LIABILITY I I i I S00 (Disease-policy limit) I I ( ! 1 100 Disease-each employee) ---------------------------------------------------------------------- IOTHER I I ! I I ---- --------- -- --------------- ---------- Description of operations/locations/vehicles/restrictions/special items: ANY AND ALL PLASTERING 8 DRY VALL OPERATIONS CEbt 1F1CATE HOLDER CANL*E%1<rATION i Should any of the above described policies be caecelled before the i expiration date thereof, the issuingg company vill endeavor to CHRIS CALi*U I tail SO days written notice to the certificate holder named to the IZ MYN CIRCLE I left, but failure to nail such notice shall impose no obligation or CENTERVILLE HA 02632 1 liability of any kind upon the company, its agents or representatives. FAX 508 979 5079 1---- IAuthorized representative: l JOAN MARTIN JA - ------------------------ —_— .............. _ dlR4 CERTIFICATE OF INSURANCE ISSUE DATE:11=101 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTiCATE- HOLDER, THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. PRODUCER COMPANIES AFFORDING COVERAGE: HART INSURANCE AGENCY INC COMPANY M MAIN ST, PO BOX 700 A AMERICAN EQUITY BUZZARDS BAY, MA.02532 COMPANY B INSURED: HILDRETH&SON COMPANY C FLO COVERING OR 440 NATHAN ELLIS HWY SU$6 COMPANY MASHPEE,MA. 02449 D COVERAGES: THIS IS TO CERTIFY T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOT WITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICTE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TERMS EXCLUSIONS AND CONDI- TIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Co Type of insurance Policy P Effective Expiration LIMITS A Commercial General ACC Gen Aggregate $2,000,000 Liability 148633 2/27101 2017102 ProdactelComp Op $1,0009000 Occurrence X Personal S Adv inj $1,000,000 Claims Made Each Occurrence $1,000,000 Fire Damage $ Medical Expense $ Automobile Liability Combined Single $ _,Any Auto Limit _SRO Owned Autos Bodily Irdury $ Mired Autos (Pe Person) _Nom-Qrvned Autos Bodily Injury $ —Garage Liability (Per Accident) Property Damage $ Excess Liability Each Occurrence $ 1lmbreila Form ^Oder Tban Aggregate $ Umbrella workers Compensation Statutory Limits And Each Accident Employers Liability Policy Limit Each Employee Property DESCRIPTION OF OPERATiONS1LOCATIONS/VEHICLES/SPECIAL ITEMS' OPERATIONS PERFORMED BY NAME INSURED AS PROVIDED FOR BY THE TERMS&CONDITIONS IN THE POLICY. FAX TO 508-776-607g. CERTTIFICATE HOLDER: CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE C HRIS CALDVMLL ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 12 EVELYN CIRCLE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT CENTERVILLE,14A. 02632 FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRE ATNES. ACCORD 253(7-90) NOV 13 2001 3:37PM L M VAN INSURANCE AGENCY 9706570201 P. 1 AGO_�v CERTIFICATE OF LIABILITY INSURANCF - fi 11/13 91 THE ATE IS ISSUED As A MATTERNFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE L.K. Van Insurance Agency HOLDER THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 668 Main St. Suite 9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington MA 01887-3377 INSURERS AFFORDING COVERAGE Phone:978-657-0263 Pas:978-657-0201 ENSIIRERA. Norfolk 6& Defflxam Xutwa INSupm a Granite State Ins Cc R�p6 R Construction B� FR uRQ 90berI�yAillt Hargis Cen e MA 02632 peURFRD: LNsuRet e COVERAGES THE POLICIES OF INSURANCE LISTID BELOW NAVE BEEN MEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY R CIUMMEdT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMEVTWiTH MPE CT 70 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE MIRANCE AFFORDED BY THE POLKMS DESCRIBEDHEREIN IS SUWECT TO ALLTHE TWA FJCLlEIONS AND OONI)MONS OF SUCH POL IC16S.AGGREGAM UNUTS SHOWN MAY HAVE BM REDUCED BY PAID CLAIMS. rREOF WISURANCE POLICY NUMBERimam 1pA78 GENERAL LLABIM EACHOCCURRENM $500000 A X COwAER mLG3JERUL"ILlw 1Z022340 12/06/00 12/06/01 Fm DMAGE My am ft) 650000 CSAWMADE QX OCCUR MEDEW Wnaaepmlm) S 5000 PERSONAL&ADVMUURY $500000 GSJERALAGGREGATE 6500000 WMAGGRE"TE L[WrAPPLE$PTR PRODUCT11-COMP)OPAGG $500000 POLICY R PRO- UDC AUTTOMOBI 2 Ll#J = 00MINED SINGLE LIMIT T AWAIM s ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUT03 (Perpermn) S HIRED AUTOS LY NJ U V IOON4OINNED AUTOS B'er S FROPERTYAUAGE ('er acdclard)I) $ GARAGELLIBRM AUTOONLY-EAAOCUDEN'T S AM'AUTO OTHER THAN EAACC S AM ONLY: AGO S EXCESS LIABILITY ENCHOCCURRENCE S OCCUR CLAIMS MADE AGGREGATE S S OEDUCTIBIIE S RETENTION i S WORlIERSODIVE SATIONAND, XFWYW7E B EYSIJOYERTLIANUTY W2A502236401 11/15/00 11/15/01 e.L. ACCIDENT $100000 MILL RENEW 11/15/01 11/15/02 E.LDw-P--;E-EA2nTmd s 100000 E.L MEAN-POLICY UNIT 16500000 OTHER E PTMCPOPERA7XMWOCA7HMSM04CLESM=USKMACMSYENDORSEMEWfiWECtALPRDVSSM CERTIFICATE HOLDER IN ADDmaru muAm:INet=mLuTER CANCELLATION CHRl$ .A SHOULD ANY OFT1KE ABOVE t> EMPATION we TIEREoP,THE mum NULL EIDFA►VDR To MAIL IQ-_ENHY$IAWRRTEN NOTICE TO THE COMCATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO OO S)SHALL CHRIS CAIMMLL IMPOW NOOBUGATION OR LIABILITY Of ANY KIND UPON THE MIRIM ITS AGEITIS OR 12 EVBLYN CIRiCId3 CBETTLRVILLE 14A 02632 REPRESMATIPIPEL AUTHOR ROMES TA 114 Eaa M. Van ACORD z"s(TAM OACORD CORPORATIOII lees ACORD,, INSURANCE BINDER DATE 11 09 2001 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER (TcM . 