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HomeMy WebLinkAbout0135 DEVON LANE ' TOWN OF BARNSTABLESUILDING PERMIT APPLICATION Map Parcel Application #6q0 T 6FIARNSTABGE C10A 51 Y b Health Division A?; 8: S 1 Date Issued Z�:.LY Conservation Division Application Fee S I Planning Dept. Permit Fee (57 Date Definitive Plan Approved by Planning Board • O Historic - OKH _ Preservation/ Hyannis Project Street Address - J�EVC J LA J (, Village I 612-5 d'1/J 14- Owner d e:-f C. L,L C,zn_. Address s0W6_ Telephone .Permit.Request VA"LIOATe- q 1 0A1 21w Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family�gr Two Family ❑ Multi-Family(# units) " Age of Existing Structure Historic House: ❑Yes *o On Old King's Highway: ❑Yes ANo Basement Type: Gull ❑ 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: existingew •—'� ��,�vr�or Sl Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 0tas ❑ Oil ❑ Electric 0 Other Central Air: ❑Yes Flo Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes-za'Ko Detached garage: � ting ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:2 existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: i Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address ] 3S -DZ5:� License # Y�/J UL,S 4 0Z6 Y Home Improvement Contractor# Email^L4,5, R/CC- 2 -0) (2)6A4( L &V1 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE Vim[ a ►`"C�� L FOR OFFICIAL USE ONLY r APPLICATION# r DATE ISSUED MAP/PARCEL NO. `R s ADDRESS VILLAGE r OWNER i ' DATE OF INSPECTION: FOUNDATION FRAME } INSULATION FIREPLACE t y ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH INAL FINAL BUILDING I� Gv s i f DATE CLOSED OUT ASSOCIATION PLAN NO. i _ _ M _ . l -- -� �� S� ����� ,, L � l � �5 � TTte Comviom aerr&ofHassachimelfs Dqw*aent of hdaftidAcuden Office ofTIis�si oorrs 600 J€Ym-*wpton Street Bostan,MA 021H wMV.rnasr gmld= Workers' CompensatiunInsuranceAffidav&BmTders/ContractersMecfricians/Plumbers AppIieant Infarmaiaon Please Prim[Lepih1v Nanm(>3usmess!(}rganhmtian/individmo- l) L/z C r dress 2� D ^ �/ tityfStat e/Zip_ /lit k---S vph(=g- Aire you an employer?Check$ie appropriate bow T of, o ect (r 4. Isiaa coniractarandl � Pa' ] (���= I.❑ I am a employer with g 6- ❑New eamstruction: employees(full andlorpart-time)-* have Yu-edthe sub�contracto=s 2❑ I am a sole propfietar or partner- listed on the attached sheet y- ❑Remodeling ship and harve no employees These sub-contractors have g- ❑Demoliiiort . working for me in any capacity. employees and have woda!rs' g. ❑Btn7dmg addition [No w0do is'Comp.insm-Mce Comp.mcnrano 5. ❑ We are a corporation and its 10 Q Electrical repairs or additions 3. I am a homeowner doing all wow officers have exercised fheir Plumbing repairs or additions nn mM[No workers'comp. rigght ofesn tioaperMGL 12❑Roof instrratme re(v 11 I c.152, §1(4),and we h 'e no employees-[No wormers' comp.insurance required.1 *Any applkmt6;d checks bozirinmst also MoutthesectioabalowshnwingBreirwariceni'compenord ink T Sameawnets who submit this jdEdxVft ftuE sthrg they ate doing eff uv&and Brea hire onhide couttacmrs matt snbutit a new afdacst merrAting such_ tCautcaanm that rtixtr this box must attar-bed an additiansl sheet dowmg the name of 6a sub-oommcbDrs and state whether acmt lhwe have emphtpees. If the s ffh aco radms have employees,they must provide their waters'comp polite n umber- I am an employer thnf zs prmidfug tt orkem'conWerzsrrlinn irzsurartce for my ezrgvdnyeas Below is Ste palicy curd job site irffOrrrtQtiQiL ' Imm�-acre CompmyName: Policy#f or Self-im Uc-& Fxpi ationDate: JobSife 0 a yam_ Atlfach a copy of fhe workers'compensation policy declarstiou page(show. g the policy mrmber and expiration date). Failure to secure:caverage,as mgaimdun&x Section 25A of MGZ c. 152 can lead to the imposition of criminal penalties of a fine up to$L500.0a and/or one-yearimprisoament,as well as civil penalties in die 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 funs r,ce coverage vecifica5ion_ I do hereby certify render tkeped zs andpsnaWas of my Statthe uz,formtdzanprovi&dcabava is fnm zmJd.c^amct C turf: Date: ZS FS=e#: (iokial use only. Da not writs in this area,to be campieted by city ar town official City or Town: Peres tMiceuse If fss ngAuthtu4(drele one): L Board of Health 2.BuHding Department 3.Cityf£own Clerk 4.EIectrical Inspector S.Ph=bmg hupector 6.Other Coact Person: Phone 9.- 6 Information and Instructions �=J Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an m ployee is defined as"...every person in.the service of another under any contract of hire, express or implied, oral or written." An anployer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more ofthe 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 - dwelIing house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or budding 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 Iocal 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 into any contract for the performance ofpublic work until acceptable evidence of compliance with the in ui-ance 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 partaers,'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 maybe submitted to the Department of Tndusirial Accidents for confirmation of inso ance coverage.• Also be sure to sign and date the affidavit. The affidavit should be retamed to the city or-town that the application for the permit or license is being requested,not the Department of In.duslrial 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. Self-insured companies should enter their self-inset-ance license number on the appropriate line. ' City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current 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 bum 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 CoMMoawealth of Massachusetts Degaitoamt Qf Ilidust ial Aocaidents GJfitee OfkVeeStigatjaus 600 WaAingtoa Street Boston,MA 02111 Tel.,#617-727-4M ext 406 or 1-977 hg SS.A'B Revised 4-24-07 Fax#617-727-7749 www_massgov/dia Town of Barnstable Regulatory Services - OpZHE � Richard V.Scab,Interim Director °* Building.Division - a R�RxcrAAT.F_ t - Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION n Please Print DATE: JOB.LOCATION number street village "HOMEOWNER": F -✓ T Cc2 ''—� �:0� U L/ name home phone# work hone# CURRENT MAILING ADDRESS: "cfty%tow�n� = 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 procedure,,, e ' men and that h she will comply with said procedures and requirements. Sign Ho er Appioval 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 1091.1-Licensing of construction Supervisors); provided that if the homeowner engages a persons)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; n 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 belshe 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. " �_inmrrrrcnr✓�ni met..a.7:......e....:►fi.....c1FY04CCC.irv: of'ME lgyy Town of Barnstable Regulatory Services Richard V.Scab,Interim Director i63 Building Division Tom Perry,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner ust Complete.and Si his Section If Us' Builder as Owner of the subject ptoperty heteby authotize to act ou tap behalf in all ma.ttets relative to wotk authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or.utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date v .. . � � I �. � - ' . - f. 1 ' _ , , �; . . . ;• . I SMOKE DETECTORS REVIEWED IMPORTANT - UPGRADE REQUIRED �ZIP�� STATE BUILDING CODE REQUIRES THE UPGRADING OF BARNSTABLE BUILDING DEPT. D SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. CARBON MONOXIDE ALARMS j NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE MUST BE INSTALLED PER FIRE DEPARTMENT DATE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL MASSACHUSETTS BUILDING CODE j BOTH SIGNATURES ARE REQUIRED FOR PERMITTING PERMIT DOES NOT SATISFY THIS REQUIREMENT. i Iz•Iz oE.cic.. 4'iLIDCR v10a9S S1.0 T. c• 'v mI 1L� Frp 4.O 4.0 ' I ' I �3 3'8 I '9'D' '3" (0•9' 1 v Pi GE - _ 1 .. - . Nqr � � b i SH CExRa1�1VALLS � - — — — — •'..