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0040 PERCHERON WAY
y a YI 'f 1� , • C t 1 I� �ttCYCLED 00 UPC 12534 No.2-1�53LOR HASTINGS, MN ��....y� ����q� a �� �� - � o ��'� f. �. o .,, . .. I } t Z � � � 1 � Go v�c� �� � � s�� r � ���� � U e �cr�e � o .,��_.r _4� _ _-_ .� . . . r f I I i i � ii �� i i Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 10 A- ""'� Posted Until Final Inspection Has Been Made. _ ��-a---r—r- 1a39. ,� - _ — -.�_ r CI-Illl t, �:hC.'Z a Cel Lircate of a,ccupancy is Kequired;such Building shall Not'be Occupied until a Final Inspection has been made. Permit No. B-20-1330 Applicant Name: Steve J Spengler Approvals Date Issued: 06/01/2020 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 12/01/2020 Foundation: Location: 40 PERCHERON WAY,WEST BARNSTABLE Map/Lot: 174-001-054 Zoning District: RF Sheathing: Owner on Record: MARTINS,JOEDES PEREIRA& IVANI SILVA Contractor Name: VIVINT SOLAR DEVELOPER LLC. Framing: 1 Address: 40 PERCHERON WAY Contractor License: 170848 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 15,769.00 Chimney: Description: Installation of roof mounted photovoltaic solar systems 8.96kw 28 Permit Fee: $ 130.42 Panels J Insulation: Fee Paid:? $ 130.42 Project Review Req: Date: 6/1/2020 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan2. icia Final Plumbing: All work authorized by this permit shall conform to the approved application and the5approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas:. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: I I . � . The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire-Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT " Final: Town of Barnstable *Permitm�?b ! YGO I q8 Regulatory Services F4 months ro��e e g rY HAM i Richard V.Scali,Interim Director A J.f, Building Division Tom Perry,CBO,Building Commissioner 100v 200 Main Street,Hyannis,MA 02601 www.town.barristable.ma.us Office: 508-862-4038- Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number G 6 S Property Address D rP U" ,01Q o 1 j WAY I&E S r @ 1Z D)�2 I-S ❑Residential Value of Work$ �_3,�`7 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ITN -a- A 7) F O vll gLC, Yo fae-yge6N 14/A V Wgs-r a,AP_Aj sTAPL� Mq Contractor's Namab A NJ J UA ZD DM y6 VIZ /NI�/► f, �k)91099 Telephone Number 01 j g5- r Home Improvement Contractor License#(if applicable mail: �r0I Construction Supervisor's License#(if applicable) (53,Workman's Compensation Insurance Check one: E,I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re uest(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value a (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License 6 quired SIGNATURE: TAKEVIN M3uildin anges\EXPRESS PERMMXPRESS.doc Revised 061313 n n n n 0 U R CONTRACT TERMS AND REQUIRED NOTICES !� ��II O� Notice:All home improvement contractors and subcontractors engaged in home improvement contracting, f _ unless specifically exempt from registration by the provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts.Inquiries about registration and status should be made to the Director,Home Improvement Contractor Registration,One Ashburton Plac;,Room 1301, 7 Gloria Drive•Mansfield,MA 02048•(508)269-8469 Boston,MA 02108. www.yourhomeexteriors.com I/We hereby agree and authorize you as contractor,to furnish all necessary materials,labor and workmanship,to install;construct and place the improvements according to the specifications,terms and conditions,on the premises belov,described,which I/We represent that we have good record title in our own name. Owners Names 174 p-4 Kul t 6' TDQ WE UU Job Site Address_ a ��'I-1 4;: 0,-, t,J City g.S- ?>+Qt3 V ST�Zip Pa' � Home Tel.No �� Baa.Teloi_�t�� 7S1 600°) E-mails(�t"M F. Y Work Specifications described attached on pages: �_of of of _ Permits:The contractor agrees to apply for and obtain all construction related permits(Building/Electrical/Plumbing)but shall not be deemed responsible for delays in the work described in this agreement caused by regulatory,permit granting or inspection agencies,authorities or individuals. Notice:The homeowner who secures his own permits will be excluded from the guarantee fund of MGL Chapter 142A. Price:The contractor agrees to do all the work described by the contract for the total price of$J I. S-5 q — Notice: No agreement for home improvement contracting work shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make,in advance,to order and/or otherwise obtain delivery of special order materials and equipment, whichever is greater. Security Interest:Yes No -To be held in the form of a UCC-1 form to be filed only if payment is not made on completion. Notice:The contractor does not have the right to request payments in advance of the times set forth in this agreement,although,by.agreement,the parries may jointly agree to escrow any portion of the contract amount.In the event that it becomes necessary for the contractor to employ an attorney to collect any balance due hereunder the owner agrees to pay in addition to the said balance,the costs of collection and reasonable attorney's fees. Work Schedule:The contractor will not begi work or rder materials before the third day following the signing of this agreement unless specified in writing.The con- tractor will begin work on or about /�/ (date).Barring delays caused by circumstances beyond the contractor's control,the work wid be substan- tially completed in�—we day .The