5 0 8—4 2 0-9 011 COMPANY BINDER# an McShea Insurance Agency, Inc. Zurich Insurance CoMD DA EXPIRATION 749 Main Street, Suite#H °A� TIME TIME Osterville, Ma. 02655 N AM X 12:01AM 11�09/01 12:01 PM 01/09/02 NOON THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: SUB CODE: PER EXPIRING POLICY#: AGENCY CUSTOMER ID• DESCRIPTION OF OPERATIONSIVEHICLES(PROPERTY(Including Location) INSURED Christine & Edward Caldwell General Liabilityfor general contracting at 194 Main Street 12 Evelyn Circle Centerville, MA 02632 W Barnstable, Ma.02668 COVERAGES TYPE OF INSURANCE LIMITS COVERAGEIFORMS PROPERTY DIEnUCTIBLE COINS% AMOUNT CAUSES OF LOSS BASIC 0BROAD DSPEC :ENERAL LABILITY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,0 0 0, 0 0 0 FIRE DAMAGE(Any one fire) $10 0, 0 0 0 CLAIMS MADE 0 OCCUR MED EXP(Any one person) $5, 0 0 0 PERSONAL&ADV INJURY $1,0 0 0, 0 0 0 GENERAL AGGREGATEs2, 000, 000 RETRO DAIS FOR CLAIMS MADE AJTOMOBILE LIABILITY PRODUCTS-COMPW AGG s2, 000,000 ANY AUTO COMBINED SINGLE LIMIT $ BODILY INJURY(Per person) $ ALIOWNEOAUTOS BODILY INJURY(Peracddent) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS NON-OWNED AUTOS MEDICAL PAYMENTS $ PERSONAL INJURY PROT $ UNINSURED MOTORIST $ UTO PHYSICAL DAMAGE $ DEDUCTIBLE ALL VEHICLES Lj SCHEDULED VEHICLES ACTUAL CASH VALUE COLLISION: OTHER THAN COL: STATED AMOUNT $ OTHER ARAGE LIABILITY ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ (CESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: AGGREGATE $SELF INSURED RETENTION $ WC STAMORY UMITS WORIQ:R'S COMPENSATION AND E.L.EACH ACCIDENT $ EMPLOYERS LABILITY E.L.DISEASE-EAEMPLOYEE $ ECAL E.L.DISEASE-POLICY LIMIT $ )NDIMOMW FEES $ TIER NERAGES TAXES $ 4ME&ADDRESS PREMIU ESTIMATED TOTAL M $ MORZPAYEE ADDITIONAL INSURED LOS LOAN# AUfHORMM REPRESENTATIVE :ORD 7"(1/98) NOTE:IMPORTANT STATE INFORMATION ON RnMPQ9:emc ___ i The Inland Marine Declarations and INLAND MARINE DECLARATIONS Endorsement, if any, issued to form a part thereof, completes the Commercial I Insurance Policy numbered as follows: BR 51237460 ZURICH M New Policy ASSURANCE COMPANY OF AMERICA ❑ Renewal of NEW YORK, NEW YORK 10038 ❑ Rewrite of A Stock Company In return for the payment of the premium, and subject to all the terms of this 2. Producer Information (complete A-E) policy,we agree with you to provide the insurance as stated in this policy. A) Name: THIS IS A COINSURANCE CONTRACT. Please read your policy. McShea Insurance Agency,lnc. 1. Named Insured and Mailing Address: 749 Main Street,Suite#H Christine&Edward Caldwell Osterville, MA 02655 12 Evelyn Circle B) Telephone#:508-420-9011 Centerville,MA 02632 C) Fax#: 508-420-9010 11 09 /2001 D) Zurich Producer M 11745775 3. Policy Period —From Effective Date Of: E) Field Office Name:HARTFORD EAST to (check one): ❑Continuous Reporting ®One Year From Effective Date F) Field Office Code: S4 12:01 a.m. Standard Time at your mailing address above. 4. Form of Business: M Individual ❑ Partnership ❑Corporation ❑Joint Venture ❑Other 5. Limits of Insurance (select either One-Shot or Reporting Form option below) ❑ Reporting Form (continuous policy) ®One-Shot(non-reporting form/single structure policy) HBIS-1 ❑Annual Rate ❑Monthly Rate (HBIS-4) R1 1-12 Family Dwelling ❑Commercial Structure ❑ Including Existing Building or Structure (HBIS-37) ❑Including Existing Building or Structure (HBIS-37) Property Location 194 Main Street A) Any one structure* $ 3,000,000 W Barnstable,MA 02668 B) Property temporarily at A) Any one structure $ 850,000 any other premises $ 10,000 B) Property temporarily at C) Property in transit $ 25,000 any other premises $ 10,000 D) All covered property C) Property in transit $ 25,000 at all locations $ 5,000,000 D) All covered property at all locations (same E) Development/Subdivision Fences/Walls as A unless otherwise noted) $ 850,000 or Signs Per Report E) Development/Subdivision Fences/Walls or Signs $ 0 F) Rate Per Report F) Rate $ 0.22 G) Premium Per Report G) Premium $ 1,870.00 H) Tax (applicable in KY only) Per Report H) Tax (applicable in KY only) $ 0.00 1) Total Fully Earned Policy Premium Per Report 1) Total Fully Earned Policy Premium $ 1,870.00 *Subject to underwriting guidelines (minimum premium applicable) 6. Deductible (minimum $500 unless otherwise indicated): ❑$1,000 ❑$2,500 ❑$5,000 ❑Other 7. Forms Applicable To All Coverage Parts: 1940471 Builders Risk Coverage Form ❑ HBIS-42 Florida Fraud Statement ®47681 Comm. Inland Marine Coverage Part ❑ HBIS-43 Windstorm Percentage Deductible ®CM0001 Comm. Inland Marine Conditions ❑ HBIS-44 New York Fraud Statement Nisi IL0017 Common Policy Conditions (IL0146 in WA) Other Forms: (list other applicable state and/or HBIS ❑HBIS-58 Development/Subdivision Walls/Fences/Signs forms; all required state forms applicable) ❑9H0003 Florida Builders Risk Declarations 0 ❑HBIS-35 Windstorm or Hail Exclusion ❑HBIS-37 Existing Building(s)or Structure(s) Countersigned: By: Date Authorized Representative FM 170001 Rev. 07/00 INSURED COPY MORTGAGEES COPY AGENT COPY BUILDERS RISK PLAN COPY Affidavit of Substantial Financial Interest I, C OW-;STI AAJC- 6- (24LP L- of on oath depose and state as follows: ` 1. 1 am an applicant for a building permit for the pro perty-located_at_Map (3�r , Parcel 071- . The address of the property is( O q . 2. 