• —• — — — — � 4-0 I •i o I. l/� LIVING I: ;I� • I I •Ze • I I .. I I .,,• D I I I 4'o 160 D� .. ------------ a el • I do• — _ — ' KP w II 1 i 00 4,` Sr CO�n FLOOR 1,1 tllnoll .om i. .. i i ' 'T11 a7�r'd,.lYO SZ1vn\'llfll..a_. ' . •unnOd'd•y 53015—_. i � s,,£ 13.7n0]"Arilol"9Z�eZ— i I J � I _ • .01 p f 1 N'3- 4'4' -•.gyp' I I - 0 ILL - I %�� ! i � � � KITC4IEN IS2C.i1K�AST — I I I rw�cep.uK S:N.\ i c• c ml � �� �� � 0 �3'8 � •9'O- 3'3" 6.g.. i 14'O' (I i i I � p' TS�p,Ct r-� I• LlyhC� I' �I "'� S N' �..3 �•I — 41, =0 i i .I I I ; 1 I I —`.2.. ..i._...: w2r, 3".0.. � �o•noar�eR I 6-01 oil ju: F a, mu ! tf 1\ ZICILO 1C I Q� N M�STER3EnROpI.� -...----.- 13EnROOh�I or a nr P ul N V SI_CO�i`� FLOOR PL/.N so 6'0• 6'O' O �'o' I ti'O• e r _ I 'V a J 0 m d 0 N 10, .. -l`O' CO.'... `•4' S4•, I .. L'4. . _I .. .....-4'4'-----'--.. L'4. L•.Z. 2'4- i T-T _'L4.tc.1°TKK,C0W CZTT4.FOR 3:,Z.. I°cT4.,PRA.1.C!°Tuu.l nit ";m,e-o44 F!la.Eh,V•-l1V_CUC:;"` sloES F.P.ro(jNO. O O i io 19 D m m i �� - _. __ '"0'ZII Y„\V/.ILS 01J"1'•4'_:0.`?U!(. -, ' ry ' (O 0 I - I 14.0. iuo i i ASP NnQ'6NI�IC�LES ��•.-' C." e CPvA/\LT.541 MG EE5 �._. ... µC,Al..t7RIt.EnGE - IiG'60FCT'\v/VEIIiS ,Iti0�Fn5UA .. � ' CTOPf3+(n) ... G001.F21E-E 16OARn YDVE'MVLJ)'NG _.. ... OF -� 1•t••I'.4') .._ pORc_H'?RIM t•, r ........__. $.B CnFTERS ---.. ." . "I"PL4\VC->O 2.4 COLLAR TIES- . .- 12 8 � i.S STR.PPrINCI I -- '/•L^54LCTR OCK IC 2.�P RInFTLES —_—.-- _ - `,I F -,-L-cL`r\VOpn \-1 N 2.G CLCt. )01 1�1 - -r v j 1 -� T 1.5 ST4nPp'�VS I I 3�4"Ta C\PLY\\/CC)O -- .. "L•SMEE T0.0CK, 2+B Joll,* --""' IL I��J R.aOnopl n;lmUT INSUL. Ina STRn PPINC, 1r/ - N . ll2" SHEET ROCK �� �i iD 7 :a8 JOIbTS I 2,4 STUnS w/R•f1 INIWL, I � so In KI 5 -'... 77 _ t. RLOC N . 314"11C,PL4{\vCIOn � 1.3 STRAnP�V(T 2.6 JolSTsl I SIB"P.C.co SILLET ROCI _-- _. .. W __=2+�CJ_ST6.11�1 I o p.17 udsVL, ... t 312a I O S14nE?, — c 77, i TNK.DtTnLC' I''i'�.L—p') q•:TVk•CONE,sLAA� I Fire peP o uLocabon RED Numbeq�7ypa •, 6smi 1st Floor t 2nd Floor . Otter Notes: _— -_-- evie` a Y' — -ASPunt7"SNIN'q.Ls4_ . _ _ CAP - TTT �' tl ... ATFRTAAS C'LOP, - pl �•' /f ow, LOT 09(135) DEVON LANE COTUIT LITHE NORMAN TRUST" I l T 24• _ ..\VHICC:LLOnR'S111N 4LE$ .'..'-� I f_ IRS 1 I 0004' 0197(114 LIFT EI_LV/�710N��i,ac� _. . O 1 i 24". —'RAV13:L01:t—, ,1 wWI77 E..cannrLSw J4�5 L I pw W I I I u 1. TRIPLE KIUHENChS@SE�T ?use N LI.oN -ZEA7-ECE A-7.IC 1 Ay s o 4/ Parcel &1&Permit# 3 2 Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) i`i� 111.6 Q?!t:h Date Issued Board of Health(3rd floor)(8:15 -9:30/ 1:00-4:45) ?6, OW /� Fee Engineering Dept.(3rd floor) House# d IMF Planning Dept.(1st floor/School Admin. Bldg.) � n `:I�i Ii� 5T E Definitive Plan Approved by Planning Board 19 L (.��� 41 I��-P /-c e- y'�(o IT 5 TOWN O� �ARNSTAB OMENTAL CODE AND Building Permit Replication : TOWN REGULATIONS Proje eetAddress LOT #09 , HOUSE #135, DEVON LANE, "DEVON CROSSING" Village (X'IM C_e4� Owner DEVON REALTY TRUST Address P.O. BOX 599 , MASHPEE, MA Telephone (508 ) 477-0023 Permit Request TO CONSTRUCT A NEW SINGLE FAMILY DWELLING. First Floor 11NNN 1 ,900 square feet Second Floor ZZXXX 1 , 1.91 square feet Estimated Project Cost $ 110,000 Zoning District RESIDENTIAL Flood Plain 11C11 Water Protection Lot Size 50, 600 s . f. Grandfathered ? d Zoning Board of Appeals Authorization Recorded Current Use RAW/VACANT LAND Proposed Use RESIDENTIAL HOME Construction Type WOOD FRAME, CONCRETE FOUNDATION Commercial Residential X Dwelling Type: Single Family X Two Family Multi-Family Age of Existing Structure N/A Basement Type: Finished Historic House Unfinished X Old King's Highway Number of Baths 2.5 No. of Bedrooms 3 Total Room Count(not including baths) 9 First Floor RX 5 Heat Type and Fuel FHW BY GAS Central Air N/A Fireplaces YES Garage: Detached Other Detached Structures: Pool f Attached X Barn None Sheds Other DECK 12 X 12 THE NORMAN TRUST Builder Information Name DONALD H. PRIESTLY, TRUSTEE Telephone Number ( 508 ) 477-0023 Address 13 STEEPLE STREET, SUITE 2.02. License# 001023 P.O. B O X 599 Home Improvement Contractor# 10 7 2 6 3 MA S HP'.E E, MA 02649 Worker's Compensation# WC 2—31 S—2 2 2 0 9 0—016 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 SIGNATURE � DATE 10/30/96 BUILDING PERMIT DENIED FOR THE ALOWING REASON(S) r- FOR OFFICIAL,USE ONLY PERMIT NO. DATE ISSUED 1AP/PARCE L NO. IRESS VILLAGE OWNER DATE OF INSPECTION: n FOUNDATION /.?.9 ~ FRAME (( 11q? ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' • PLUMBING: ROUGH FINAL GAS: ROUGH t% FINAL FINAL BUILDING " 1 r 7 vL s ,r op 1 DATE CLOSED OUT A ASSOCIATION PLAN NO' I�' • , �,r V Town of Barnstable Building Permit Fees: 1.) ($55 x Sq. Ft. of living space) $55 x 2ssi Sq. Ft. _ $ iqni3os 2.) ($20 x Sq. Ft. of garage space) $20 x -3 b Sq. Ft. _ $ 71�20 3.) (Leave out Sq. Ft. of deck) _ $ N/A 4.) (Add lines 1 thru 3) Sub-Total 9 ZZS 5.) (Multiply by .0031) x .0031 6.) ( Check amount ­D) Total -------------------------------------------------------------------------------------------- Other Fees: $1.00.00 for Health Dept. _ mcti r C�ykk = 1 16��✓� `/\/�`� 1f+ ,',fir^ FY 12X�I')- NOCL — s� �Lc�o►� �,�r. = 1 Ana s .�o r o � KITUJEN I I •LAN h_M{ -� , �I I i,(•,y I O 1 3 4� co�c.sNe All LIVING — � r I I 2 7 3 0�► I s,-� . y / Z�J 0 FLs-)ofz, 31PT1 I I CO• I I ^'1' VVV s� I Y. � lc••6i.cl'uwE 2� � ri..' I 1 N — _ M�,.REitgEnAOpI,� ' � P 1 I e'c ...{'.}ra-..v�'.ar�N�.t/..�-:}}v!.•!r.•r....•'.-.�.a-..,.v`L.-..n,.,;.,,r •Y�i rn„w�.Tt�K;r,f,ti,,-s+r^,.--.fy:.:�.�1+!"�+r::'ti{y�".1-+`-.-+-+*S.f�i"-^+:i..^"t rt iti��•.»_y '"k*"y+..`..+.�%ti.^".FI1v." •-..s....,. rF c R `OpIME Tpy O� . .The Town of Barnstable r. BARNSTABIE. Department of Health Safety and Environmental Services u 6 Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice ..y e Type of Inspection Location ��'� r�Q�3(M Permit Number q ` Owner �t �)Vv Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 2 C --�. . � 0 'r i IV ' Please call: 508-790-6227 for re-inspection. Inspected by Date �.� -Y ;f f t l i 1 .. V H� y yl ° DE VON 50• LANE core a � ! ( I T�• DRAINAGE ( I • 2 . I QI I I N 199.00 E �� 00 _I �1 I EASEA(ovr f1A 6!!g•� 1 - - - � 44'I M � ( I N LOT 10 III o LOT 9 50, 600 tS. F. a 57• H CURVE RADIUS ARC �I '�• ! 30.00 40.40 • I ( 5,9 � I TOAW REFERENCE 1 ASSESSOR'S NAP 40 PARCEL 133 ( � 310.25 LOT 9 HOUSE !35 1 1 S 54'24'41'M I III it PLOT PLAN OF LAND 'rO THE BEST OF NY KNONLEDS& THE FOUNDA rION L OCA TED IN '° BARNS TABL E - MASS. SHOMN ON THIS PLAN IS AS IT ACTUALLY EXISTS AND © THAT IT CONFORMS TO THE TOMN OF BARNSTABLE ! ���' j9 ZONING REGULA rraW REGARDING YARD SEreACKs � PREPARED FOR Rl % =�' THE NORMAN TRUS D TE.A 'DECEN 6 B a�`' ?s''s f"� & Is jr; �+ ru? T r m DAM DEC. 14 IMS SCALE.' !'-60 Fr. FERREIRA ASSOCIA TES FLOOD ZONE C (NON-•Hs1aARD) r\ ^ :� D DL � I„ " . . r�,<' 131 SPRING BARS RD. FALMOUTH-MA . i The Commonwealth of Massachusetts 6 Department of Industrial Accidents &Wce 0"81009aUens 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit MIN name: location: cli)' -hone# ❑ 1 am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. tam-anvonafoe�'De on 12'e.alty..::'>TY:U9t':.. bo'n.a:: tl.yi.;::Trustee a3ldress: . u , fS , MA 02649 (f1Fonea { 08} 477 0023 Insurance co. Li}se1 tyILh�isY� W02 315-222090 OF6 ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: . .....:...:. . . comoanv names ....:. :. address: city: ::.. . .. ::..:.:.......:::;• nIt'. it insuMCC Co. poY# company name: ......:.. . city -hone# insurance co. po Y ii fit_ c s 8[Ti'on a ee •L,nec a . Failure to secure coverage as required under Section 25A of MCL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'Imprisonment as well as civil penalties In the form of a STOP WORK ORDER and a tine of S100.00 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 eerrify under 11 pain u d p�n olfies ojperjtrry that the information provided above is true and correct. Signature Date ` (//J y Print name Donald H. Prie fly