homeowner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the contractor shall considered as violations of this agreement.The contractor shall not be liable for any delay or non-performance caused by strikes, accidents,weather or any other contingency beyond its control. Insurance:The contractor agrees to maintain workers compensation and comprehensive general liability insurance during the operation of this job to cower the acts of its employees and/or agents. Warranties:The contractor warranties its workmanship for up to a period of five years and assigns the rights to any manufacturer's warranties to the homeowner after the substantial completion and payment of the contract terms. You may cancel this agreement if it had not been consummated by a party thereto at a place other than an address of the contractor,which may be his main office or a branch thereof,provided you notify contractor in wilting at his main office or branch by ordinary mail posted,by telegram rent or deliv- ered, not later than midnight of the third business day following the signing of this agreement.See the bottom of this form for an explanation of this right. This instrument and any other documents attached hereto and signed by the parties set forth the entire contract between parties and may be modified only by a written instrument executed by both parties.Receipt of a copy of this contract and duplicate notice of cancellation and explanation thereof is hereby acknowledged. Payment Terms: Advanced Deposit $ O D Payable on signing of contract Interim Payment 1 $ Payable _ Interim Payment 2 $ Payable Final Balance $ 5 Payable y%,-PLX&T1 n,� HOMEOWNER: Do no ign t ' cont if there are any blank s1!%ayof IN WITNESS WHEREOF, h pa 'es her signed the' ames this Owner/Representative Homeowner ' Approved by Owner Homeowner HOMEOWNER: You have a right to a copy of this contract. CONTRACT WORK SPECIFICATIONS OME 01 iiTl Initialiang this page indicates receipt of the CONTRACT TERMS • • • AND REQUIRED NOTICES as page 1 of this agreement 7 Gloria Oft•Mansfield,MA 02048•(508?2694K69 Mass HIC#162185 Owners Names: Keith and Katie Powell Job Site Address:40 Perdteron Way City.West Barnstable ST MA Zip 02668 Home Tel.No. 508 6810789 cell.Tel. E-mail:kmpkmp97 a@yahoo.com Details of work to be perfbrmed and materials to be supplied follow. This proposal covers the following: 24 individual double hung windows One large front window currently a 4-lite bow window One 6'x 6'8"Patio door See price schedule for any repairs found during installation. 24 Individual double hangs: 1. Remove 23 double hung wood sashes and jamb liners,and one twin casement window and properly dispose. 2. Install 24 OKNA Insul-tec 500 series deluxe vinyl replacement windows with screens and double sash lock. 3. All windows will have 6/0 internal contoured colonial grids unless otherwise specified. 4. U Value=.25 for double pane Low E and argon gas. Total for 24 windows installed.................$10,632.00 Large front window 1. Remove one 4 lite bow window and replace with new OKNA TRIPLE MULLED vinyl new construction window. 2. All three windows will be equal sized double hung windows close in size to existing windows on left front wall. 3. Carpentry work and new interior casings if required included as well as exterior soffit work and trim. Total for triple mulled unit installed...........$2,147.00 Pado Door: Remove one existing patio door and properly dispose. Install one new OKNA Elegant entry patio door in white with Low E and argon gas. Includes locking screen and Brushed Nickel locking two point Merit Hardware with keylock entry system. Total installed door...................................$1,575.00 Repair schedule.- 1. Replace rotten sills @$140 each which includes the nosing with PVC composite trim. 2. Replace only thelill nosing @$40 each. 3. Replace 908 wood casings with PVC 908 composite for both sides$110. This includes a new sub casing also. All windows have a life of the home warranty which covers seal failure,parts,hardware and screen frames f9r Is�ng as you own the home. G.3 a Price includes all taxes,permits,disposal,and installation. Initials Admowledging this page:YourHome Eterfors Homeowner 4__Ie2 Homeowner Date HOMEOWNER,Do not sign this corrdact if are arty blank spaces.You have a right to a copy of this contract Page -)—of The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le>ai_yl Name(Business/Organization/Individual):I.1.1,E B�. V' Q] D YdL)e fid" Address: 7 &L,n 1,14 ae i VAS City/State/Zip: AA15F I Phone#: �_n t46q Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp.insurance.: 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job sr.'te information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: _ Job Site Address: * 0`JQCdJ f9JV I A I V AA W City/State/Zip:W. LM 211(�'f; Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby MW under ains�oypenaldes of perjury that the information provided above is true and correct. Si ature: Date: 1 _ Phone#: 9 014q E Y 6 q _ i Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i ACORQ CERTIFICATE OF LIABILITY INSURANCE O"6 . 9/201 '' 06/'19/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,DO-END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. N SUBROGATION IS WAIVED,sub)ect to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this ceRlficate does not confer rights to the certificate holder in lieu of such endonwme PRODUCER CONTACT Gwen Vosbur h Mason & Mason Insurance Agency, Inc. . 