1 have �C % legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above. I Within in the last twelve months from today's date, which is t1A1OV zc1v( , the following individuals or entities have had a 1% or greater legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address 4. Within the last twelve months, from today's date, which is A17A) 5,1)1 , 1 have had :a 1% or greater legal or equitable interest in the following properties which have been the subject of a building permit application: Map/Parcel Address 5. Within this calendar year, I have submitted ( building permit applications for property in which I have a 1% or greater legal_or equitable interest. 6. Within the last ten days, I have submitted building permit applications for property in which I have a 1% or greater legal or equitable interest. 7. Within this month, I have submitted tor building permit applications for property in which I have a 1% legal or equitable interest. 8. Within this month, I have received building permits for property in which I have a 1% legal or equitable interest. J Signed under the pains and penalties of perj ry,.this day of , 200-1. 2001-0050/affin 1 O/LOTTERY/AFFIDAVIT The Commonwealth o Massachusetts Department of Industrial Accidents ' �==� � = Office of/nsest/gations . 600 Washington Street Boston,Mass. 02111 Workersfom ensation Insurance Affidavit name: - location city phone# ❑ I am a homeowner performing all work myself. , ❑ I am a sole r rietor and have no one workin 'm* capacity I am an employer providing workers' compensation for my employees working on this job. A:ir! :COIIt Any, >:?:::'s'.;:: `:`::z::: ;:.;::•: �?. s..:::::...::..:::..:::: ':.::::;:•:::::.�.fit: :::.:' .:::;::. :..... X. ::::.:.;.:.:.: :::.>.::::::..>; addrts _ „ one h # e - ...................... X. .. R olt .:.#.: ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers'..compensation polices:.... ::::.::.::::::::::::::.::::.::::::::::::.:::.::.:::.:::::::::.: ::: :.::: :::::::::::.::.: :. :::::.:::::::::.:::::::::> is na 12P5 `>i`>?s i s '? f- >'?> as `i sii iai ii iasii ii .... iii>i ji <<i}t>i s2's??i fAmtpa t! } itirCSSr '' '' "'y'' '`<Y`?`' c`:`?#':.`: < `:`+ ': % ':? " ss '2?< 2% < ` >' sus':. 2 `:. ` ` ` 2 }"'' ::::.:..:::::::::::.::::::.:.:...........:...>:...:.....:::::::::.:.::::.::.....:.:.::..:..:::::.:.........:.::::.:::... ... :....X. <•:. eltvx i:i' :•:':•:'i: iii ^i::i�?i>iiii:j;n}... .v;:....:+;nL!iiiij;i:iiii'i i: :i:: :^:•,:;i:•:'ii::'Y,;:::yi:•ii::iii:4'$ii:iii:i:'is is i::;:}L;:;: i':G;$::?•::ti: i:!:r}i::v:i:C v:•::•:i::R:ii::ii �{ v4%w4i:4i:^i>�:F:+:i':iiii:•'.tij .;:M:<::ii`:':;:;j:;;:::;::j:ii:::::>::?'T:::::::::::::::%i::;:;':yi:;.i;iii>:'y:;:Yi:?.::iii:•i:i:4i:?:•i:?•:i:?;iL:!G: ....:. :`tiiflltan :cl .........::....:.•:::::::::::::::::::::::.::....::::::::::::::.:. ................... h ..................................... ::;;.`�::y; ;:#:;;:G;:;<::�i :::%::'is{:y;':;i<:;?%';•`:cj><fi;�:`i�:'vie::iv':::ii:'•',•�ii:<:{::;i:;i:>y2:?yi:.>t:r_::i,{..?'.':;' :+�:;isi?i}isi:;i::•ii}}}:;'isi!'vi:4:'i:<r.'vi:i::iriji?i?:{::4ii:h%�:�<��X�'::�:!LiJ'r::i;:S�,v:?Ji:tii':!�iiY{:ii:ti•?i:�::i�i:'�i':ti�<:+4:'ii�i:i�;fi;i�;:;i::{':j::i;:::i 'S• nsnr Fanure to secure coverage as required under Seaton ISA of MGL 152 can lead to the Lnpositton of crirnirtal penalties of a fine np to S1,500.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a 11ne of 5100.00 a day against me. I�mderstand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify u the pains and penalties of perjury t at the information provided above is true and correct Signature Date Print name i/� // �, /� Phone# official use only do not write in this area to be completed by city or town official city or town: permitilicense# ❑Building Department ❑Licensing Board ❑check f immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other Ouvised 9/95 PW r 1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the -�---- affidavit for you to-fill out-in the event the Office of-Investigations has-to contact-you-regarding the applicant. Please be sure to fill in the pemut/license number which will be used as a reference number. The'affidavits may be retiiihR*ib the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of 111=119811ons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 °CIME�°� Town of Barnstable ti Regulatory Services Thomas F.Geiler,Director MASS 9`�pr 0119. a`0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 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. (' Type.of Woxk:,i��. &,tw— r1w.wli`7�J�cy/' 1&F,stimated Cost vZ Address of Work: /& CIS� Owner's Name:Fi 4'- !CT/ C61"&eZ1_Z_ Date of Application: ���l`d 3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 QBuilding 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 IlYUROVEMENT 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: cS= 03 �I��J o L. ��/L /2 I V-O Date Contractor Name Registration No. OR Date Owner's Name rHUM K I I i►tLOGE INSURANCE (THU) FEB 6 20001 10: 17/ST, 10: 16/0. 6310050797 10 2 AQjPRD,, CERTIFICATE Or LIABILITY INSURANCE C9R 3G ai:tR.�RS 02 OS 03 P RCOLIClR THIS CERTIFICATE 15 ISSUED AS A MAT—I ER OF INFORMATION ONLY AND CONFERS 40 RIGHTS UPON THE CERTIFICATE Kittredge Insurance Agsncy Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 276 W.Main St. , P:-0. Box 1129 ALTER THE COVERAGE AFFORDED BY THE F'OLlCIE3SELOW Morthboro MA 01532 Phona: 508-393-7744 I INSURERSAFFORD!NG COVERAGE I NAIC;; INSURED INSURER A: Continental Casualty compan 20443 IINSURER0: Transportation Insurance Co.