Phone# ( 508 ) 477-0023 r onlclai use only do not write In this area to be completed by city or town official s cih or town: permit/license N 0l3uilding bepartment j' []Licensing Board J _j O check if Immediate response Is required OSelectmcn's Office 1:4 C]Ilealth Department �- person: plwne N; -Other ,. contact rrewsed 3/95 P)A) l VDAC ISSUING OFFICE 181 LIBERTY Workers Compensation and INFORMATION PAGE MUTUAL. Employers Liability Policy ACCOUNT NO. SUB ACCT No. Liberty Mutual Insurance Group/Boston 22 20 90 10002 LIBERTY MUTUAL FIRE INSURANCE COMPANY 16586 POLICY NO. T'D/CD SALES OFFICE CODE SALES REPRESENTATIVE LCODE N/ 1ST YEAR C2-31S-222090-01698/2WESTWOOD 101 ASSIGNED 2 93 Item 1.Name of DONALD H . PRIESTLY 1 Insured P O BOX 599 MASHPEE, MA 02649 FEIN 206328861 Address Status INDIVIDUAL Other workplaces not shown above: MASHPEE : 13 STEEPLE STREET, SUITE 202, 02649 Mo. Day Year Mo. Day Year Item 2. Policy Period: From 03 25 96 to 03 25 9 7 12 : 0 1 AM standard time at the address of the insured as stated herein. Item 3. Coverage A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states 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: Bodily Injury by Accident $ 100 , 000 each accident Bodily Injury by Disease $ 5 0 0 , 0 0 0 policy limit Bodily Injury by Disease $ 10 0 ,0 0 0 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION OF INFORMATION PAGE Item 4. Premium—The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rates LINE 1 1 0 Estimated Per 1100 Estimated Code Total Annual of Re- Annual Classifications No. Remuneration muneration Premiums SEE EXTENSION OF INFORMATION PAGE MA ASSESSMENT $ 16 Minimum Premium $ 500 (MA) Total Estimated Annual Premium $ 500 Interim adjustment of premium shall be made: ANNUALLY Deposit Premium $ 500 *N*9N00* ARC 45 This policy, including all endorsements issued therewith, is hereby countersigned Authorize Representative Date 02/07/96 THIS PROPOSED RENEWAL POLICY WILL NOT TAKE EFFECT UNLESS THE POLICY PREMIUM IS PAID BY 03/25/96 Loc.Cod Term.Oper. J A C Audit Basis Periodic Payment Rating Basis Pol.H.G. Home State Dividend RENEWAL OF 1 2/07/96 1 NR MA WC1-312-222090-015 GPO 4033 RI WC 00 00 01 A Copyright 1987 National Council on Compensation Insurance ` • _ }J.rlti.. .rn... ..1. ... .... ..- ....J."a -:.r. erii. .: ..iy't�... .s ... ..4.... < • ' • I V/W ����/�Z��.wL'1.44W4 ��QfARALIIO�(LO Restricted To: 00 16479 DEPARTMENT Of PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - None Expires: 1G - 1 & 2 family Homes �;:Sestticte _To.! ..�00 Failure to possess a current edition of the Massachusetts State Wilding Code ` DOBALD H PRIESTLY is cause for revocation of this license. MASPEE, MA 02649 w• ✓fie -Commoouuaa ol-Awad oeCt HOME IMPROVEMENT. CONTRACTORS REGISTRATION Board of Building:' Regulations and StandardsI One Ashburton Place - Room 1301 Boston s Massachusetts. 021.08 I . HOME' IMPROVEMENT CONTRACTOR , -------------------------- i'I I Registration 107263 , ��. Expiration 07/30/98 Type' - 'INDIVIDUAL ;h •. I HOME IMPROVEMENT CONTRACTOR Registration, 107263 I Type - INDIVIDUAL DONALD H . PRIESTLY' Expiration 07/30/98 PO Box. 599 , 13 Steeple St .Suite 202 Mashpee MA' 02649, I DONALD H. PRIESTLY I G� o jj/O Box 599, 13 Steeple St.Sui fI ADMINISTRATOR Mashpee MA 02649 I I i b"114 1i CAFE COO. BANK ANO TRUST COMPANY 'AMENDMENT#1 TO OUR IRREVOCABLE. 'LETTER OF CREDIT NO. 96-04 October 28, 1996 Town of Barnstable Planning Board rown Hall-367 Main St. .• I lyannis,MA 026.01 F. E Gentlemen: s:f I'er the request of our client,Donald Priestly,Trustee of Devon Realty Trust,we hereby AMEND our Irrevocable Letter of ' Credit No.96-04 (The"Credit'%.in the amount of$189,600,written in April of 1996, in your favor,as follows: AMEND THE AMOUNT OF THE LETTER OF CREDIT FROM$189,660.00 TO$81,370.00. All other terms and conditions of the original Credit remain unchanged. Very truly yours, Cape Cod Bank&Trust Company ACKNOWLEDGED AND ACCEPTED: By: TOWN OF BARNST ry C.Farnham PLANNING BO Senior Vice President By By: S.Raymon Assi is ice President redit Officer Date:. Please Return this Acknowledgement Copy _Z2 to CCB&T in the- self addressed enclosed envelope. ' Thank .you. CORRESPONOENCE CENTER P.O. BOX 1180, SOUTH YARMOUTH. MA 02664-01e0 c5061 394-1300 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0 y 01 133 coo o y 6 (1 3 3/71 D Permit# 13(53c/ 4a t,r� It �r1 I~\'i J t.�".S✓�. Health Division / S Date Issued 3 0/6-� _ Conservation Division IvL Z3 Os "`' AIJ C 23 n14! 8:Fey ,„• Tax Collectorfj(G/////n/ I V 1 � Treasurer T� '111 V I S I O N� Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address 13 5- D4W 0 aJ C-Ani>c Village C C� Owner HV+-8 l-ZcF- Address ( 3 -per 0 "NJ t-eJ Telephone S@ t ^ 9 20 - 2--1 6 g Permit Request -50 t-A-R, eT,&JSY-1r(4-/ -- c.,,J Square feet: 1st floojr,:Cexiisttiinng proposed 2nd floor: existing proposed Total new Valuation �/J-1` Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other 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 Cl No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Q-A-�D G--'` Telephone Number �0?� '—�(2 2 Y C-1 Z Address NO - %O A R License# Ca TV-VTd,(A o Home Improvement Contractor# 1 �f 6 2 7 6 Worker's Compensation#ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO k" . -TR-"5, 'tom.�b /, SIGNATUREX7=::� DATE �'Z to,5 FOR OFFICIAL USE ONLY J PERMIT NO. DATE ISSUED 4 MAP/PARCEL NO. ADDRESS',- VILLAGE z OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL_ GAS: ROUGH J FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents n. Office.of Investigations* ' . 600 Washington Street r Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/In&vidual): C tj &EV S-V f 1 Address: City/State/Zip: C®Yu's�- M K D 2-6 3-3_ Phone#: $Z?'P -- (12, 9 3 y 2 Are you an employer? Check the-appropriate bog:. Type of project(required):. 1.❑ ! am a with 4. ❑ I am a general contractor and I -employer 6. ❑Eew construction employees (Aff and/or part-time).* have hired the sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet t emodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. g. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.�lectrical repairs or.additions required.] . . 3.❑ I am a homeowner doing all work right of exemption per MGL 1*1.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required,]t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: `e t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site. information. - Insurance.Company Name: Policy#or Self-ins.Lic. #: Expiration.Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$.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 maybe forwarded to.the Office of . Investigations of the DIA for insurance coverage verification. I do hereby a under t e par and penalties of perjury that the information provided above is true and correct: signafore: Date: '2 2 n S Phone#: 5_0 9 '-4 Z `f 2 Of cial use only. Do not write in this area,to be completed by city.or town official. City or Town: PermitUcense# 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#: Information and Instructions. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their enloyees. ` 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-A an indivi4ual,...partaMtip;:association, Forporation 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 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 woTknn 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 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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone number(s) along with their certificates)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 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.. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant e number which will be used as a reference number. In addition,an applicant Please be sure to fill in the permit/licens that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current 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 perms or-licenses.licenses..Anew affidavit must be filled out.each year.Where a home owner or citizen is obtaining a license or permit not felated to any business or commercial venture (i.e. a dog license or permit to bum 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 r b04 Washington Street . . MA 02.111: Tel. #617-727-4900 ext 406 or-1-.877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia °FfME 1py, Town of Barnstable Regulatory Services 9anxr' AH1E' Thomas F.Geiler,Director �'OFFpMp'1a�0 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: -� S YkU,.,k>T:Sb IJ Estimated Cost I S C O00 Address of Work: 13 5� tf;v 0 AJ LN ' Owner's Name: (=�C Date of Application: S�Z VOg 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. SIG7n�tjthe ER PENALT S OF PERJURY I hereby apply for a permit as the owner: '2Z pS � �f627� Date Contractor Name Registration No. OR Date Owner's Name Q:forms1omeaffidav r oFTME r Town of Barnstable �o Regulatory Services BAMSTMMMASM Thomas F.Geiler,Director �'OrEDMA'�a`0� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Ace, , as Owner of the subject property hereby authorize C�'-N P-4-40 , LyS L to act on my behalf, in all matters relative to work authorized by this building permit application for: 1 (Address of Job) c v AA r 04 A Ob Signature of Ow1Vr Date '/—J C14 C�►�� J 2 Print Name Q:FORM&OWNERPERMIS SION i 1+�4 R�c� .p�JeN �P• Cm�'� d Pn��ss @ I l o �Bs • �N S r E-- 36 SPA ZX�p eo 16 S Ps'rc}I - � - ,•"i _. � ,,, , t .� k i i f Jlte �/ Board of �ingati ns and Standar s One Ashburton Place.*- Room 1301 Boston. Mass - usetts 02108 Home Improvemen • LOTactor Registration Registration: 146276 Type: Individual z Expiration: 4/8/2007 CONRAD GEYSER CONRAD GEYSER , d P.O. BOX 89 COTUIT, MA 02635 'cam ,0 5-4 e�Update Address and return card.Mark reason for change. ❑ Address ❑ Renewal ❑ Employment Lost Card 41 0 50M-04/04G101216 ✓fee �ammzaouuealU a�../�aaaa,�,/usaelta Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registra •_a, t46276 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Ex 2007 Boston,Ma.02108 dto, ual )NRAD GEYSER v INRAD GEYSER, OLD SHORE RD. )TUIT,:MA 02635 Administrator i Not valid without signature i i '. I _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcd 'I3 C QL rY _-AppIicatibh # 2,60'T0 S Health Division `" 'Date Issued {.. a. r.. Conservation Division rApplcation Fee s:.Permit Fee` Planning Dept. Date Definitive'Plan Approved by Planning Board Historic -:OKH Preservation/Hyannis D Project Street Address , `) l , �'.�Qn N1 Village ar5 l`©ns Owner eX 0 £ LA MY Q. C e, Address 3 5 �eV(�Y1 Lan e. Telephone l� `'[ 2 0- Z Permit Request 1/0 C- f/L sG 7�t L/k7 UYU S 77 SC h/ T7- PeM�, 5 ' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I-i Construction Type 1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. ❑ Two Family ❑ Multi-Family (# units) bAge 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 t new =n Number of Bedrooms: existing new 1 y Total Room Count (not including baths): existing new First Floor Room C �nt Heat Type and Fuel: ❑Gas ❑ Oil ❑ Electric ❑Other . 0 . Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal st e: ❑Yeses ❑ONo cn 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 APPLICANT INFORMATION /� (BUILDER OR HOMEOWNER) Name C nA U\� 3 d`ar Telephone Number ( j- 4 2 fr?-B 4`T Z Address Fo oX License # Coy �A'ft . MA 02 `QK) Home Improvement Contractor# 1 `t l023 Worker's Compensation # - Zq q � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO aY�si ab darn a SIGNATURE DATE 2_(17 Le q i FOR OFFICIAL USE ONLY -' APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: f FOUNDATION j f FRAME , i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL .PLUMBING:- ROUGH FINAL } GAS: ROUGH FINAL FINAL BUILDING QC D } DATE CLOSED OUT ASSOCIATION PLAN NO. i t '1'0W :ot--`-B- stable Regut}atory; -ervices suss, � Thomas�F;Ge�l�,�Director ' BIItgD.lYlS10II iTom P omimssioner 200 Main Stzeet:.HYsanis,MA b2601 www.toWn: arnstsblegmus office: 508-862-4038 Fax: 508-790-6230 Property:Owner Must Complete a>nd:Sign This Section if Using'A Builder b �I C'2 ,as.Owner of the subject property hereby authorize l 0��( �" SO Qlr to act on mybehalf, in d=Mters relative to work mithorized bythis binding pe=it application for. J. 5 vo Lane -by) Ad&iss of Job) /Oq of Owner Date Print Name Q•FORMS oWNERPF.RIvIIS5MW Current Use rruputieu utic BUILDER Lh'FOi3L�1' (3� h, t .......... ....... .... .;::_, ,..r Vic-=.. _w_ i The World 's Single Most Powerful Photovoltaic Module Utilized in a wide range of applications,the ASE-300-DGF/50 is an industrial-grade solar power module built to the highest standards. Extremely powerful and reliable, the module delivers maximum performance in large systems that require higher voltages,including the most challenging conditions of military,utility and commercial installations.For superior performance,quality and peace of mind,the ASE-300-DGF/50 is renowned as the first choice among those who recognize that not all solar modules are created equal. Faster Installation ■ Large surface area requires fewer interconnects and structural members ■ All module-to-module wiring is built right into the module ■ Multi-Contact Plug-n-Play connectors mean source-circuit wiring takes just minutes ■ Unique mounting systems available for commercial roofs eliminate need for traditional mounting rails, heavy ballast,and roof penetrations More Reliability ■ Bypass diode protection for every 18 solar cells in series,thus minimizing power loss,and mitigating overheating/safety problems ■ Advanced encapsulation system ensures steady long-term module performance by eliminating degradation associated with traditional EVA-encapsulated modules �•.. �� ■ Moisture impermeable glass on both sides of the module protects against tears, perforations,fire,electrical conductivity,delamination and moisture ■ Patented no-lead,high-reliability soldering system guarantees long life and ensures against environmental harm should the module break or be discarded ASE-300-DGF150 diode Full square semi- housing with bypass crystalline EFG cells Higher Quality diodes,UV resistant ensure maximum ■ Each of the module's 216 individual semi-crystalline silicon cells is inspected and cables with MC®- energy yield. connectors. power matched to ensure consistent performance between modules ■ Every module is tested utilizing a calibrated solar simulator to ensure that the Designation: DG=Double Glass electrical ratings are within the specified tolerance for power,voltage,and current F=Frame ■ Module-to-module wiring loss is factored into the module's labeled electrical 150=Nominal Voltage at sTC ratings by testing through the module's cable/connector assemblies Independently Certified The ASE-300-DGF/50 is independently certified to meet IEEE 1262, IEC 61215, and UL 1703 Standards ■ It is also the only module in the industry to receive a UL(Underwriters Laboratories)Class A fire rating SCHOTT solar currentivortage characteristics with dependence on Electrical data irradiance and module-temperature. The electrical data applies to standard test conditions(STC): - -- - - ---, Irradiance at the module level of 1,000 W/m2 with spectrum AM 1.5 and a cell temperature of 25°C. 1 src:ao0o- - -- - 6 /wim=?2s•c Power(max.) Pp(watts) 280 W 290 W 300 W 310 W 320 W : c/-_ Voltage at maximum-power point Vp(volts) 49.6 V 50.1 V 50.6 V 51.1 V 51.6 V 7 Current at maximum-power point Ip(amps) 5.7 A 5.8 A 5.9 A 6.1 A 6.2 A 2 600w m{zsc/ Open-circuit voltage Voc(volts) 61.9 V 62.5 V 63.2 V 63.8 V 64.4 V Short-circuit current Isc(amps) 6.2 A 6.4 A 6.5 A 6.5 A 6.8 A 0 10 20 30 40 50 60 70 Voltz L Chan applies to ASE 300 wmodu�e only. The rated power may only vary by±4%and all other electrical parameters by±10%. NOCT-value(800 W/m2,20'C, 1m/sec.)=45°C. 1892 � A A !