781.447,5531 T81.�t47.7230 458 South Ave. , EalA6 soh i dean, MA 02382 PRODUCER Gwen Vosburgh INSURER(S)AFFORDING COVERAGE NNC N INSURED INSURER A: Western Wor 1 d 000071 John Rivard INSURER B: DBA: Your Hoare Exterior So I ut i ons INSURER C: 7 Gloria Or INSURER D: Mansfield, MA 02048 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13/14 GV built REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. TYPE OF INSURANCE wr POLICY NUMBER Y LIMITS GENERAL LIABILITY NPP1349116 02rM2013 021=2014 EACH OCCURRENCE S 1,owl DAMAGE TO RERTw_ X COMMERCIAL GENERAL LIABILITY p $ 50, CLAIMS MADE F-K OCCUR MED EXP(Any one person) $ slow r PERSONAL&ADV INJURY $ 1,ow, GENERAL AGGREGATE $ 2100131 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000, POLICY EST LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMB $ (Ea accident) ANY AUTO BODILY INJURY(Per parson) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per�sot) $ NON-OWNED AUTOS S s UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAa CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION -A CRY STATU- OTH- AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETDR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.OISFASE---EA-EMPLOYEI S fl dewribe under RIPTION ow E.L.DISEASE-POLICY LIMB I$ 13FACRIPTI02 OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,AddMloral Remarks SaMduls.Ir nn o space Is required) ce Copy CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. John Rivard . DBA: Your Home Exterior So i ut i ons AUTHORIZES REPRESENTATIVE 7 Gloria Or Marlsfield, MA 02048 ,Philip Mason 019W2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE 119/rIVOO/YYrr, 9/19/13 PReoue�R THIS CERTIFICATE IS ISSUED AC A MATTER OF INFORMATION Louis Sweet Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CIRRTIFICATE DOES NOT AMEND, EXTEND OR 125 South Main Street PO Box 397 ALTER THE COVERAGI APPORDIED NY YHE POLL I S eELOW. Sharon, MA 02067 781 784-2461 781 784-3278 Fax — INSURER$AFFORDING COVERAGE NAIC# INSURER A: The Travelers David J. Brooks DBA INSURERS: Raynham Home Improvement INSURERC: — 1 528 King Philip Street II s ERD: Ra nham MA 02767 INSURERE: 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 DY 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. INlR -- - — _.. ----- POLICY NUMBER T POLICY EFFECTIVE i POLICY EXPIRATION i -- -— LIMITS . I GENERALLIABILITY CHOCCURRENCE $ l,y_000 GOO_ A iX 1X 'COMMERCIAL GENERAL LIABILITY 680-6375N542 i 7/10/13 71/10/14 r_,PREMISES( aoxuronce) $ 300,000 CLAIMS MADE IX 'OCR I I I --� �— - CU— ( I MEDEXP(Anyoneperson) $ 5,000 — ---- 1 I ---•--- --- I I PERSONALS ADV INJURY $ 1 ,GOO,,000 GENERAL AGGREGATE— I$ 2 r OOO s OOO _ I 11 GEN-L AGGREGATE LIMIT APPLIES PER: ! I I PRODUCTS-COMP/OP AGG I S 2 ,000,O00 I X ' POLICY!- PRa 'LOC I 1 I I(AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT , I I ANY AUTO I { 1 (Ea accident) $ — 1 ALL OWNED AUTOS I BODILY INJURY ;$ SCHEDULEDAUTOS (Perperson) i HIRED AUTOS I I j BODILY INJURY - _—`-- — - NON-0WNEDAUTOS � � �(Peractident) $ ' I PROPERTY DAMAGE I$ (Per 8eeitlenQ 1 GARAGE LIABILITY ! jI AUTO ONLY-EA ACCIDENT (_$ ANY AUTO EA ACC I I S OTHERTHAN I — — I AUTO ONLY: AGG $ i (EXCESS/UMBRELLA LIABILITY I ; EACH OCCURRENCE ^OCCUR Il CLAIMS MADE I (AGGREGATE $ :$ —_ } DEDUCTIBLE +t I )�$- I I RETENTION $ j I S WORKERS COMPENSATION AND E I I TORY UM TS�—iEAIII _ EMPLOYERS'uaelLm IHUB-3531 R079 8/1/13 °: 8/1/14 A i ANY PROPRIETORMARTNERIEXECUTIVE I L.EACH ACCIDENT - i$ 500,000 — OFFICER/MEMBER EXCLUDED? { j [E�L DISEASE-EA EMPLOYEE$ 50,000 Sy E describe under ! — -- PECIALPROVISIONSOeIow 1 tE.L.DISEASE-POLICY LIMIT +S 500,000 ;OTHER - I I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Your Home Exterior Solutions SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 7 Gloria Drive DATE THEREOF,THE ISSUING INSURER?nLL ENDEAVOR TO MAIL 20 DAYS WRITTEN Mansfield, MA 02048 NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE TO,00 SO SMALL IMPOSE NO OBLIGATION�. ABILITY OF ANY KIND UPON THE INSURER,I7S AGENTS OR REPRES ATIVES AUTOO E o riner ACORD 25(2001/08) 0 ACORD CORPORATION 1988 Massachusetts -Department of Public Safety Board of Building Regulations arid.Standards Gmstructiun Supervisor License: CS-059506 JOHN RNAPJI 'N "!: a MANSFIE1 MA 02048 .%.C..,,fir- - �� • ' rsts�a Commissioner Expiration 01125/2014 .; (9.-/e Wpl mo*uuea a�C�/ aac/zaaelGt . Office of Consumer Affairs&Business Regulation ME IMPROVEMENT CONTRACTOR Wgistration: 1fi2185 Type:piration: :;.1/291201_5 DBA� 1 .�1" YOUR HOME EXTERIORS''.'.' JOHN RIVARD I 7 GLORIA DRIVE \ I: MANSFIELD, MA02048 � j' Undersecretary r Massachusetts - . a: afet Department of Public S Board of Building Regulations and.Standards Cunstr•uctiun Sujlcrlisur 'License: CS-059506 �.>titi•r•r.5 � �. JOHN 4 WARD•. 7 G -- „� LORIA D�12 '✓ ` MANSFIEj MA 02.048 9.e:— . Coin►nissioner Expiration 01/25/2014 ' r License or registration valid for individul use only P before the expiration date. If found return to: r Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 - Not valid without signature X-PRESS pERMIT . oF*wer" 1EP.2 j 2012 Town of Barnstable *Permit --�. Expires 6 Regulatory Services Fee mant om issue date MAM ' s - :yg.� �� Thomas F. Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION b- RESIDENTIAL ONLY. Map/pazcel Number t alid without Red X-Press Imprint ' Property.Address A-Residential Value of Work 300, D Minimum fee of$35.00 for work under$6000.00 Owner's'Name&Address ur��'f Contractor's Name — Telephone Number Home Improvement Contractor License#(if applicable) 13 ?, 3 Construction Supervisor's License#(if applicable) g ❑Workman's Compensation Insurance Chec one: I'am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# dYU1. W(n 4ci Copy of Insurance Compliance Certificate must accompany each permit. Permit Request eck box) . n/ e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) (( ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum A5)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: PrFopy erty Owner m t sign Property Owner Letter'of Permission. A of the H e Improvement Contractors License&Construction Supervisors License is quire_dJ IGNATURE: AWPFILESTORMS\build' g permit forms RESS.dop j evised 053012 r yak- David Sawyer Construction 318 Meiggs Backus Road Sandwich, MA 02563 508-539-1992 Proposal Submitted To: Work Address: Keith Powell Same 40 Percheron Way, West Barnstable MA 02648 207-751-6009 Worked to be Performed: *Strip old roof shingles and replace with new CertainTeed Arc ' et-Land mingles Color: *Nail Plywood as needed *Clean Gutters as needed *Install: Vented drip edge as needed Ice &water barrier on all edges of roof, cheeks, velux, chimney Underlayment Paper System Ridge Vent Pipe Flange Hurricane nail roof *Remove wood rake boards --Replace with Azek Plastic Trim with Stainless Steele Nails *Strip 2 front sidewall cheeks-Replace with R&R Cedar Shingles Install New Step Flashing *Clean & Remove all debris from workplace, take to landfill. *Please note when installing ridge vent sawdust may fall into attic. Please cover items. Total Investment& Labor: $ 10,700.00 ten thousand seven hundred dollars Payment is due at time of job completion. All materials guaranteed to be as specific, and work to be performed as stated above in a workmanlike manner. Please remove and secure any fragile household items. Not responsible for broken or damage to household items. Five year Labor Warranty/Plus"tM " ufacture warranty. Contract may be withdrawn if not accepted within 30 days. Please see back for ad ' nal term Respectfully Submitted . l 'Date Acceptance Of Proposal l The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work. Payment is due in full at job completion. Owner signature: j f WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY' INFORMATION PAGE AGENT NO 3020 OFFICE NO 3020 MARK SYLVIA INSURANCE AGENCY LLC 771 MAIN ST OSTERVILLE MA 02655-1903 FARM FAMILY CASUALTY INSURANCE COMPANY 508-428-0440 NCCI COMPANY NO. 16721 POLICY NO 2001WG406 ........... INSURED AND MAILING ADDRESS: RENEWAL OF N0. 200lw6406 ........:.......... :..::;:..... ..... ... DAVID SAWYER EFFECTIVE 3/05/12 DBA SAWYER CONSTRUCTION 318 MEIGGS BACKUS RD SANDWICH, MA 02563-3131 THE INSURED IS INDIVIDUAL Workplaces covered by this policy: ST WP NO. ADDRESS OF WORKPLACE RTG.BUR NO. INTRASTATE PJO.' MA 01 318 MEIGGS BACKUS RD 210677 SANDWICH MA .....�".'. : .. .::. i^lv, %i'ti:?i`.%iiiii?�::>%:?%jji'.:::i>:i:;i<:::vf:;{:<;}:L::2':>t�jilt i�ii:iiii•�::;}:?iiiiYiiii:�?i ii`:Lititi iiiii}�%iji 3ii:::;:�;:;:;:i>%i::iiii��:!�:^'ji:! :��$i:�•LE.; -. ..:•.. :.: �.'�:� Y}i} '•:�� ��ii:`Yi:4i4i'ti�i:iii'.i>:%:•lei......:?ti i�S,��,.,.n•�,•,.,•,•,•`,:i� >ii::ii:::i::::.v:::::::::::::}:.w:::::::::n�:::nw. •.w:::::}...vvvv+..::.v:::::..... „v:•. <.:.v`:`::nw::}.....:.v..n:................ The policy period is from 3/os/12 to 3/05/13 12:01 A.M. Standard Time at the insured's mailing address. .............::..............................::.::................................................................:::.:....... .A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the state listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: BodlIV Injury BV Accident BodlIV Injury By Disease Bodily Injury BV Disease $ 100,000 each accident $ 500,000 policy limit $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except the states designated in item 3.A. of the information page and ND, OH, WA, and WY D. This policy includes these endorsements and schedules: WC 00 00 OOB WC 00 00 01A 'WC 00 03 15 WC 00 04 14 _ WC 00 04 22A WC 20 03 01 WC 20 03 02A WC 20 03 03D WC 20 04 05 WC 20 06 01A I , Jlte eom���� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 134313 Type: DBA Expiration: 10/24/2013 Tr# 216645 DAVID SAWYER CONSTRUCTION: DAVID SAWYER - 318 MEIGGS BACKUS RD. SANDWICH, MA 02563 - Update Address and return card.Mark reason for change. Address Renewal n Employment n Lost Card S•CA1 is SOM•04/04•G101216 .iA ✓2. Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:.. 134313.. . .. Type Office of Consumer Affairs and Business Regulation Expiration: 10/24/2013 DBA 10 Park Plaza-Suite 5170 -�;• Boston,M OZ 116 DAVID SAWYER:CONSTRUCTION DAVID SAWYER 318 MEIGGS SANDWICH,MA 02563.. :. Undersecretary / Not vali ithout;' nature ffi ... "GtT, a7as..icnaseth 'Del) -MISS. of I'ulilic Sait'rt�B o.ar(l or 13uilttin' d2c'�ufarioii`atn(}-standard rJ7,struction &jpe'rjiSOr SPSci-itl) License: CS SL 98859 Restricted to: RF,WS DAVID SAWYER ; 318 MEIGGS BACKUS ROAD SANDWICH, MA 02563 Expiration: 1/27/2013 Tr=: 9053 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbel-s Applicant Information Please Print Le i6ly Name(Business/Organization/Individual): S Address: I � }��c(L(�/� CC y V City/State/Zip: S�OdtAlta MO- 02,M3 Phone k -5 -3� Are you an employer?Check the appropriate box: Type of project(required): 1.