( 20494 Ferra_} Pogg a ¢ad a Serv, a C. INSURERC, Coerce Insuranca Cczscanv 34754 Herrari Fu1� Circle 5e_+�ca Co 467 South Street 3xt IN6URER0: Marlboro MA 01752 INSURER E: 1 COVEiZ'WES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN HUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIM INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAv PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LMITS SHOWN MAY NAVE 9EEN REDUCED 9Y PAID CLAIMS. LTR N3R TYPE Of INSURANCE POLICY NUMBER DA7e I N DATE MODM M' i UWT6 GENERALUABILTY EICHOCCURREWE $ SOOOOOO A X COMMERCIAL GENERAL LIABILITY 2048660953 02/01/03 02/01/04 PR Must 5(Eaocc eenLe) s 100000 CLAIMS MADE XI OCCUR MED EXP(Any one person( S_10000 PERSONALS AOV INJURY S 1000000 GENERALAGGREOATE a 2000000 �POUCYEPM- 'L AGGREGATE LIIMIIT APPLIES PER: PRODUCTS-COMPrOP ADO i 2000000 FILOC AUTOM000.F LIABILRY COMBINED SINGLE LIMIT S 1000000 C ANY AUTO wrL2453 02/01/03 02/01/04 (ESacdoenq ALL OWNED AUTOS BODILY IMIURY S X SCHEDULED AUTOS (Per P«so^) X HIREDAUTOS BODILY INJURY S X NON-OWNED AUTOS (Poracddeol) PROPERTY DAMAGE S (Per eceidenl) GARAGE UABILJTY AUTO ONLY-EA ACCIDENT E ANY AUTO ' OTHER THAN EA ACC 3 AUTO ONLY: AGO S EXCE881UMORELLA LIABILRY EACH OCCURRENCE 3 3000000 B 7( OCCUR ❑CLAIMS MADE 2046661035 02/01/03 02/01/04 AGGREGATE a 3000000 a DEDUCTIBLE y X RETENTION 110000 t WORKERS COMPENSATION AND TORY LIMITS ER * EIAPLOVER.S'LIABIUTY 204BG60998 02/01/03 02/01/04 E.L.EACH ACCIDENT 51000000 ANY PROP RIETORI PAATNERIECECUTrVE OFFICEFUMEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 10 0 0 D 0 0 11 y!9.dwotie undw 3 ECIHL PROVI810115 blow F.L.OLSEASE-POLICY LIMB I S 10 0 0 0 0 0 OTHER DESCRIPTRiH OF OPERAnONa l LOCATIONB l VEMCLES l EXCLUSIONS BOOED BY EMDORSEM!NT l SPECIAL PROVISIOH3 Sw z=ing Pool Iaetallation, 3er,iCing or Repair CERTIFICATE HOLDER CANCELLATION 1PGR22,7jII SHOULD ANT OF THE ABOVE DESCRIBED POLICIES 9E CANCELLED BEFORE THE E'UVIATI DATE THEREOF,THE ISBUIRG INSURER WILL ENDEAVOR TO MAIL 20 DAYS YdRFTTF tfOTME TO THE C2ATIFICATE NQLDER NAMED TO THE LEFT,BUT FAILURE TO OO POlZ LlyO 1�1 Ad'{CP, PQp nCv+�dv C��Ij IMP�18E NO GaUGATICN OR LIG.BrLT!OF ANY XINO UPON THE t"URER,rTS AGENTS C' G R£PREb ALr,HC=_�7 R!n BNTATNE 2 ACORD 25(2001/08) Z ACORD C ORAL' r [/ rr, 'norrz,rira.rtranr[��lt u!. BOARD OF BUILDING REGULATIONS aa. I License: CONSTRUCTION SUPERVISOR i Number: CS 069397 j Birthdate: 06/05/1964 s: 1 I Expires: 06/05/2004 Tr.no: 26777 Restricted: 00 JASON E WARD �j eta 35 MILL ST CENTRAL MARLBORO, MA 01752 Administrator Boaz�� o 4o ans an tan ar�� 13ui1 mZ)eg egul One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 123408 Type: Private Corporation Expiration: 2/13/2005 FERRARI POOLS & PATIOS, INC. JASON WARD 35 Mill St. Centeral MARBOROUGH, MA 01752 Update Addressand return card. Mark reason for change. Address Renewal Employment Lost Card ." .ti 19 Brigham Street 1 Bayside Road Marlborough, MA 01752 FERRAR-1 Greenland, N.H. 03840 1-88 9 3 POOLS L71C PATIOS4 �� 1603 334-34301 Fax: 508-2208-229-3304 35 Mill Street Central • Marlborough, MA 01752 Fax: 603-334-6160 800-448-6483 • Fax: 508-229-3304 www.ferraripools.com • sales@ferraripools.com SWIMMING POOL CONSTRUCTION AGREEMENT (BETWEEN "CONTRACTOR" AND "BUYER") NAME (Buyer) Fi4����,� - �/,�,�� EMAILt��'(�/�L11��L�-/1�Azz& (^C�/I�_HOME PHONE LS_G��� MAIL ADDRESS !Z ' CITY LcJ / % STATE) ZIP .Z6 WORK PHONE S0F 06& JOB ADDRESS 6� CITY Z STATE ZIP CELL PHONE G_ F 36 9 2/ 1 POOL SIZE—L?x -3 DEPTH_ TO 5;7 SURFACE AREA Sq. Fr=PERIMETER��HAPE(,'2_c GENERAL CONSTRUCTION SPECIFICATIONS 40) AGA Approved Heater Model BTU Heat Pump❑ � ��6/ ❑ Indoor ❑Outdoor ❑ LP Natural ❑ Oil ....................................e4z 1) Engineered Structural Plans, Working Drawings and Permits.................--�,L�, 41) Fuel Connections, Heater Venti g (through Roof or Wall), 2) Access Wall, Fence or Shrubs. Removed and Replaced.................. ...By Others /��. Fuel Storage Tanks, Permits......................................................................By Buyer 3) Remove from Site Loads of:Trees, Stumps,Asphalt, •— 1 TC��/`� Concrete, Other Debris ON DAY OF EXCAVATION ONLY..................... MISCELLANEOUS SPECIFICATIONS 4) Establish Shape, Elevation and Location Prior to Excavation....................Included 5) Perform Normal Excavation and Remove Soil ON DAY OF EXCAVATION ONLY(UP TO 8 HOURS)........ 42) National Electrical Code U.L. Listed time Clock.......�Z® Included ........................... g """""""""' "' 43) Electronic Control System........Type Additional Excavation.......D 1/2 Day=$600.......0 Full Day=$1200...... — ••••••••••••••••••••• 7 ..Included 44) Electrical Bonding, Wiring Connections, and Permits........... .: ................By uyer 8) Hand Form and Shape Pool...................................................................... 45) U.L. Light-Type # Watts dd Volts a ?iye, 9) Water or Expansive Soil Condition$ �i� .00 Per Load.................... 46) Flush Mounted Anchors,,Safety Rope, Flo t� � Includ d ... ..... .......... .,. .. Q Steel Reinforcing Per Engineered Plans and Codes..................................Included 47) Pool Cover-Type 4,7`CIJ �'/,� x /,, N, t✓ 10) Electrical Bonding of Reinforcing Steel, Jigs and Equipment....................By Buyer --1 ......•••••• 11) Gunite Structure (to meet or exceed local or state codes).........................Included 48) Stainless Steel Ladder. ........................................................................... 