+m Dimensions and weights +-914.4-s.4e9.:� Length mm(in) 1,892.3(74.5") - - ._ _e B: ci Width mm(in) 1,282.7(50.5") A B Cables g i i Weigh[kg(Ibs) 46.6±2 kg(107±5lbs) ^.. } Module data& hazard labels....CO 2 Area 2.43 sq meters(26.13 ft sq) 1D Diode housing..... ` A Back mounting holes B 8 Characteristic data A=Side mounting holes o=7.1 Solar cells per module 216 B=Back mounting holes o-10.4 p (all Voles mm> Type of solar cell Semi-crystalline solar cells(EFG process), 10x10 cm2 Connections 10 AWG single conductor,stranded copper with Multi-Contact h connector. Junction box comes with 10 built-in bypass diodes. Cell temperature coefficients Power TK(Pp) 0.47% /°C Open-circuit voltage TK NO 0.38% /°C Short-circuit current TK(Isc) +0.10% /°C Limits Maximum system voltage 600 VDC U.S. Operating module temperature -40 to+90°C UL certified design load 50 PSF Equivalent wind resistance Wind speed of 192 km/h(120 mph) The right is reserved to make technical modifications. For detailed product drawings and specifications please contact SCHOTT Solar or an authorized reseller. Certifications and Warranty The ASE-300-DGF/50 has been independently certified to IEC 61215,IEEE 1262,and UL 1703(Class A Fire rating).The ASE-300-DGF/50 comes with a 20 year power warranty(see terms and conditions for details). SCHOTT Solar,Inc. U.S.Headquarters and Manufacturing U.S.Sales and Marketing 4 Suburban Park Drive 2260 Lava Ridge Court,Suite 102 Billerica,MA 01821 Roseville,CA 95661 SCHOTT Toll free:800-977-0777 Toll free:888-457-6527 Fax:978-663-2868 Fax:916-784-9781 Email:info.solar@us.schott.com solar on 0 www.us.schott.com/solar 0 0 a i 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 Legibly 1 Name(Business/Organization/Individual): C oo� ,K'1� 3m\ar, LU, I conraa GE-,\(sty Address: ?o City/State/Zip: C � 'AoJ Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.(_y"I am a employer with_Q) 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ 1 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' 9. Buildingaddition [No workers' comp. insurance comp. insurance.: ❑ 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 LE]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. t 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 site information. Insurance Company Name: Policy#or Self-ins.Lic.#: - 79 4 3 q Expiration Date: 6 ZQ09- Job Site Address: I�J� DPV Yl City/State/Zip:ftS nn t'111\S I n 02-648 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 c4r-nYv under the ain nd penalties of perjury that the information provided above is true and correct. Si ature: Date: Z 2 7 IC P Phone#: 177 t{ — S 7- 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 JAN-27-09 12:16 PM TALANIAN 'BUNKER INS AGCY 781 659 2499 P.03 {( 1 A0 y, ODUCER ..od Buriker z surance Agency ONI YCANbFcoN ERSISNOEpIo UPONRTHEI6ERTIFi�A �0 Washiingt• n Street HOLDER THIS CERTIFICATE DOES NOT AIv►�ND, ExTEND dR ` ALTER THE COVERAQE AFFORpED BY THE POLICIES BELQMJr; orwell I MA 02061- COMPANIES AFFORDING CbVERAGE 659 O4 O I COMPANY __.. I '4REt1 �• --- _. . } A Scottsdale Ins. Co. I Otuit 'Soar TALC i COMPANY �• !O. Box 9 B Arbella Protection Insurance Co. ' 1 ; , 4 Old 'Shore Rd. COMPANY t}11t i C MA 02635-0 •428 84 COMPANY 2 - _... 'IH 1 w S t0' FY AT POLICIES O :.....,:> ;::..,,,....:.,..,:..,;..:. ............,,..,...,:,..,...:....., .„..:.., F INSURANCE LISTED BELOW HAVE a •� .........:..:.:�.",.,•.'..:.."•.,M••:".-.�.V.:•,�,.,.:.,.„ �. ;N .GATED;NO ITN TANbINp ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WIE INSURED NAMED O7H RESA THE PECT POLIC CH TIOD E TIFICATE IN Y BE sSUEb OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,' ELUSIONS AruD co omONs of SUCH pOLICIEs.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,. •,, +lt TYPE OF NSURA CE.. POLICY NUMBER POUOY EFFECTIVE.POLICY EXPIRATION GEGERAL LIABI 1 DATE(MMiDDNY) i DATE(MM:DD" LIMITS i '�A ;GF'NERALA0QnFGATF. :s2 T Q00,00O :X Cd"""" '"tDEN ��;CLS384056 106/01/08 '06/01/09 Nr+ooucTs.coMP,cla•ACG s2,000 CLAIMS ADE hX,OCCUR: _-- _ O O Q ' :PERSONAL&ADV IwURV '91 O 00L,bodu 'X OWNERna pNTRA�TOR'SPROT: ! •• _._. I i EACH OCCUR s 1 000 i FIRG DAMA GE ) iS 5O(AnY ore ibc iLU,OMOBIL�LIA ILITY i MED EXP(Any one Pelcnn) -6 5 000 ANY AUTO '26916400003 i 0 4/3 0./0 8 0 4/3 0/O g I COMBINED 61NGI,E LIMIT !g ALL OWNEO�UTOS ! I 1 OOO GOO_ k X $PIEDULEO UTOS i BODILY INJURY ' person) 1 •� MREOAUTO� (Pqf pe �_ _ •NON OVyNFDkUTOS i i BODILY INJURY S I acc!den t IUARAOE Ua91LITY• i PROPERTY DAMAGE !9 ANY AUTO j _ / / :AUl O ONLY-EA A_CCIDFNT •6 - i01HER THAN AUTO ONI Y: , i I EACH ACCIDENT;3 J :INCIiSSLIABILITY; I ! AGGREGATE S UMBRELLA FCIRM I X Z,(J O O 5 5 O 7 7 :EACH DCC:URRENCE $1, 0 0 0 1000 10/24/08 .06/01/09 'AGGREGA(E 51,000,000 i =X OTHER THAN MBR FORM 10 000 S .r YY s COMPE SATIO AHO ��L WC STATU- �:.`eYrERs'juae PRCrraLtnRl� FI EACH ACCIDENT 1 5 .}}. INCL EL DISEASE-POLICY MIT 5 ER3/EIICCU IVE LIMIT , AHE: EXCL EL DISEASE EA EMPLOYFF 6 ON OF OPER� ONO CATIONSNEHICLES/SPECIAL ITEMS ' Liab.l crage' applies on a primary & non--contributory basis & includes, �s. Techr>,olo y Park Corporation & The Rebate Recipient as add'1 insureds . oli inc udes Coverage for inde endent/sub-contractors & Residential work ,t, _.....,.b.. .. . ,� ............ .... :'.'y.�v:v:}�.:v:v.v,:n::': .:.a..n-o n_.':.:'.�.'...:.:n,. .M..:':..vw: :i>•.w • i I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES ryBEMCANCELLED BEFORE<THE EXPIRATION DATE THEREOF, THE IBBUINO COMPANY WILL ENDEAVOR TO MAIL . •�Q_DAVs WRITTEN NOTICE TO THE CERTIFICATE HOLOEA NAMED TO THE LEFT, 4. North t tS Technology Park Corp. BUT FAILURE TO MAIL SUCH NOTICE 3NALL IMPOSE No OBLIGA27ON OR 11AHN01' �- 7,� North riZ81 ' ANY KIND UPON THE COMPANY, ITS AQENTS OR REPRE9ENTATivttL t!p9Stbor6 A eN OAI REP i?: `��'A'�x3P3D••�<JiFiP'tiF1A7`tGti1.T • �S a ch•R �o©u c,k: •_..�-•'-_..� � P B o 3 e c•Adt, T:r•6i� DOWN CGrtN% p If P (t��' s >c , • wP�u P 4�'.� 1 IA If OC.k„• " Ty •t . ''fin :: ,,,• -}"'•;.^i a./�u''CI,v� �„''��57.�..`�`I��'�.n{'ar• L?�4{`�".�,•`41's$.�iu.? < �' d.f�'f.� E.,.'W i��e.•�ei'f..•��./Y<.'L`X.•eu"�t�'Y?✓';< - :' Board of Building Regulations and Standards '!j"3• 'i,,. ne O �slburton Place - Room 1301 -Boston. Massachusetts 02108 Horne Improvement Contractor Registration Registration: 146276 Type: DBA Expiration: 4/8/2009 Tr# 131107 COTUIT SOLAR CONRAD GEYSER P.O. BOX 69 COTUIT, MA 02635 Update Address-And return card.Mark reason for change. Address Renewal Employment Lost Card IPS-CAI 0 SUM-05106•PC8490 1 "IX g License or registration valid for Indlvidul use only Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations.and Standards :Registration: 148278 One Ashburton Place Rm 1301 Expiration: 4/8/2009 TO 131107 ' BoatonJ Ma.02108 . Type: DBA COTUIT SOLAR CONRAD GEYSER 3800 FALMOUTH RD. Not valid without signature MARSTONS MILLS,MA 02648 Administrator i VINCI & ASSOCIATES Structural Engineers CLIENT: Professional Solar Products,Inc. 1551 S.Rose Ave.,Oxnard,CA 93033 Tel:805486-4700 - Building Department Note:NOT TO BE SUBSTITUTED WITH STANDARD STRUT OR COUNTERFEIT PRODUCT. Subject: Static load test results for the following: Mounting System Module Maximum Frame Maximum Frame Frame Minimum Load Equivalent Wind Speed Manufacturer length (in.) Width (in.) Height'(in.) Pbs/ft2) (mph) RoofTrac® Evergreen 65.0 37.5 1.80 55 130 TEST SETUP(as shown in attached drawing detail):Three Evergreen modules,as specified above,were bolted to 136"x1.5"x1.5"Professional Solar Products(PSP)RoofTrac®support rails using an assembly of 5/16"stainless steel bolts, lock washers and proprietary aluminum clamps and inserts.The RoofTrac®support rail was attached to the PSP TileTrace structural attachment device with a 3/8"nut and washer at six attachment points.The setup was attached to 2"x6"wooden rafters using 5/16"x 3"Stainless Steel lag bolts.The attachment spans consisted of 48"front to rear with structural attachments spaced 48"on center. TEST PROCEDURE(as shown in attached drawing detail):The test set up was top loaded to 55 Ib/ft2.The setup remained loaded for an approximate period of 30 minutes.The maximum deflection and any