❑�a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.t 9. ❑ Building addition required.] 5. ❑ We are a corporation and its ME] Electrical repairs or add:itions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12. oof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13. Other lVb J 1 comp. insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ! Policy#or Self-ins.Lic.#: p? �p LtJ (� Expiration Date: Job Site Address: `1 �O,Y��140—NO-1 Vl 11/. 4/&ity/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of 4DIA for insurance erage verification. I do hereby cer• under the pa i an penalties of ury that the information provided above is tru and correct. Si ature: Date: / Z. Phone#: / Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel r O Application # ,a 011, I c3 Z Health Division rrWi) �,05q Date Issued Conservation Division Application Fee 150 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis A � Project Street Address Village V A+ 5&r ns Owner (;_Ob C C-- AddressLIU Telephone lephone S-V 9- —7 Permit Request (0 0M loo se me/fit Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project-Valuation (o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docurrientation. Dwelling Type: Single Family- A Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count_ _a c� C) Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other �M Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood coal stoee: ❑Qp ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: & isting L?newer-s ize_ c Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 4 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ rn Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address qo -2���111�or1 wr.�-� License # w rn Ste-b t W7 �'�' Home Improvement Contractor# Worker's Compensation # I ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i s r FOR OFFICIAL USE ONLY r� r APPLICATION# DATEISSUED j MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: Y `` .FOUNDATION .: :,I Fy FRAME • ;INSULATION? =` r FIREPLACE ELECTRICAL: ROUGH FINAL C PLUMBING: ROUGH FINAL !� FINAL GAS: -{ ROUGH € tFINAL-BUILDING'S_ t ;DATE.CLOSED OUT - t ASSOCIATION PLAN NO. St i Town of �3ar'wtable Regulatory Services xu Arc Thomas F. Geiler, Director • s6s9,• w ilding Division ' rED lr� Thomas Perry, CB O,Building Co' issioner 260 Main Street, Hyannis,MA 02601 www.town.b arnst2 b l e.m a.us r 'Offices 508-862-4038 Fax: 508-793-6230 ' �1� '4 �V -PP Z o t l 0 3 7 � S� Owner.�1 CsGS Map/Parcel: p. Project Address YV 1 E OCRWJ W41 Builder :S*UE The following iterris were noted-on reviewing: RePiewed by: /� i Date: The Commonwealth of Massachusetts �s { Department of Industrial Accidents r. 1 Office of Investigations - I j ;�, 600 Washington Street ,I/ Boston, MA 02111 e www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plunzbei:s Arpplicant Information Please Print Le>?ibfY Name{Business/Organization/Individual): L4 Address: q0 2(L�he.�c OaAj Gity/State/Zip:Gd• Q tJ 4TA 8 L C Phone #: Are you an employer? Check the appropriate box: F oject(requiredIm 1.❑ I am a emp.loyer with 4. ❑ I am a general contractor and I construction employees(full and/or part-time).* have hired the sub-.contractors 2.❑ I am a sole'proprietor or partner- listed on the attached sheet t odeling ship and have no employees These sub-contractors have olition working for me in any capacity.. workers' comp, insurance. ing addition[No workers' comp, insurance 5. ❑ We are a corporation and its/ required.] officers have exercised their rical repairs or ZY 3 Iama homeowner doing all work nght of exemption per MGL bing repairs or myself. [No workers' comp. C. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp. insurance required.] ]3.❑ Other 'Any applicant that checks box N I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such* tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address- City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. kPhone o hereby certify under the pains an enafties ofperjury that the information provided above is true and correcC Signature: Date: G �UL. Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or theme receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who 'resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter inio any contract for the performance of public work until acceptable.evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial r 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 Iisted below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that�the affidavit is complete and printed legibly. The D.epartment has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating currept policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-977-MASSAFE Fax # 617-727-7'749 Revised 5-26-OS www.m,ass.gov/dia �oFt Teti Town of Barnstable Regalato'ry Services s�xxsrAsrE. 