12) Install Bond Beam Around Perimeter of Pool and Skimmer(s)............. 49) Stainless Steel Rail.......................................... ......Included ......................................... 13) Elevated Bond Beam 6" 12" 18" 24" 50) Diving Board Size Color ❑ Dive Rock ..................... 14) One Set of Contained Shallow nd Steps with 4' Bench... ...................... Included 51) Slide Size Color Curve ............................. 15) ❑Swimout ❑ Love Seat Deep End Bench.......4......................... • !r� (Jigs for Items#48, 49, 50, 51 Installed by Deck Contractor) (Buyer's Responsibility to water-cure Gunite Shell twice a day for one week) 52) Therapy Spa Size Shape Depth Ft. 16 ..Additional Gravel for Grading ❑ Sep. ❑Att. ❑Sep. Spa Pak ❑ Raised......................................... ......................... g.....................................................................By Buyer 53) Hydrotherapy Fittings...........Type 17) Deluxe Safety Grip Coping.. ......Number ........ ............... 54) U.L. Spa Light-Type # Watts Volts 18) Coping............Type Ft............... 55) Re-Routing Sanitation, Water Supply Systems and Utilities............ 19 Natural Stone Coping Type By Others P 9 YP Ft. ... 56) Payment of All State and Local Taxes During Construction.....................: .Included 20) One 6" Band of Water Line Tile Color Type .....................Included 57) Negligent Property Damage, Public Liability, and Workers 21) Finish Pool Interior with Marble Plaster.......Color_ ................... _ PLUMBING, HEATING & FILTRATION SPECIFICATION STARTUP AND INSTRUCTIONS 24) Install Non-Corrosive Plumbing and Fittings Throughout............................Included 59) Deluxe Maintenance Tools (nylon brush, leaf skimmer 25) Self-Adjusting Surface Skimmer(s) with Weir(s).......Number ......Included telescoping pole, test kit, vacuum head & hose, manual............................Included 26) Leaf and Hair Strainer Basket for Skimmer(s)............................................Included 60) Start-up Service and Maintenance Instructions...........................................Included 27) Return Inlets and Directional Fittings........Number ......................Included 61) Start-up Balance Chemicals........................................................................Included 28) Main Drain, Cover and Hydrostatic Valve ..................................................Included 29) Install Piping and Fittings for Future Pool Cleaner................................... ADDITIONAL SPECIFICATIONS 30) Flexible Hose for Pressure Backwash of Filter up to 25 Ft.........................Included �ULL / /�fJ,��Jj /jyt i A1611 ?ZiQIll�jl7- 31) Up to 25' Plumbing Run Between Deep-end Skimmer and Filter...............Included Extra Pipe to be Charged at$6.00/ft Per Line........................................... I 1!N. a f'6 Ry xC/'•�j,C 32) Pressure Testing of Plumbing Li es during C qnstruction ............ IncludedOlt/ U��"�L � E 33) N.S.F.Approved Filter Type - 6 Size �15�...........Included f 34) N.S.F. and UL Approved Pump and Motor; Size I � = ........................Included r 4t ydg tf- 35) Hair and Lint Stainer for Pump Pot.............................................................Included 36) Automatic Chemical Dispensec....Type ............ 37) Alternative Sanitizer........Type f 38) Automatic Pool Cleaner............Typ(; �Q 39) Automatic Floor Circulation............Type ./.L......... � Contra7ae' to by Contractor nd Buyer PAYMENT SCHEDULE Buyer Buyer(s) agrees to pay the Contractor the sum of $ 92Ow er Down Payment, receipt of which is hereby Buyer acknowledged.Joi Owne g $ Balance: $ Contractor's Representative The balance will be paid as follows: Contractor reserves the right of final acceptance.or refusal of this contract, if said contractor feels ❑ STANDARD he has not been fairly represented by any or all of his representatives. NO VERBAL AGREEMENT WILL BE ACCEPTED.The General terms and conditions on reverse side are part of this agreement. 40% prior to Excavation . . . . . . . Buyer(s) acknowledges that he (they) has read this agreement in its entirety and has received a 55% prior to Gunite . . . . . . . . . . completed, signed, legible copy thereof. Buyer(s) also realizes that any amounts indicated on 5% riot t0 Plaster other contracts and addendums with this company are in addition to this contract amount. p . . . . . . . . . . ❑ FALUSPRING Accepted this 30% 'prior to Excavation . . . . . . . ' Day of a04 Y 20 40% prior to Gunite . . . . . . . . . . 15% prior to Tile . . . . . . . . . . . . . 10% prior to Equipment . . . . . . . You may cancel this agreement if it has been consummated by a-party thereto at a place, other 5% prior to Plaster than an address of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. 1 + 18.8 + 8.1 LOT 4 loo, /50' 18.9 129,334 SFf + 15.9 14.0 1 79 + 18.8 + A+ ' .3 + .9 2.0 + 1-5 's dl so.o• B + 3.2 + 8.3 + • .310 r I + I + 14.1 BENCHMARK - TOP OF � Vr CONCRETE BOUND P \ LOT 3 EL. = 18.7'(NGVD) ( \ } ad- + 1 4 + 19.2 VrIN � 219' ; ;\ ? 3.4 ` i o_ ' 0, + 14b :3.9 �Q 1 + 13., A 24 .;\ + 14 7 25 1 Sry 7..3 3 I -` PROP. DWELL. .0o ` , TOP FNDN =25.0' /� � t e� � 163 y0 m +/3 .6 � �\ /� + 1 14 2 © + 9.5 ROP. WELL -\�l a ,-..+ 23. 5 +128.7 ry ��� `• ! 