signs of permanent deformation were recorded.The test setup was then inverted and loaded to simulate the uplift condition.The test set up was re-loaded to 55 Ib/ft2.The setup remained loaded for an approximate period of 30 minutes.The maximum deflection and any signs of permanent deformation were recorded. TEST RESULTS: The maximum top load deflection was recorded at 0.438",with no permanent deformation. The maximum uplift deflection was recorded at 0.250",with no permanent deformation. Building Department Note: This document certifies the RoofTracs mounting system used with Evergreen modules,as NOT TO BE SUBSTITUTED specified above,withstands a 55 Ib/ft2 static pressure load,equivalent to a wind speed of WITH STANDARD STRUT OR approximately 130 mph**. The mounting system performed as expected. COUNTERFEIT PRODUCT. Sincerely, James R.Vinci,S.E. This engineering report verifies that Vinci&Associates has provided independent observation for load testing as described in this report resu f this load test reflect actual deflection values and are generally accepted as the industry standard for testing module mounting systems. Vinci oc' t does not field check installations or verify that the mounting system is installed as described in this engineering report To assist the building inspector in verifying the authenticity of this proprietary mounting system,a p ane adhesion,silver reflective"RoofTracG'label,as shown,is placed on at least one of the main su rt ra Is Structural attachment: Lag bolt attachment should be installed Roof Trac• using the proper pilot hole for optimum strength.A 5/16'lag bolt requires a 3/16"pilot hole.It _is the responsibility of the installer to insure a proper ndy agl attachment is :- �� I(,: .; :;•.. made to the structural member of the roof. Failure to securely attach to the roof structure may result in damage to equipment personal injury or property damage. This office does not express an opinion as to the load bearing characteristics of the structure the mounting sr;:_' system/modules are being installed on. ICC accredited laboratory tested structural attachments manufactured by Professional Solar Products(including,but not limited to Fastlack®,TileTracO.and Foamlacke)can be interchanged with this system. *Modules measuring within stated specifications are included in this engineering **Wind loading values relative to defined load values using wind load exposure and gust factor coefficient "exposure C"as defined in the 2006(IBC)/2007(CBC) 31324 VIA COLINAS STE 101 WESTLAKE VILLAGE, CA 9136 Page 1 of 2 PSP:RT_EG 2 I48" 37.5" ->I i . i 136" Building Department Note: NOT TO BE SUBSTITUTED WITH STANDARD STRUT OR COUNTERFEIT PRODUCT. C R E 5/16°Stainless Steel Hex bolt Ll Top Load Deflection: 0.438" 5/16"Stainless Steel Lock Washer Aluminum ProSolar Y Inter-Module Clamp C RE lA T Aluminum ProSolar Channel Nut ::::i Aluminum ProSolar Up lift Deflection: 0.250'Roof rrao®Support Rail 3/8"Stainless Steel Hex -%- - Bolt and Flat Washes Aluminum ProSolar FastJack®Roof Attachment 5/16"Stainless Steel Lag Bolt and Flat Washer `- _ Professional Solar ProductsRoofrrac® Paten&6,360,491 RoofTrac® Photovoltaic mounting system Evergreen Solar odules Static load test illustration Page 2 of 2 PSP:RT_EG_2 135 devon 02648 - Google Maps Page 1 of 1 C,00,ql(! Address Maps s + i http://maps.google.com/maps?q=135%20devon%2002648&rls=com.microsoft:en-us:IE-S... 3/18/2009 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION o, Map .0 40 Parceli - r7f7 Health Division Date Issued Conservation Division App!i0ation Fe Planning Dept. Fee Date Definitive Plan Approved by Planning Board Historic OKH Preservation Hyannis Project Street Address Village MAar-,,�Dns: Hi'� S �� n e- Owner Address oh Telephone k � Permit R6queRequest �tnS+aj 10_+i6h op 2- W z5o la r 4rlermct "Day)f-dS -PhASk mDun*_,,c4 d n' SDIAPIK) � QrZP Square feet: 1 st floor: existing—proposed 2nd floor: existing—proposed —Total new Z6ning District Flood Plain Groundwater Overlay Project Valuation 5 construction Type Lot Size Grandfathered: Q Yes Q No If yes, attach suppo'rting documentation. Dwelling Type: Single Family Ll Two Family L11 Multi-Family (# units) C^ Age of Existing Structure Historic House: 0 Yes Ll No On Old King's Wg1hway: G;Yes No Basement Type: U Full U Crawl 0 Walkout LJ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)— Number of Baths: Full: existing new Half: existing new. rn Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: U Gas U Oil Ell Electric Q Other Central Air: El Yes Q No Fireplaces: Existing New Existing wood/coal stove: Q Yes LJ No Detached garage: Q existing Q new size—Pool: Q existing LJ new size Barn: Ll existing Q new size Attached garage: Ll existing U new size —Shed: Q existing Ll new size Other: Zoning Board of Appeals Authorization U Appeal # Recorded Q Commercial Q Yes U No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Geqsex — Telephone Number 6-oe- 72B_ 0qq2_ Address Po R(!),/- E3 9 License # Cafm 1_+ 0 Hn-0 2 6135 Home Improvement Contractor# Iq l 2-7 Worker's Compensation # �42-2389 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS P OJ CT WILL BE TAKEN TO BA r r) s--,4 a ah d- SIGNATURE DATE Q /1/ 9 r 'F L FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. -. ADDRESS VILLAGE P`OWNER DATE OF INSPECTION: FOUNDATION 1 , FRAME '-INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: r ROUGH FINAL FINAL BUILDING ®��' ®� (� �` DATE CLOSED OUT Y ASSOCIATION PLAN NO. 7 ' IF 1 f The Commonwealth of Massachusetts ID Department of Industrial Accidents Office of Investigations 600 Washington Street Boston:,MA 02111 b� www.n:ass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information l Please Print Legibly Name(Business/OrganizationMdividual): 1la, LL C S ffr Address: C) City/State/Zip: r2+I AI+, H R 0263J5 Phone.#: 50B Are yoy an employer?Check the appropriate box: Type of project(required): 1. In am a employer with�_ 4. ❑ I am a general contractor and I employees(full and/or part:time).* have hired the sub-contractors 6. El 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' 9. Building addition [No workers'comp.insurance comp.insurance.t g 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 11.❑Plumbing repairs ouidditions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees.[No workers' comp.insurance required.] *Any applicant that checks box a1 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 mustsubmit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcdntractors 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: G r I tSia4e —Ln2 r 0 CP Policy#or Self-ins.Lic.#: 2�� 9 Expiration Date: 2 2 Job Site Address: 13.5 _Devon Lan 1. —City/State/Zip:N t LQ.rSm Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). �Z 7 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 imprisormen:,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 instrance coverage verification. I do hereby ere under th pains an realties of perjury that the information provided above is true and correct Signature. Date: Lo f Phone#: -7-2 r 133 2 1 7(a 31 Official use only. Do not write in this area,tb be completed by city or town offrciaL 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#: Town of Sandwich-Revised March 2008 16 i i PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Don Bunker Insurance Agcy HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 320 Washington St I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Norwell,MA 2061 II COMPANIES AFFORDING INSURANCE COMPANY A GRANITE STATE INSURANCE COMPANY INSURED .f I Cotuft Solar Lie j Po Box Be 64 OLD SHORE RD I Cotuft,MA 02633-0000 THIS IS TO CERTIFY THAT 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 CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY-HAVE BEEN REDUCED BY PAID CLAIMS. 