1 Thomas F. Geiler,Director 019. Building Division QED µl+'t k Tom Perry,Building Commissioner 200 Maid-S_treet,_lyannis,MA_02601 www.to wn.b arnstab l e_ma.us Office: 509-962-403 8 Fax: 508-790-6230 HMn OWNER LICENSE EXEMPTION Please Print DATE 4/ JOB I I LOCATION: T pE'_�G number street village "HQMFAWNER 6&r ,T(ti 15W _7 2. Cc�® � �G��_�y -J _l�a •� � name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a-license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or fa2m structures. A person who constrgcts more than tine 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) "4r-undersigned"homeowner"asstanes responsibility for compliance with the State Building Code and other applicable codes, bylaws,Hiles and regulations. The undersigned"homeowner"certifies that.he/shc understands the Town of Barnstable Building Dcpa t- =. t rrvuuin,nm inspection procedures and requirements and that he/she will comply with said procedures and irequirements. Sikn ' of Homcowna j Approval of Building Ofncial Note: Thrce-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. Homxovv iER's EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shaD be exempt from the provisions of this section_(Section 1D9.1.1-Ucensiirg of construction Supervisors);provided that if the homeowner atgages a parson(s)for hire to do such work,that such Homcowncr shall act as supervisor."' 4-any homcowncrs who use this exemption an unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Ru1cs&Regulation for Litmuing C aistruclion Supervisors,Section 2.15) This lack of awanncss bft=reruns in serious problerns,particularly when the homeowner hires unlicensed persons. In.this case,our Board cannot proceed against the unlicensed person as it A pu)d with a licarsed Supervisor. The homeowner acting as Supervisor is ultimately responstbia. To ensure that the homeowner is fully aware of his/her nsponnbilities,many communities require,as part of the permit application, that the hDmcawner certify that hrlshe understands the responsibilities of a Supervisor. On the last page of this issue'is a form cun=t)y used by several towns. You may can t amend and adopt such a fomr/eertifieation for use in your corranunity. Q:forrns:hom=xcmpt THWEr ti Town of.Barnstable • Regulatory Services � M LM Thomas F.Geiler,Director �ED µ1C.16- Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable ma.us Office: 508-862-403 8 Fax: 508-790=6230 Property Owrier Must Complete and Sign This Section If Using A Builder as Owner of the subject.property hereby authorize to act on my behalf, is all matters relative to work authorized by this bAdi.ng permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on 'the reverse side. Q:FO RM S:O W NERP E RM IS S I D N I -Qa 1 ¢CD CD J ] t �.m N y i 7 m U { k fLd •� < 1 ' 1 i � cc i t - 1 s �'• i 10 3 i I � i I 1 i i f i I I i I I f j i � I I I I I FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139 , SEC. 3B TO: BUILDING COMMISSIONER OR BOARD OF HEALTH OR INSPECTOR OF BUILDINGS BOARD OF SELECTMEN Barnstable Town Hall Barnstable Fire Department 367 Main Street ADDRESSES P.O. Box 94 Hyannis, MA 02601 Barnstable, MA 02630 ATTENTION: FIRE PREVENTION RE: INSURED: RIGGS, Richard W. and Barbara A. PROPERTY ADDRESS: 40 Percheron Way - West Barnstable, MA 02668 POLICY NO. H3049321 LOSS OF Wind damage on June 13, 1998 FILE OR CLAIM NO. CH9806010A CLAIM HAS BEEN MADE INVOLVING LOSS, DAMAGE OR DESTRUCTION OF THE ABOVE CAPTIONED PROPERTY, WHICH MAY EITHER EXCEED $1,000.00 OR CAUSE MASS. GEN. LAWS CHAPTER 143, SECTION 6, TO BE APPLICABLE. IF ANY NOTICE UNDER MASS. GEN. LAWS CHAPTER 139,_ SECTION 3B IS APPROPRIATE, PLEASE DIRECT IT TO THE ATTENTION OF THE WRITER AND INCLUDE A REFERENCE TO THE CAPTIONED INSURED, LOCATION, POLICY NUMBER, DATE OF LOSS AND CLAIM OR FILE NUMBER. s 0 SIGNATURE EdwJr. DiBona I T.M. SEGER CLAIM SERVICE, INC. 60 Park St. - Hyannis, MA 02601 Telephone (508) 771-7432 Fax No. (508) 771-9023 ON THIS DATE, I CAUSED COPIES OF THIS NOTICE TO BE SENT TO THE PERSONS NAMED ABOVE AT THE ADDRESSES INDICATED ABOVE BY FIRST CLASS MAIL. R/ -1-Le 06 16 98 SI ATURE & DATE Patricia L. Carroll, Secretary i FORK 13 (6-90) i - - ------- ---�I I I � t Q ,� • ZJ�S 16 IJ 77ATA 50461 FAMIL`( 3 $EGR�M. iz� �ZZ�� ����• \ : \ n 6AZ3A6E GRIIJAEiZ _ 1-15.00 . . SE'Pi'I c TANS •3�i�15a 7�• Ari��-- -r -� �\ � \�� �` ,� � 1 \\ ��° LK G 1000 GA[, v15Po5aL PIT -Izn I'STet,Ig ��, �M°�P>• , 1 1 \ 19)9op (- / BOTTOM AeZA Sa 5r \ t4 TOTAL t I6N - 4Z S Gib. / Y TOrAL DAILY MY/ = 33&D6Pb O►L-_ PE240(_ATI ON eA-('E t I-'IIQ Z�ni►1�i.�SS I "I \�� I ll ( I 1 f3J G¢At& S►1o2T 'PE I ' I I � AF+ ur O� p PETER V IA- SULUVAN anx£n f( No. 29733 1r Nm 24043 1 _Twat 3T i T�5 - (�t7L:t Ro=_12g-mc�r� TF 1'4 ,a�` Ao l.o,kwl 1- v.C— ��J =►21 DKT GAL lue loci �u rz>� OCK IZo4- Imp 5eprlc Meg GAL � TANS �E LPG /o - - - :; W SaN� 1 -� 1 I' WISILr �ZWA49EP �`'cl>=: A►L 5teunvQFs s�T 'SToaE M W TILW 4. -DEEP . ...... B CezrI�I® PLOT FLAN ! 'pCRyELcPFo . . 'Peop uz - I j o -- -- 1,4 A.9lot SGAL E-1, �� d� DATE,' MAZ 11495 I�v t,Ua oPoa� PLAN VeVERWJ ' 41AY 1io,149v i 1 CFZDT-%( _ T4AdT TI•{s awwwow, '%C>WW NEZWf4 J� �O� 'PLY5 WITA lUf- SIU�JE I-OT ld.L P. Q. or E- IDA OF. UIZ S7&A & Pt. . `Be 431 Pe, It,A�•tD I L-o t,A-F�'� w to I ,�I�[ TCoo� pt-ol t�l -� 5•fG•9L PP4FE�ffOtJdL LAub Suevl=yta�z5 7AK FLAN IS HOT- T04ED c*4 AN (447P_txiE+,1T' z��I t_ E+JGI►J EEI[.5 6utzvcy Al V ENE OWJeTs 4400LX) uor 'De 0 >Ter2_vIU:G MA44 . ! uSL'1_> TO EMELISN PtzopetzTy U WC-5 A dPPLICANT; � 1s it)x 301L� /�A►N6 c.0 lug I I TJS'S 16 W DATA 5W/-j FAIL`( .3 $Eti�Ms iz< �Z�/�� . 0 6,05A6E G)ZIIJVEK 1-15 00 :..PAIL'-( FLOW V110- 3W 6,� � � � $EPT'Ic -rANL/_ -3los15a Ix ���-- — , \ \ 1&' VlSFMAL PIT -IC �i►t./1 sTa�JB 1 �. BOTTOM A A So 5f TOT'AL Vp51614 = 425 6W, TOTAL DAILY MW OIL.— 1-S¢4aLATIoN ¢ATE 1"'14 24MIJ/LZS T�j C¢AIL S[Ip�T- PE II ( ( I ��✓ t ur .0 PETER ;; 11l-� �` ( I 1 \ R!G►�ARD ��� SULLIVAN �' `- 3 Ia Fl f"' No. 29733 ?1 �tao.2rtotts t���E. � �eQ�sTs�� Q►�ar:�• ��r ENt'JO i OA►At R-L�3I i WAH _ Try T - 0L.ttS K=1W77 _ Flo=123 _r� TF I'Z.