202 � GAR 10.0 �1 25 + / ry a 9 2 .9 + 21.4 4 P � y� P C a r Application to elb Ringo Jbiabb3ap Regional Jbiotoric 39iotrict Committee In the Town of Barnstable G , 0219 CERTIFICATE OF APPROPRIATENESS f2 2 _ Application is hereby made, with four complete sets, 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 ❑ Addition El 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: El Fence ❑ Wall El Flagpole ❑ Other ,w, TYPE OR PRINT LEGIBLY: DATE �� L� ZcU Z ADDRESS OF PROPOSED WORK /gY MAi A) S1 ,(�• t�7 +y"Q4SSESSOR'S MAP NO. 3 OWNER f%t� am'"�SJ t�n/�E /��.t1LL ASSESSOR'S LOT NO. QZ G HOME ADDRESS �z GyC�'-j�^ ��e�t° l-e`^ 11i I �� TELEPHONE NO. 3�� I FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) AGENT OR CONTRACTOR C tkAS CA C6 L&/�--Z-L TELEPHONE NO. ZOZc7 ADDRESS l Z ZJe(1,.., �a4 Ge-� �l' v iA gLVS Z DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Ak� �i`J(,{ • 4,,n.0 L`'l (40�t c/q A::�CLted 2 CA-,Z 64-A+6f Signed Owner-Contractor-Agent For Committee Use Only This Certificate is here P Date Approved/Deni JAN — Q 2002 .Committee Members' Signatures: Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOIINDATION (5 A-,,,�L,,r,- A-TO C_4494� SIDING TYPE COLOR ljf�L�tflyy& _ C CHIMNEY TYPE �W S 1�'t: JC COLOR co ROOF MATERIAL COLOR tn�tl t PITCH WINDOWS (,� OLOR SIZE TRIM COLOR ' DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS MATERIALS GARAGE DOORS COLORS SKYLIGHTS SIZE COLORS SIGNS COLORS IF JAN -a 2002 ' _ _ APPUVE D FENCE COLOR NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT 12-4 a:aaA 11/99 1 �c E V� I JO 16g. ' I CONCRETE 10 ,31 pg' FOUNDATION T.O.F. = 24.4 LOT 4 129,334f SQ. FT. cis 16p 6 Cn JOB# 01-098 45.10 CER TIFIED FO UNDA TION PLAN PREPARED FOR: FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT 194 ROUTE 6A ED WARD & CHRISTINE CALD WELL LOCATION (WEST) BARNSTABLE, MASS. SCALE 1 = 40 DATE JANUARY 2, 2002 REFERENCE ASSESS. MAP 134 PCL 24 I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. off. 508-362-4541 OE �\ { I fax 508-362-9880 ARISE down cope engineering, inc. H. C ALA C� No. 06?48 CIVIL ENGINEERS` LAND SURVEYORS 939 main st. yarmouth, ma 02675 DATE REG. LAND SURVEYOR 2001IE ON . 112 lIE I I � k co k 1 . APPROVED Ela t TON OE d o O ILI I i ILI i� i r - i ! ; Ll . i . i s � — • i ti I ` I i i �. i � � , ii I�Hl LEJ� rZfe 1 i f} ` 12 o l n2 FJO&E VENT V • N yN ARUTITEW rtAL�^ A9PMALTALT 5N145LE9 � 1 omorw-pm ON I"1[AKG O I] BUILD OVT RAKE 0'•/- ® (� 1 x WILD MIT&ABLE O' -'�• � � �.9NiN15LE�i U � 17 IxA.U.MB LA31N9 � � � O p IX5 NEAP LASINDLj 0 Q 0 U s o E ea 4•/ ON I%FA- MB i V t FF 1E IE El El E El'. �� • � � M �� CLSTOM BRACKET 9TONQ STEP/ LANDIN5 AITH FIELDSTONE / ELOSTO/E VENEERAT WLI."DAM / S O U T H E E 5 T E L E V A T I O N S C A L E 1/ 4 ' I' - O' Q E ClmmcY 1I1ys. �;� ! RID6B veNr ® n i ?d a— $�`IM AGNITPLTURAL W A9PNALT 9NINSIES .W` J Z 9 ADOVvE Wft��B9 W m N 3/- is) I. O 12 J gFIE W W rl _ -FE-1 In ON 1. �DINO -u Y _z ] a J a v o LU 00.7 m I _ _ N'10.51uN0LB5 .LLT IB.2001 rn • � O'11✓I PAN I� ®'. OW.10.2001 BOUT HEAST E LE VATION S C A L E : 1/ 4 ' Cal a bOB9-ozb-Bog-xoJ 9S�'9zo�w•q�n'�p0 1—P41 10 - .wacl" SNOI1VA3-13® SdB6f-OZb-B09-I� anal�v�ooyoo g 4� c'W1 Y'oVdnca„ g \ , • ,0 4avwnav.0 4al�.d�, g yd `l/ 'uollo.aLo'fdo�Foy -obbl Q n s J U u 6 ea p �..A n a.oa� y o..4 19,,N yq,,-wp i„b,idn 91GVISNNVG 1S3M"AVMH9IH G. �bM 10-112b4-V.�41 of 6 1--'& Q Xa11 10 /� �! GA-L d1DOGGV HDA1-IHO'J4V ���" . ��� 37)N2(3lG2 ! TlDM P 101 > kVuV'�V'caR�?cry V>71iYlp O CD 't 1 o I n ,ems LB ITIF P h Hid u I - .Ir.9 FE 1 0LLI a I i z III I III � • yy���� � I � O I'—`�'II � W " o� eFEEEHp - P IEEEIII w @FET= LO uj ® In � w 0 Q o a w � z P U Z m Y 1 r 7 1 N � I cam'. r ;N,��c N Ill.V2* < L ----------------------------- ---- m ----------------- -- -----------------------------------------------------=------------------------------------------ -—---------------- - ------------------------ ------------------------------------------------------------------------------------------------------- t—UW-x AVAIIV < PROP TOP Cr WALL ----------------------------------------------------------------------------------------------------------I IX2.1 T -------------—--------- ------------------------------------------- ------------------------- --------------------------------------------------------------------------------------------------Z---- : -: ------------------------------------------- --------------------- . .. ------- - s . ........... 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F===] •I A-A .L/I G .11-dMA Pdl A+I o- .ul r-.v - ohc � 7 s 49- a ` o c h � O IV O n • 9 I Ri i n � R I � Z --� •ao ac a Q " I Y m { O aft lL o i i n z O ` Ud W --------------------------------- -------------------------- ----------------------- \-------i .O-.L .L/I►-.G .C/I L-.G .o-•L .O-,L .tl1 t-. .t/I M.9 .O-A 1'n WII p P'o'u bO of fd-oZN ®09-x�d 989Z0 vw atnaao _�.�.,oe •�ao SN`d-ld 39d?J`d9 9ECe9-OZb-809�1�1 ��-+ao 1�4�g v-ayrn w v'an„uwa- mrx+� «a.d„a oyl YWY�wqd raWl v p--IMA p n ual�'P�du. ♦p 9 p , uowAnjv'fido fiuv 'OYM O o u I •u 61 sa p I�..�nq oaf 14�-+ -"-wb uF>,Ad.-,) 319V1SN?JV9 153M'AVMH91H S,9NIN alo .n1 —,4, -&Wv,w v.n w S3-LVIOOSSd H031.--IHD�Id 3�N�Q1S�?J "(��MQ�`d� P ' I e ' z " 1 Q U+ ^ P a 9-9x9.c� o Q ° O It ........................----------------------------------- f 9-O%9-r __--- _________________________________-___, --� .b.tl .O•.rr O t M1 O '1U1 W LLl Q o-rl o-rl N u m I .L/l 4.L1 .O-.Y .b.