00 L-M T m or UISURA of POLICY NUMEER FOLICYEFFEUM DA1E FOL14Y EX MAMON DATE A DEMPLOYERS'LIABILITY LIMITS E PROPRIETORI PARTNERSIEXECUTIVE OFFICERS ARE: INCL 0 EXCL❑ 7422389 1 3/26/2009 1 3/26/2010 FATORY LIMITS ERC—SLApplleelaMAOperdare0npr. ACCIDENT $ 300,OD SE POLICY LIMIT $ 8OO,OO SE-EACH EMPLOYEE 500.00 DESCRIPTION OF OPERATIONSNEHICLMSPECIAL ITEMS RE:NO PARTNERS ARE COVERED BY THE WORKERS COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANYOF THE ABOVE DESCRIBED POLICIES'BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF.THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 14 BARNSTABLE, MA 02634 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE, 06/15/09 09:47 AM AIG SmallBusComp C4 Page 2 IKEI-, Town of Barnstable ` Regulatory Services . EMPNWABLM hUM Thomas F.Geiler,Director �b'°rEn 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject.property hereby authorize C o2 j,/L L S b (-_/4-)/L. L to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) 44 02,& ct �/ YL �r�7 signor o er Date 14 , D� Q l C-& Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION Town of Barnstable zHE rq�y� .. Regulatory Services Thomas F.Geiler,Director tKAss Building Division PlE° A Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis,MA QM01.. www.town.b arnsiable.ma.us Office: 508-962-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": 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 sic 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 BOMEOW-%'ER 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 inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homcownerr 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 parson(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 assurning the responsibilities of a supavism(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 responsrble. 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/certificatian for use in your community. Q:forrru:homccucmpt COTUIT SOLAR P.O. Box 89 • Cotuit, MA 02635 • 508-428-8442 • Fax 508-428-8441 • www.cotuitsolar.com 135 Devon Lane, Marstons Mills, MA Herb Rice 2: 4' x 10' solar thermal panels to be flush mounted on roof—3 '/21bs/ftz Ai Jr t pMEHcgN6 pNEPICgN Quality renewable energy CERTIFIED', systems since 1988 =CERTIFIED % F Design, installation, service Cert#03140940 Solar Thermal, PV, Wind °j`1ovua °� Conrad Geyser Cert#ST032407-B Conrad Geyser THE SERIES ipl. MU01HRIHodels DEC and P SPECIFICATION FLAT TOLAR COLLECTORS SHEET THE VALUE LEADER IN SOLAR WATER HEATING TECHNOLOGY Stainless Steel Fasteners Riveted Comers Low Iron Tempered Glass Low-Binder Fiberglass Insulation Rigid Foam Insulation Secondary Silicone Kr.-• Glazing Seal • Black Chrome or Moderately Selective Black Paint Absorber Coating • Copper Absorber Plate Integral • Type M Copper Riser Mounting Tubes and Manifolds Channel Extruded Anodized Aluminum Casing and • EPDM Grommets Capstrip Vent Plugs Primary EPDM Glazing Seal 15%Silver Brazed Joint Aluminum Backsheet t 1 PROTECTING OUR ENVIRONMENT-SINCE 1978 �UR[HRTHIHI. EMPIRE SERIES SPECIFICATIONS 41 C h D° JA �cry yJCC¢,o� 3'c mac` c P�• �' 3.ay a�'`° ;�o'�' J ` {�' m �' z��� F a�� r�c�C p` o EC/EP21 40 76 3 1/4 21.12 18.70 70 0.72 0.54 0.003 12 160 43 3/8 1 71.25 EC/EP24 36 1/8 98 1/4 3 1/4 24.61 21.88 80 0.78 0.62 0.005 12 160 39 3/4 1 93 5/8 EC/EP32 48 1/8 98 1/0 3 1/4 32.79 29.81 106 1.00 0.83 0.006 12 160 51 3/8 1 93 5/8 EC/EP40 48 1/8 122 114 33/4 40.81 37.33 141 1.20 1.04 0.009 12 160 51 3/8 1 115 5/8 EC/EP40.1.5 48 1/8 122 1/4 3 1/4 40.81 37.33 150 1.61 1.04 0.006 25 160 51 3/8 1 112 115 5/8 MODEL EC 'THERMAL PERFORMANCE RATINGS' MODEL EP Btu/ft /Day Btu/ft2/Da Category CLEAR MILDLY CLOUDY Category CLEAR MILDLY CLOUDY (Ti-Ta) DAY CLOUDY DAY 'DAY MI-Ta) DAY CLOUDY DAY DAY TI-Inlet Iluidtemp. 2000 1500 1000 Ti-inlet fluid temp 2000 1500 1000 Ta-atnblenl atr temp Btu/ft2/Day Btu/ft2/Day Btu/ft2/Day Ta-emblem air temp Btu/ftZ/Day Btu/ftZ/Day Btu/ft2/Day A(-9°F) 1,332 1,005 680 A(-9°F) 1,284 971 659 B(9°F) 1,218 890 565 B(9°F) 1,169 854 542 . C(36°F) 1,040 1 720 402 C(36°F) 984 677 372 D(90°F) 699 405 127 D(90°F) 619 343 89 E(144°F) 390 137 E(144°F) 280 62 A-Pool Heating(Warm Climate) B-Pool Heating C-Water Heating(Warm Climate) D-Water Heating(Cool Climate) E-Air Conciltioning/Industrial Process Heat. Thermal performance is obtained by multiplying the collector output for the appropriate application and insolation level by the total gross collector area. 'Collector ratings are derived from the Solar Rating&Certification Corp(SRCC)Document RMA and Standard OG-100. ENGINEERING SPECIFICATIONS (Performance specifications subject to testing error of+/-3%) The following shall be the specifications for the solar collectors. Collectors thermal isolation oflthe foam from the absorber plate. Total thermal resis- shall be SunEarth Empire model ,and shall be of the glazed liq- tance shall be a minimum of R•12.The sides and ends of the collector shall uid flat plate type.Collectors shall be tested in conformance with ASHRAE 93- be insulated with a minimum of 1 inch foil-faced polyisocyanurate foam 1986 and SRCC 100.81.The collectors shall be certified by the Solar Rating and sheathing board. Certification Corporation(SRCC}and the Florida Solar Energy Center(FSEC). ABSORBER PLATE AND PIPING GENERAL The absorber shall consist of a roll•formed copper plate of no less than.008 The dimensions of the collector shall be inches in length, inch thickness.Risers shall be a minimum of 112 inch O.D.Type M copper inches in width and 3 1/4 inches in depth.The collector casing tubing on no more than 4 1/2 inch centers continuously soldered to the shall be an anodized aluminum extrusion(alloy 6063 T5),minimum thick plate utilizing a non-corrosive solder paste with a melting point of 4607.. ness .060 inch, with an architectural dark bronze finish. The casing shall The risers shall be brazed to 1 1/8 inch 0. D.)Type M(1 5/8 inch O.D.on have notched framewalls for ease of plate removal and reinstallation.Sheet EC/EP40-1.5) copper manifolds utilizing a copper phosphorous brazing metal screwed fasteners shall be stainless steel(18.8#10).The backsheet alloy with no less than 15 percent silver content and conforming to the shall be textured aluminum not less than.014 inch thickness.A 1 inch vent American Welding Socie'ty�BCuP-5 classification.EPDM grommets shall iso- plug shall be installed in each of the four corners of the backsheet to min- late the manifold from'the aluminum casing.The absorber plate shall be imize condensation. it designed for 160 prig.maximum operating pressure. GLAZING ABSORBER COATING fAND PERFORMANCE CURVE The collector glazing shall be one sheet of low iron tempered glass,with A)Black Chrome(EC Series):The absorber coating shall be black chrome on a minimum of 1/8 inch thickness(5/32 inch on EC/EP 40), and a mini- nickel with a minimum absorptivity of 95 percent and a maximum emissivity mum transmissivity of 91 percent(89 on EC/EP 40).The glazing shall be of 12 percent.The instantaneous efficiency of the collector shall be a mini- thermally isolated from the casing by a continuous EPDM gasket. There mum Y-intercept of 0.714 and a slope of no less than-0.7271(BTU/ftz-hr)/F. shall be a continuous secondary silicone seal between the glass and cas- ing capstrip to minimize moisture from entering the casing. B)Moderately Selective Black Paint(EP Series):The absorber coating shall be INSULATION a moderately-selective black paint with a minimum absorptivity of 94 per- The insulation shall be foil-faced polyisocyanurate foam sheathing board of cent and a maximum emissivity of 56 percent.The instantaneous efficiency a minimum 1 inch thickness,siliconed in place to the aluminum backsheet, of the collector shall have a minimum Y-intercept of 0.682 and a slope of covered by low-binder fiberglass of a minimum 1 inch thickness,providing no less than-0.7995(BTU/ftz-hr)/F Due to SunEarth's policy of continuous product improvement,specifications are subject to change without notice. MANUFACMM BW. AVAIIAM FROM.' hPIORTh. 