� 14 r24 PVT. � W GAL juo �oqy �N ►,��.eac 120 4- Ifiv Sr�rlc ; MW GAL v TANJ: F& WL�I{ - /o - - - ,��su r A I/z �:.Aw-5rzucn►RE) sr-T s'iKo� MOM TlIA4 a-DEEP sr4a,c1,; T& A-20 ! Cezrrpi ED FLer PCA IJ I 'pm_vE1.opZ' . PEOFI Lz— j o - -- t4 a.91ol SGA Lam; �� Dart% 1IA¢ 1 I9gs IJo•wArV, s� PLAN ZeFEROJr.E' 44Ay 1(,,1"& l C EZO FY . T+I dT T* LOT I tLL %ow w WmeoN �M'PLyy5� %urrA 'TEE 51 uQe 25 P%Q. op llic- TDA OF. 'BAX44T>aLa. p� • -be 431 n&, I G A�dD 15� l_04ATVD w T�11 Tl� �ioao 1�.nit i -� .. 5•IG•9L QPo�.55lorJd!_ LAuti Suev�/oz5 .54K FLAQ IS NOT- T"3A<,p 01.1 AN t 4-mo vT' c�.� C-�JGI N arcs Sup"`j AIJD THE oF::5E1 44omx) uor I3E 0 >TEIZVIu:G MA44 • ((' uSL� To EST�•BLI�t� PrzaPerzry LI+JcS / I dPPLICA NT ; �A�S iDg ~1t Olc-Di�16 (p (IJG ' �„-•, . ILfP i I ; • LIM 'lll ill I ' -- I-11 kPI I!�I II I!: •! a ET D W I , J c' i 14 --- ' '9 3 . m i; do u do i ! I '. c9 .I f 1 � N »vM �J.•s:L �o� j 2 ew- - -- --� --j� I. it I � i i �,� •' � III W _ oo r-�I J Fm , � i 41— I 11 �Fl o Gj 1, o ® 'v n. i Ii 0 - - -L4 o o. '• _£961 �cb61 _ i I "IIla V3N i • m _ OI�� p r m N!w D r y ti 19 � I �o•>_L �5 of m 0 ? d p II Z i+ to N 10 I i o z ' o I z I I111 ul 2 CL 0 I 'ODIIV v f oe'I 2 a lb - S •i l z '•1 d NS �d3 1 00 0 3 p 1-T N Z 0 t a i I c -co J 12-C o __ N 79 ..g.L n! VC10"I vn T,,%Nor 2rv72j-."r. 1 MOOR I N r b .Z• N u "moo 01 Q i N. (P. I rLU — — _ Cdl b a 0, 21 • I v I c0 p. jw, III I I m"0' iiO4 I ( b � FO a GeV I b. F �� I I I I u I o a Fr- i t L ; - - - r I I t .1m \ — s � i :- - �I o Li 3o a ° ' D 3r � �J • I � U _J t 0• 0 dOc7e �� R�,c "�QQ Z Zr • gar u�� � 400 � o� Li ' runty �• �;;.�EJ �� � dND f.Lo � a—F 0 e�°•:: G� �CD o Q m dZ 0 Y Ro�jci Q1 W J1, Q�Crtje Z a .2W7. �o, a o= mID3ya� }�, s ► r x_Q?.� S_ Y. _._ �Q 1 i. I . I tj I ea, � b 1p �--- o to- o I ul V J d N t 70 y 0 vY - Ir W I N 0 r-j oV11g`- �11 3 7* ,•'S',B:L= fonlS.y-,L Ty.B•,L= SGn1 .� , bQ;, .Q•,L-- 3;£ ��'i� 9� 0 ;fig � •0 ��; 2 9 - 03 w „ 0 lid: ul ' d4 — — m I ..E?,L of • t r4 0� Cas 3IKC -,a tA �Z l➢c ar t' q•.c.. a (11 �� fC - -- - - -I 9 - -- a plyRr ty Ice p C c�f p •� S ' iZ i t l r u di C. Y. '• a� _- ate. / K° i dm a _ Oo 3 �� r � � LP rim/ Pr i r' — to -ri i a x Sri ,j?i rI l7 `�"i •N�..Q1N ? m •Q N 0 n c(% P za OQ1 � D i n p o.= A� o� r a a .Cn t C n f4 F D Y ' TOWN OF BARNSTABLE ' • i CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 056 GEOBASE ID ADDRESS 40 PERCHERON WAY PHONE (506)771-1040 WEST BARNSTABLE•, MA ZIP 02668- i LOT 146 = BLOCK LOT SIZE DBA DEVELOPMENT ' DISTRICT i PERMIT 17935 DESCRIPTION SING.FAM.DWELLING (PMT.015608) PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY , CONTRACTORS: Department of Health' Safety ARCHITECTS: ;`� and Environmental ,services TOTAL FEES:' ' BOND $.00 Ox CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY BARMAB MASS. OWNER BAYSIDE BUILDING, INC. , , ADDRESS P.0.BOX 95 BUILDING DIVI IO CENTERVILLE, MA BY ! DATE ISSUED 09/17/1996 EXPIRATION DATE I` i . . l!._. „'� ..... ...�1 !.�.i.,'_��.. . .i ,.. DIY:•.... Department of Health, Safet, and Environmental Services - • BARNSTAB'M s 03 . BUILDING DIVISIO'K BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED' FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDINGGIINSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS <22 N � - 9-cam 2 2 2 /=/ . 1, //VX/rJt'�nPf 3 ` t HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT pr' 2 Cj-t b-�i (� t BOARD F H ALTIi OTHER: SITE PLAN REVIEW APPROVAL ;n00, WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE 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. To Date ZZ( Time s•�� WHILE YOU WE R OUT M Y v Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILLCALLAGAIN WANTSTOSEEYOU URGENT RETURNED YOUR CA message( . L�LC%^� LO?l W Operator AMPAD 23-021-200 SETS EFFICIENCY® 23-421-400SETS CARBONLESS Assessor's O e 1st fl'r) o��2 Lot /" �- s / Permit# /���V Conservation Office 4th floor . �, 3 �- SJ./ Date Issued toy Board of Health Ord floor - 7 V SQ -r.En in,� eering Dept. (3rd floor) House# � 77 ocs. P - Planning Dept. (1st floor/School Admin. Bldg): MAM .. Definitive Plan Approved by Planning Board (A lication�r cessed 8:30-9:30 a.m.&=1:00-2:00 D.M .) TOWN OF BARNSTABL:F_' Building Permit Application Pro•ect Street Address Z GL/ 470 r Village may," " ' "� "� " Fire District _ Owncr /'�Y�l,//1�lir cP L'C.�i 44 Address Telc hone </V Permit Re uest: h it q Zoning District C- Flood Plain Water Protection _ Lot Sizc /_31' QQ ) Grandfathered Zoning Board of Appeals Authorization Recorded Current Use ProlLosed Use Construction TyX Eaistin2 Information Dwelling Tyne: Single Family V Two family Multi-family Age of structure Basement type Historic House Finished Old King's Highway Unfinished 1S Number of Baths 3 No.of Bedrooms -3 Total Room Count(nIogt including baths) � First Floor Heat Type and Fuel/M �L w- 4 Central Air /yQ Fireplaces I Garage: Detached Other Detached Structures: Pool ^ Attached oZ Barn —' None Sheds �^ Other r Builder Information ;I u Name Telephone number Address �0-� q 5 License# t9U Sit Z `S l� Home Improvement Contractor# Worker's Compensation # GflG 3 lJ, de-2-d Z Y_o 13 1 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO--"I-Cad� )0,20 A0 @,S°'V, 00 3/- RY Project Cost 4 3 ' 1 S1 > Fee _* * - SIGNATURE / DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T II i FOR OFFICE USE ONLY ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION i y ° FItA1� q- • y. ��vt17 INSULATION a_xA ._J�` v� FIREPLACE rt ' ELECTRICAL: ROUGH