► Ilr.l .9-0I .9-.9 .o-.11 4 .9-.9 m v e z t h.9• rl a .G1 9-.9 .u1 9-.9 .44 - n I a n 1 I I — 4 1 I 1 ® I J I 1 1 I 1 1 0 1 c 1 � LL N — 0 ------------------------------------- _ u LL n or.l or.l .o-.r Q - Ll z Q , , , , -----------------' 4 !--------------- -------' ------------------- ---------------- mo------ -----: ----------- ---------------------------------------- . _ Q - ° t7-- -------- n ' Z W .F.11 .® .O.rl ,b-,I .9-,Y .9.,1 .9-.► .b.l O u aL m a .9V11 F.9 .Oval r-.c RIDSE VENT AV N p CJ Y! —SDfr VW*Zr8p:;�°RAC \ I I BUILD-OVT*ABLE B- y • PLC.$MINBLE9 19GA51 a3•/- -; nn r 1__11J - �BpGU�US@ETggO�IMBRAGCET •riCL75�ONL'��ISCRS I 1 1 S O U T H W E S T E L E V A T I O N -o S C A L E , 1 / 4 ' Y r --�, zUJ w �o Lt5 Qn lu ♦Y/ Ell MH 12 J w wEl a 4 = - ) W ,m ro.I 00+1 au y-r Lb.JOOI 0 .fr w5 NOTED eaI PAM 7 .«. S O U T H E A S T E L E V A T 1 O N A-5 SCALE : I / 4 ' - I' - O- �1 LU • O aW, IQ I ------'--•�------._..._RIp6[very � v V 4 OWLD-DV'6ABLe D' -- , MO BAND rV Ix CAP ' DECORATIVE BRACKET T EY • _o i 'd�'s4�"'�d��R V g p L o 13'DIw.l.i.COL. Omni[ LEI N O R T H E A S T E L E V A T I O N S C A L E : 1/ 4 ' �.SyE�U a11, 0 ID tu V BALD-OVT SABLE B' Z LU m Z LU cuaTDM eRACKeT < > lu J lu - K 0 = w Q FY 7o w 1] ,ob re.r pOA C- : ALY 16.2001 cv5TOM BRAOK[T IE ' 111I�y1''1 ��{"� IB �� �® a,~ Ab MD1ED •Ir •'1�,•1 DWI 1 KG.OINMSIEB bM1 I/1N LJ2-0 G401.AFl.ON N O R T H W E S T E L E V A T 1 O N 5 C A L E I/ 4 ' I' - O (-n rn (P z -4 z rn Z o-il Pl (j) n > m W-o" m n I I'M M z tE r-7 -V NEI (�J) CALDNELL RE51DENCE ARCHI-TECH A550CIATE5 Ue'Arthfta6t—1 HbrkM OLD KIN&'E7 HIGHWAY,VeST BARN5TADLE cIPPYd AC4*01 dAgmtem,149r-t. lr-v<--- U—p V.A th.-7— row�&�4���;hWt.U- W 117--t.1=T..h FRAMING 5Er.TION5 A--Wt-. b C.47vult;.MOO 02038 flux-�aOB-42o-�304 i a 1 5� fn I r ° � I I I ,tp IIAp' V iu i I 9'-B Irl' I I rn rn ire, i 1D- rn 11/< I 1 V, Itt So m I I I I ti r 8 - ° r - --. — O -- ... .................. I -- I -- ------.._.-. . I rn In E_ IVY I I I i I ' I m -4 I �a a D --------------------- • r I I I I 1 I s• s• U 1 I 1 I 1 I I I • I I �, I II I I I I I 5 I 1 ; � I j } a CALDWELL RE5IDENCEof thetse AfZCHI-TECH ASSOCIATES U1p•MGhIt.CGLVrpI Ybrt1 1 & $ OLD KINW5 H*HWAY,WEST 5ARN5TA13LE C�PJ 9A 10A .# w_ pl—a db4QAlw,d (\VP wu pwe d GFu• w's 6�F�ool etroet tel-1J08-420-8998 r Rla co—M1 d ArU4Tet� A—"td tic.b a tihtiy- DETAILS ,mod ucdat. ootult.ms 026315 Psx-600-420-19504 ;t 4' Pioket Pod Fence /'/ Rose-of-Shoran Hedge } -__ -_ -- �- -- t Femme American Holly -- -- -- _- -- -- -- -- -- Lawn Existing Vegetation to remain / --\ / Stepstones Lawn � � o Proposed 18'u34' Pod CM Existing Vegetation to remain Lawn t Male lue Holly t BWe Princess Holly 4 C laurel Parking Pool Deck �d 7 Double Blue H ron eo Garogs 3 Kousa Dogwood lawn Brick Walk Lam Cate 3 Spreading Yew 1 R ►eadleat Jap. Maple / 4' Pool�UFence � 7 Heller Japanese holly 9 Pink Winter Heath 4 Common Boxwood / Lawn 14' Asphalt Driveway / 1 Dwarf Hinoki Cypress 3/ Lawn Porch Brick Walk '} ! Lawn t 3 Pink try Rose 4 Spreading Yew t Blue Princess Holly /11a 1 Village Green Zelkovo i Lawn Lawn I t Kwansan Cherry r I DPorch Lawn Lawn U f J ! - Perennials M Fieldstone wall retains grade this side as needed Existing Vegetation to remain`- JUN o 62 01 ' OF BA ST LE _- TOWN Landscaping Plan ►GH AY The Caldwell Residence -�__ OLD ACING' W RL a& west Barnstable - 8y: Philip LChe�al �394-1373 �-- Scale: 1 =20' /5/ 200 12 b 2001 11 d) (711 F1' 1*1 2:21:221=113 3 I o, MAY 2001 TOWN OF BARNSTABLE � OLD KING'S HIGHWAY r C A L D W E L L ' R E S I D E C E Old K i n g' s Highway, W e s t B a r n s t a b le, M AI A R C H I - T E C H A! S S 0 C I A T E S I N C . r - 7 I I LILL ETI 13 l , r---1 F , L�ma , I , I El LIA I i , i I I � I i I ®' , i I i I I I , I o j = CP o � 03 vm � i z j II EE ' EIEO- ILLM rn I p I � I j .I 0EB =EE EB ,! LEJI a � Q 2 Z o O N3 v Da - v v v (D 1 d , 3 a i E== C � o 7, z°z -� cp ` �— p. GENERAL SPECIFICATIONS _ ..� SIZE-1 x 33 DEPTH 3 tb 0.PT. Srt..{. PERIMETER o S )o ., VOLUME STUMPS # N o LOADS # FILL AWAY Er D.O.P GRADING NO#� :YES❑ HRS. ` RAI SED BEAM ft 6 : "ft 12 ft.18 LIG HT 110❑ 12vD - F PER O IBER OPTICS# . ' tN POOL p FILTER c p,ti-r 54 SIZE 4• �- PUMP 1 Z SIZE SK IMMER RETURNS# s-tom .-: a•t� :. . , - _ . FLOOR RETURNS # : : LEAF TRAPPER - POOL'CLEANER S . HEATER BTU • : NATO PRO D OILO HEAT PUMP SANITIZER ra CC NATURAL STONE No COPING K° P TILE 'C N A o� INTERIOR FINISH TL t DIVE BOARD 1.1,o SIZE:. DIVE ROCK❑ sKtr'1 STEP RAIL fy o fig. 40 LADDER❑ S REMOTE CONTROL do TIME CLOCK 220v HYDRO THERAPY SPA f SIZE JETS i SKIMMER YES❑ NO❑ $ ...,..� MAIN DRAIN ' SKIM❑ NO❑ C LIGHT 110v ❑ 12v ❑ SPA POOLS AIR BLOWER YES❑ NOD & PATIOS, INC. DECK by: MaClb01'O Ugh, MA 01752 FENCE by: 00-448 6483 Fax. 508=229 3304• ELEC by: -DIRECTIONS - FUEL HOOKUP by: SET BACKS SIDE REAR r , . . . PERMIT DIG SAFE NOTES: DATE • o - SALESMAN DRAWN BY DRAWN CH B KED Na e: p Address:-:) `) AWN T' , State: Zap Code: : FILL OR STONE GENERAL NOTES: OWNER ELEVATION ONE .. heli Residence Phone•., Wet down concrels aat feast Mica daily for 7 days. Owner to determine correct elevabon as noted BrouQM to job by addendum. 1.Electrleal,gas and fence wont by others..;' Do not hum on pool WTf when pool is amply or established on excavatbn'day. Pod area to be fenced.per Canty or My Ordinances, 2.Heater verghg by others. Do not Use rubber hose when Riling pool as It will marls pfastgter. No graft unless epecMed. gates to be"If doeft and sell htchkp by owner. s.up m ei�M hov.pooi excavatlon allowance. 