8425 Aimeria Ave=-Fontana,CA 92335 W (909)434.3100 - Fax(909)434-3101 O O y O wwwsunearthinc.com _ I RFCYCItD PAPER-SOY BASED INK g k-- „A� N Structural Certification Collector Manufacturer and Address: sun /Earth, In4315eetOnta Collector Model Number: EmpireEP-40 Gross Area: 40.8 Sq Ft Transparent Area: 7.3 S Ft Type of Glazing: Low Iron Tmpr, Thickness of lazing: 5/32 in (4.Omm) The undersigned, an engineer registered i e state of Florida does certify that, having used generally cepted procedures, he/she has determined that the wind load that may a sustained by the solar collector identified in the heading above with t structural damage is at least 2 Pa ( 30 psf). Signed: - Date May 3, 1994 Typed Name Hen_y Tj Healey, Registration N —_. 35056 SEAL 1 FLORIDA SOLAR ENERGY CENTER TEsting & OpErations Division 300 State Road 401. Cape Canaveral. Florida 32920 2 T �` ��• 1 PPPEE I4SULATION COTUIT SOLAR P.O. Box 89 • Cotuit, MA 02635 . 508-428-8442 SOLAR SYSTEM SCHEMATIC ,X/x RETURN 7" ROOF JACKS COLD COLD SUPPLY L a LIFE 84 s II to 4 iIL7 3 it 6 19 � ( 8 II 9 II(T-1 10 13 11 1) SOLAR COLLECTOR 2) AUTOMATIC AIR VENT/COLLECTOR SENSOR 3) TEMPERATURE GAUGES 4) CHECK VALVE o J 5) ISOLATION VALVE `6) GLYCOL LOOP PRESSURE RELIEF VALVE 'n GLYCOL PRESSURE GAUGE 8) EXPANSION TANK 9) GLYCOL FILL VALVE 10)PURGE VALVE 11)GLYCOL DRAIN VALVE 12)CIRCULLTOR ISOLATION VALVE 13)CIRCUALTOR 14)CIRCULATOR ISOLATION VALVE 15)TANK DRAIN 16)TANK SENSOR 1'n N/A 18)CONTROLLER p' . -x< s f= -t k -.,i...-- r e • {--._i---ti . r- s '� r - r c- - a - - --_ __ _ _ _ _ — _. _ TOP OF i M o U of iTi/�1 G M O U u vS�rJ G CL.Z'P GR..OGV`E' i 1_ t G"-P-)\J Do OFF 5 VA-c-A-f-J !� Q A ... 0;e - ie q-/pSt nBoru ig gulalons an aars One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home ImprovementContractor Registration Registration: 146276 =- Type: DBA -Expiration: 4/8/2011 Tr# 282763 COTUIT SOLAR CONRAD GEYSER P.O. BOX 89 COTU IT; MA 02635 Update Address and return card.Mark reason for change. Address C] Renewal. Employment Lost Card I)PS-CAI 0 40M-08/08-DBSLIFORMCA108212008 . ... .. - Cf� ��nmzo�.zeuea�z �✓�aQaac�zuac.CT . Boar o mlding Regulatio sand Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 146276 One Ashburton Place Rm 1301 E?ep rattgn-,478/2011 Tr# 282763lug Boston,Ma.02108 _-- COTUIT SOLAR CONRAD GEYSER` 3800 FALMOUTH Rb. MARSTONS MILLS,MA'02648 Administrator Not valid without signature TOWN OF BARNSTABLE `';... CERTIFICATE OF OCCUPANCY PARCEL ID 040 133 TOO GEOBASE ID 38700 ADDRESS 135 DEVON LANE PHONE (508)477-0023 i - a on L q ZIP _ LOT g BLOCK LOT SIZE .DHA DEVELOPMENT DISTRICT CO i PERMIT 21913 DESCRIPTION SINGLE FAMILY DWELLING (PMT.419329 PERMIT TYPE BC00 TITLE . CERTIFICATE OF OCCUPANCY ' CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: BOND $:00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY +" + � 1ARN3TA8LE. • MASS. AOWNER DDRESS� DEVON REALTY TRUST, i63� / P. 0. BOX 599 BUILDIL�Y/ x A1�V MASHPEE, MA BY . DATE ISSUED 03/20/1997 EXPIRATION DATE THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA D 040 133 T00 GEOBASE IDa 38700 135 DEVON LANE PHONE; (508)477-0023, Ma>e-stan9- _ ZIP - 9 C� BLOCK l LOT SIZE DEL�OPMENT DISTRICT CO 19329 DESCRIPTION SINGLE FAMILY DWELLING (SEW.PMT.096-568 Y.PE BUILD TITLE„ NEW RESIDENTIAL BLDG PMT ` emu, ORS: PRIESTY, DONALD H. Department of Health, Safety .CTS: - and Environmental Services ES: ' 1 $466.00 �TNE CTION COSTS $110,000.00' SINGE FAM HOME DETACHED 1 PRTVATE PABLE. ; MASS. DEVON-'kEALTY TRUST; 1639. A� P. 0. BOX 599 �� BUIL IVISIO MASHPEE,.- MA B DATE ISSUED 11/15/1996 EXPIRATION DATE 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. PRIORITO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. _ 4.FINAL-INSPECTION BEFORE OCCUPANCY. VISIBLE- POST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPR ALS fa- - �lL;/97 3 1 G INSPECTION APPROVALS ENGINEERING DEPARTMENT P � og 2 B P AZD Xqf"; E ALTO GNU n D 4j ATH R SITE PLAN REVIEW AP R VAL SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS '!3PECTOr-HAG^PPPnVE0THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY TA;`-:`' ;, ., ? MO'!THS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. g�R�ia." .. •4. y, e�as NZ i BUILDING .,.,, . t�.l 5 ,I r:! ih • F 1 . 1 1 i 1 ' 4 � • t AREA PLAN SCALE: 1 „a 4-o. S YS TEM PROFIL E FINISH GRADE NOT TO SCALE SOIL EVAL UA TIONS s�.o APPL ICA TION NO. P-8756 '••- FINISH GRADE FINISH GRADE 5 7•S �. OVER TANK OVER TRENCHES '7.0 AUGUST 19, 1996 TOP FIVO EDWARD BARRY TOWN OF BARNSTABLE SCH 40 PVCOR i CAST IRON TEES '' 9 •o' r?4.84- �••°o°s0oa 0 c e00oo0 000o a o::v=i TEST 1 TEST 2 �.'.."' `1.A•O :, '. p• 0 BSM'T FLR e.i:. �_ _ it 24 S�.00 ooao�o�000ac. •oe ogCAP ENDS G . : 'O' :•.: I d� GAL. EQUALIZERS S�.Sb °QOoao°,oD oo°o o: oAT ELEV. A JO•� '' ' •. oDOD a° °. io • o0. o•o oo•oo o• ° SANDY LOAM 1r ,: °oo oDocQo ,O poQ o REINFORCED ° o o° a �•• � ,•. ses DIST.BOX 0YR 312 ... :;.: o .. CONCRETE aoo..°o , . o o°a �.•Ql� 1 A ,. ::•. „ •, � y BAFFLE oo.eoo�.o 00 0°•0 00 ;. • . •► • ,.•. _ :: 't•.• ..i:. :„ TO BE INSTALLED ON A °o° o°' p°po o•°o'o' oys°aQo'w i;o• SANDY LOAN op o o° co•° ao •°oo ° °000• •„°o s' 10yR 3/2 LEEVEL STABLE BASE n o o °.°•o ° sANDBLOAM �• SEPTIC TANK 5 TRENCH LENGTH 3� 10YR 6/4 ,B, TO BE INSTALLED ON A SANDY LOAM LEVEL STABLE BASE 24• 10YR 6/4 4'MIN.HEIGHT NO TE: DO NO T RUN HEA V Y EQUIPMENT O VER S YS TEM ABOVE OBSERVED rL.r 241 GROUND WATER SAND 2.5Y 6/19 'C' SANG 120• 2.5Y 6/4 L EA CHING TRENCH SEC TION NOT TO SCALE SOIL AND PERCOLA TION DATA 120' FOR FINISH GRADE NO GRCOVDWArER APLLICATION NO. P�-8756 (PERC'D A r 4B r - 2MIN/rN1 SEE SYSTEM PROFILE _ PERC. RA TE < s MINVIN 12"MIN. TAKEN BY RIQ�,4RD-F�4REI�tAI— ;,;; NI TNESSED BY �• yyq�,gARq.� DA TE WASHED STOONENE 4"DIA.PIPE MIN.2" - "-1/2" TEST PIT ELEV. --57.8— TEST PIT ELEV. 56.8 /'-NATURAL SOIL-'t 2'MAX EFFECTIVE 'NOTES DEPTH LINE BEARING DISTANCE 3/4"-1 1/2" N WASHED S TONE 1 S 54'24'41'N 22.00 MIN.• 3x I. ELEVA TIMIS BASED ON M.S.L. EXCAVATED SIOEWALL • EFFECTI,V WIDTH 2. TOWN WATER ON SITE - OR DEPTH 9. FLOOD ZONE 'C' 4. GROUNDWATER ELEVA TION 2O. 7 — EFFEC T I VF WIDTH NUMBER OF TRENCHES 2- DEVON LANE LOT B �' {•` � � S. F. SIDEWALL AREA GALS SF GALS. DESIGN DA TA 00 — - - � NO.OF, BEDROOMS ' 900•A0 iw�A-- S. F. BOTTOM AREA GALS/SF p GALS. DISPOSAL . -a-��- EST. TOTAL DAA IL EFFLUENT_..440—GALS. ° ? W SEPTIC TANK GAL. AV- S. F. TOTAL AREA ,46p GALS. 5 CATL7/BASIN, ti 1 DRAINAGE EASEMENT _1 fae aa.fo Q \y N 54 GENERAL NO TES I 1 59 18 pp m I i I 189. 00 / \` 00 rj - -- NO TE: .1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN i DaurNAss MADE / p:60 9,90__\ _® ` A CCOROANCE WI TH TI TL E 5 OF THE S TA TE SA NI TA R Y CODE I E.I SEMENT � S �1 4 / A ! LeAc�rsNs T�rw-s EXCAVATE TO ELEV_ 8,o OR LONER AS REQUIRED DA TED AND ANY L OCAL RUL ES APPL ICABL E ter«p'EEo TO REMOVE ALL LOAM AND CLAY CONTAINING MARCH ?995 I _ MATERIAL BENEATH THE LEACHING AREA.REPLACE P. ANY CHANGE IN THIS PLAN MUST BE APPROVED i \ D-ear ,R`e�v �� `�' EXCA VA TED MA TEAIAL WI TH CL EAN, CLA Y FREE GRA VEL BY THE BOARD OF HEAL TH 'sE�viJCAiANf—1 MECHANICALLY COMPACTED IN PLACE 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING LOT 9 NOTIFY BOARD OF HEAL TH FOR INSPECTION 4. FND. ELEV. MUST BE CHECKED WHEN COMPLE TED LEGEND 5. THESE ELEV. MUST NOT BE CHANGED WI THOU 1" `� 4 i THE BOARD OF HEAL TH APPROVAL I � -� rpo (5. BOARD OF HEALTH INSPECTION REO 'D WHEN EXCA VA TED au � EXIST.GROUND ELEV. J' Iztcr 1 �` FINISH GROUND ELEV.UNDERLINED Oi PIPE INVERT ELEV. ����" ` SEWAGE DISPOSAL SYSTEM PL A N PREPARED FOR TEST PIT L OCA TION 1 � � 7' 1A i o o SEPTIC TANK �o THE IRENE TRUS T �/ /' 122.o0 28B.25 o DISTRIBUTION BOX may` LOT 9 DE VON LANE 46 I IL1 48 �o S 54*24'41'1✓ fg 4PC.X.OR SCH 40 PVC I ,...�., BARNS TABL E — MASS. INIF CHARLES N. SA VARY ++++++++ 4-BIT.FIBER PIPE-TIGHT JOINTS — PROPERTY LINES : ��`� �T• DESIGNED : DATE : OCTOBE/9 19, 1996 `.6 a�r SAP FERREIRA ASSOCIA TES MIN.CODE DISTANCE q.,.�'4 is DRAWN : SCALE:AS SHOWN 131 SPRING BARS ROAD Ap r Ott''. ` CHECKED : COS DRAWING NO. 101996 FALMOUTH - MASS. MAP SEC PCL L O T f-/SE