FINAL PLUMBING:' .f'`9 ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: 4 I� v 4 � DATE CLOSED OUT. t r e ASSOCIATE PLAN NO. PHONE-CALL A.M FOR DATE TIME_' M jPHONED OF "RETURNED PHONE ! YOUR CALL AREA CODE NUMBER EXTENSION 1 PLEASE CALL MESSAGE 1 WILL CALL AGAIN CAME TO. SEE YOU s WANTS TO SEE YOU SIGNED Universal- 48003 _ Z O rrr U]� i L � , i_ F __ _____-- �-____ __ �. __ __ _ _. _r `OFtME Tp� The Town of Barnstable WOE 7 BARNSTA . MASS. � Department of Health Safety and Environmental Services � 059. �0 prEO ru•+" Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location. � ��1f1 Permit Number J �� Owner � Builder �Cl One notice to remain on jobsite; one notice on file in Building Department. The following items need correcting: 0 �La �e� v ( E P c-)� ni��0\3e) Q�� zvp--Ic� Q00 VVN i Please call: 508-790-6227�for 9 re�einsppection. Inspected by S\ y ��u,� Date o N 101900 1 �pJ JA QKMAPV o� MX FA v Vo 810M cEeTi,�i,E� / cE2r'r,�'y T.U,4T 7-/-/.C- I UNZ)4rlonj SCA L E- - 40 -4T� 7'i�/�,S"/OE.0 1A AAA SETBA Cl- �?EQU/.2E�lE�'S OF TNT' ToWiV aF $q P�tJ5T�48L6 .4.vo /s A&r Z07- 146 Lac,4 rEv. l,�iTs�%t/ TyE Za��G4141. PG B4 0.4Vf STEST.=eo lr1v/.U1 a41�vi/tS/7".t./$a!/T.2 B1/E.aYSE OT dham�E/A te!/ �2EQG/SSTT2E��.2.21/ �Lv.y 4aE�/O/i/�_�. 1A'SSU S.el�6y� . 0.�.�SE�.S,syay✓y s�,lo�tit� �/aT g� CLO 3 LA-)CO o, coca °4 m VJ N V� V CID W d pq a VJ cx. gbQ N � v� o ►�— pn p w caa -w r-. cv a.a .—� u-, -d o-. m a, CM.pdcl U A ate--. a~i •H v7 ca 01 O CJ] d, I� V P4 13 04 i ez- c CO MM O TH OF MASSACH USETTS DEFAFU-1AFN-I OF LNDUSTRIAL ACCID ITS 600 WASHINGTON STREET BOSTON, MASSACHUSETTS 02111 James.: Car mei: ;or-rn ssrone WORKERS' COMPENSATION INSURANCE AFFIDAVIT Avu4ln �. (licenses/permiaee) . ' with z principal place of business/residence ac 6 3 . (Gty/Satel ip) do hereby certify, under the pains and penalties of perjury,than. [j I am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number ( J I am a sole proprietor and have no one working for me.. ( J 1 am a sole proprietor, ncral contractor r homeowner (circle one)and have hired the contractors listed below who have the following woe err compensation insurance policies: Name of Contractor Insurance Company/Poliry Number .. Name of Contracror Insurance Company/Policy Number Namc of Conrracror lnsumnee Company/Policy Number 0 I am a homeowner performing all the work myselE NOTE_ .)']case be aware t :t wbilc bomeo»men woo emoio-epersons to do maintenance, construction or repair pone on a dwriiint of not more tb>_n three umu to wbtch the homeowner aiso resides or on the Frouctis appurtenant thereto arc trot eeaenDY considered to be crrpiovrn under the Wo rice n Comvcnsauoa Act (CL C 152.sue. 1(5)), appiieatioo by : homeowner hir a license or txrmtt may r"r-cocc foci ico suns or am empiovrr under the Woricen' Compensation Act 1 understand :nit : eot)v of this stat=ent will be forwarced to the Detsuatsent of Industrial Accidents' Ofnee of lrtsumnQ for mac vcr:f,;z:ton an,. : sa: :inure to secure ea••erarc as rreuircc undo Seeoon _5A'of�1Gi 15: an leas to the imposition of tare-"sL �•2jues mnsisone of: fine or ue to Sl 500.00 andior imprisons.cr.t of up to one yea and avv pcnuucs in the form of a Stop worse c)rdc. use a fine of S l 00.N a day a€a:ns: me. i SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 DAVID BIK: (L) MERCHANTS INS GRP- 8CM0278579150 (W) TRAVELERS - 176K337-8-94 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 ROUSSEAU, AL (L) MERCHANTS MUTUAL - 8CM0278570179 (W) EASTERN CASUALTY - ??? GARAGE DOORS: ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA MPOO21014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 WIRE SHELVING: CAPE COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS: (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 EXCAVATION & SEPTIC: DRISCOLL, JJ: (L) U S F & G - HGL 110093 (W) U S F & G - 7708711936 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION - ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006C0023972416C MICHAEL DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 ROOFER & SIDEWALL: JOHN MEE: (L) AMERICAN STATES - 01CD1486783 (W) TRAVELERS - 6NUB448K275894 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 ZJSS 16 tJ yATa 5W,54 1= FAMIL( .3 $ET.'¢c�c�Ms rho �i� �• ''� '�a /°� 0 6ArzF3Ar�E GRIIJ�E7� r1S•oc :.."PAID( ( Low Vilom "W 6WD . � lXE . 1000 6AI, �, 1 1 1 �` IBr°Ji70 DlSFMAL PIT 51DEWALL aREA-' rSv sF BOTTOM AREA - Sa Sp 1 I �• TOTAL V6516N = 4-ZS 6M / 1 'TOtAL DAILY MW = 3300o O►L- I I I I TE24 V4_ATi ohl WA7S �''Ia Z�ni►I k,�ss -� "i \AONA Art U� is �y Gea w s►lo¢-r PE i ( I I jPETER SULUVAN ( o I S SAXTFn r" No. 29733 "' too 24W I.� �f�r �'���' ��OAIAI E�°`� --yam- � �,�'►����\ ... � ,tlo•01G � .� WP4 — to�5�87 TF 114- - kIS FG=1'4 „-- `rrmTfr74 p.V.C. 2�(z I dKT ia� i►�✓ GAL IZaS logy �u ria z OCK I Zo 4- IzbL Sr�rIC Lelz IvteD GAL � TANL FNE wl t{ �o NJ�SIr r V✓�,k{� A•-r7mcruQE) srT Toarz 5i-IALL %e A-Zo c, mAp Pe - �- F CGZrIr—l® FL-Or PLAA I �P�-yELop� . 'PrzvFi Lam- -- 14 8.=lol Sl,A L7=: do DATE% MA¢ I, m 5 !J°!'Ua os� PLAN yte - RFJJow.' 44AY 1p,mi, I CFJMF,t . TEAT T4E nwd"lw, %VWW NEZ50H coM'PLJ:5 WITµ 'ME 51'PElJQE LoT !dL ;�V' 2EQ. � & 'iDWN OF '54j"x44TkSL& . A+tD I� L-ocaTVD w tt�I XTEtt O N y E (NC.. 5 IG 9L PPaFxloFJd�_ 1_AkJti SuP�I�`/oz5 VAK FLAN IS Ncr FJA/r© ON AN (46-TRWEt.Tr Surzvc--/ A►Jv TNFE OWE eT5 44oul.,� u or T3E o 5TErzv I L_.c MAC , ! u5c-i� To ESTA�81-I`f� P►zaPEtzTy U uc5 APPLICANT";