4.Additrrai work addendum BOOK PAGE • y Bus iness Phone: , ,., Brush down plaster twice daily,for 14 days. by only , Cal( PhoneFERKAKI , .Y 5 M•f//3.7nc/ b oA y ....... A��l f::he AZE6/SrZV- "S-- $ G� -31.60 P1 i X n 3, p � � ./�• nil rl f - LOT .379 0. ti b t. IAI 175 rawly' IRR .eaa .�aoo� �SE2VE0 ' '.� RirtleE,�buvp�t/B /Gd.SC vN � ' I•� y /75 so.A' Z3" "�•S 7/•r7'6t"w �' S � � I y rl C.Ctt/O MA/� .'XEKE /7•LG100• /.1'.09'..••' � f7��.pil 3-4 Z D ip II�WO. g - Lor 59 t 0 �t.yG9r�c.�afa/) daPA.eovAC NOT Rr-ou/.C'ao e141Z e r /3Ai2A./.iTA L/3 E N/Ix�A;ti a/G /.�C.1�O,eG A � � 4,�,q.4 5• -+5/t.•54,r 0 Ayr 1;10,n IL � l w p n aA4/ zoo*' /e70 FWOC 79, AovO Lor / WC57- �C31A�2AJSTA3LE, MA.9S. 0 SAOW" IV PLAN 1300C e9e / Q47C fT. 1O f• P Poe-a r>,Q ec4> FG2 ZGU/aJG GC.irS.s/F]'G'A7'/OrC/r R.F. ' /so �f. M/w. F,eowr�►sc NAr2DL.0 � FQ/EDA S�/VACL� / 4ca77ry 77•/Ar 7W/S AL44/ WA3 NfADC /4/ O '• ! ACCd2DAUCE WMM RESISMe or DEEDS SaWMAT/Drt/S Erkocc Ac 9742. sw/e in t down Cape engineerin,? Of : RIC C/V/f- c,venveE�e s �'''tl -�4�0•/7 s/ � s` �/� c�,vv su�eVeroRs W DA7T. f/�a1�/f7 Q.G.S. .GA- YAeMG(/7N MFirSS• afG3 A/o. IQ-0'59 ti� SURVE 0009 ■■■��■ r ��■....�■��■. i ■pis a A TEST HOLE LOGS 6.8 B NOT ALLOWED A.N. OJALA, PE LEGEND � �o SEPTIC DESIGN: GARBAGE DISPOSER IS ) ENGINEER: „�. 6.6 DESIGN FLOW: 5_ BEDROOMS (110 _GPD) = 550 GPD WITNESS: GLENN HARRINGTON, RS , USE A 550 GPD DESIGN FLOW DATE: 6/7/01 Locus 100.0 PROPOSED SPOT ELEVATION .7 = 1100 < 5 MIN/INCH Z 9 C5 SEPTIC TANK: 550 GPD � 2 ) PERC. RATE 100x0 EXISTING SPOT ELEVATION Y �`\ I 1500 1 USE A GALLON SEPTIC TANI' CLASS SOILS P# RouTE sa z 11001PROPOSED CONTOUR LEACHING: 10.6 2(58 + 10.83)2 (.74) = 203 100 EXISTING CONTOUR D SIDES: ST N1G� . 58 x 10.83 74 = 464 2 1 7.3 BOTTOM: (�� Q ELEV. Q ELEV. 1. TOTAL: 903 S.F. 667 GPD 0� 24.5' 0• 20.4' USE (6) 500 GAL. LEACHING CHAMBERS (ACME OR o EOUAL WITH 3.5' STONE AT ENDS AND 3' AT SIDES .. 0 0 + � 2 ) 2 2.. LOCATION MAP NTS + 1 A A 1 i LS LS ASSESSORS MAP 134 PARCEL 24 Q 147 '� I E 10" 10YR 5/4 10" 10YR 5/4 ZONING DISTRICT: P.F + 14.8 9.3 B B YARD SETBACKS: 15 LFS LFS FRONT = 30' 16.1 `VS ;, ., 10YR 5/6 1 0YR 5/6 SIDE = 15' / rf 14.6 ` 1� 35 21.5$ 35 17.48 REAR = 15' BOARD OF HEALTH 17 + 16,9 F PLAN REF. - 356/59 APPROVED DATE MA + 14 � 8.4 C C FLOOD ZONE: A3 EL. 11 AND C 17.1 AP DISTRICT P + 1 .6 M/F M/F + 17,6 cQ 0 + 1 2.5Y 6/4 2.5Y 6/4 + 18.8 + 1 .6 + 18.8 + 18.1 G 132" 1 126" 9.90' LOT 4 100' 50, 9.4 =5 i8.9 129,3 '14 SFf ._._. NO WATER ENCOUNTERED .N[ TESL N 19 15.9 14.0 � NGVD 18 8 4 0 1. DATUM IS �. + .3 2. MUNICIPAL WATER IS NOT AVAILABLE + .9 .0 3. MINIMUM PIPE PITCH TO BE 1/8' PER FOOT, 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO ,H 10 . b + 1 .5 \ #6 5. PIPE JOINTS TO BE MADE WATERTIGHT. �s0) 11.2 FLOGDZONE A3 EL 11' 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ENVIRONMENTAL CODE TITLE V. k + 3.2 ,8 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE a + 8.3 + 310 . ' USED FOR LOT LINE STAKING. nl o 8. PIPE FOR SEPTIC SYSTEM TO SCH, 40-4' PVC. + 1 .8 j #5 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT . I 11.3 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED BENCHMARK - TOP OF + 14.1 FROM BOARD OF HEALTH, 1 CONCRETE BOUND 10, CONTRACTOR SHALL BE RESPONSIBLE FOR, VErIFYING TIIE LOT 3 G . ,' ,, 1-OG�.TTf7�1 OF a' L I���?�r ^�F' +��rr n��l-r ;,� _ I �: ►, ._r, EL. = 18.7 (NGVD) 13.d- "-2 TO CUi�iN(1=Nl.,EMENT G ✓LiRN:, + 1 4 10, 3.6 ! 11. WETLAND RESOURCE AREAS FLAGGED BY HAMLYN CONSULTING :a Exlsr, WELL 18 8 0 6, + g.9 #4A I ./ N + 19.2 /�1 12. 1010.6 a 21s' a, #4 a 3.4 f TITLE 5 SI TE PLAN _ z 13 12.0 of 194 ROUTE 6 A 5� 2� \ TH1 \\�G� \\\ �'` + + 3 2 + 1 4 ORO WCTLANRK LIMIT LINE OF STAKED SILT FENCE, 100' IN THE TOWN OF: D (WEST) BARNSTABLE o v 13.9 0' + 17. + 14 PREPARED FOR: C w \ EDWARD AND CHRI�TINE CALDWELL ti + 13.7 24 #3 25 \ J� + 14 7 ^ 11.0 30 0 30 60 90 p9' PROP. DWELL. 7.3 I v51. 0 TOP FNDN = 25.G \\ 'Po + 1 163 SCALE: 1 = 30' DATE: JULY 12, 2001 1 �� +�j.4 �� 10.7 28.1 M �� +�3 .6 \\ \ 7 I \ \ ,� + 1 L T 4 ,�� 4 \ + 16. + 14 SYSTEM PROFILE 1 .6 (NOT TO SCALE) 2.9± ACRES ROP. WELL 2 ao, �� \� + 23, #1 TOP FNDN. AT EL. 25.0' 3 +128.7 �`_-_� \� N , ACCESS COVER TO WITHIN 6' OF FIN. GRADE < 11.2 ACCESS COVER (WATERTIGHT) TO k 202 123 5 MINIMUM .75, OF r_'O\ E ❑VER PRECAST /� WITHIN o' OF FIN. GRADE 20.0' - 21.0' 2% SLOPE PEQUIRED OVER SYSTE \ / / \ GAR Spo, - � �,.e, : ` ___.. _. _ R tl �__ RUN > .r E L-EVEL 2' DOUBLE WASHED PEASTONC, OF Mqs 22. _ c+-----�'` FOR FIRST 2' 2 '� \6 \/ + 2T1T.�0.8 1 PROPOSED 1500 \- + 7 *� I` `\ g H. ZF 2 .2 �. GALLON SEPTIC c .'�' MAX. o�� AF1NE 5 \ ---" 2 �` r 20.75' 20..E 1 TEE 17.83' OJAIA S ti j3 TANK (H- 1 O ) GAS 17.50' - "- No.2634 04 0 BAFFL 17.67' �� C� L� a CD 0 (-1 Cl C. I RpP ` h. M2 ` 0 17.0' [� C-1 ED 0 ED IO C7 C�+ 0 3' SIDES Fss�o cr o SI AL I ##0 < '/. SLOPE) �6' CRUSHED STONE OR MECHANICAL o Q Q Q Q O n C7 C CJ END YE H. OJA , ., P. .S. + DATE \ , 10.3 t ag 2' EDM00 0 C70C 150' ' 'g + 21.4 DEPTI [IF FLOW 4 COMPACTION. (15.22I [2]) in " ( % SLOPE) TEE AZES: 3/'4' TO 1 1/2' DOUBLE WASHE ► STONElj _ 10 IPJL :T DEPTH - J [7:J",LET DEPTH = 14" 5.1' 25, 2319 SEPTIC TANK 29' D' BOX 21' LEFT !SING FAC:,-I TY 2 0 .� off 508-362••4541 fox 509 36'-9880 4 2 2S 4 so i 1- do wn cape engineering, inc, CIVIL ENGINEERS LAND SURVEYORS 939 Main st. yarmouth, ma 02675 0 > --098 R