HomeMy WebLinkAbout0086 CHANNEL POINT ROAD �� l���ce.� �a ��c�
I, _ _- -
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1
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Assessor's office(1st Floor)-
Assessor's map and lot number J 's—
ConservationZL S
Board of Health(3rd floor):
Sewage Permit number �� �� ssaier�net
Engineering Depart(3rd floor): > ee *639. \�d°
House number �o rtr
Definitive Plan Approved by Planning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2*00 P.M.only
TOWN OF' BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO N(, S l; l 21 NEW "P[j-j H -2 ND F,OOR
TYPE OF CONSTRUCTION _1,tj [j() [�
19 q
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location JA Z62 01-4 lN�_il. 201 WE I-D. )-EyIA oV (St �ltA�
Proposed Use \AJ 1, I M CT
Zoning District Fire District
Name of Owner L I- v A M V t2 P_ A�4 Address � C�H IA N bV 1, P 6 I ftrr 2>7 (4 y& K/i5
Name of Builder 1�V�_tZ 0 1L, 01;S O lU Address E Y RPM N D O l-P K `Z0. �Yjq"PZ 0A(j i°o RI-1
Name of Architect Address
Number of Rooms �J Foundation CD r,-cre-fe, 13 L y C.}G
Exterior W Don Roofing --A St-k e F-1 QOF U i
Floors UV O 0 Interior S Kf7 C T Rc)
Heating CLC� n H �2 8 �9-W Plumbing
Fireplace (fib Approximate Cost 0 O. no
Area rT
1
Diagram of Lot and Building with Dimensions / Fee ��,
s
f
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Nam G
Construction Supervisor's License 5-41 C ( U
MURRAY, LlOYD
No 35255 Permit For ENCLOSE PORCHES/RENOVATIONS
Single- Fami-ly dwelling
Locatiori - 86 Channel Point Road
f .Hyannis"
Owner, . T,Loyd -Murray I
Type of Construction Frame " r , '`
Plot' ( Lot 1
Permit Granted 'August 5 , 19 s 92 t I I
Date of Inspedtion 1 19
R
Date Completed 19 • :�
I
"U
� 3 i
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map M2 Parcel Permit# d ,0 3 7
Health Division ✓ �V ��� � Date Issued 3
�/ -5r5i,
Conservation Division s 9 Application Fee ® " Q�
Tax Collector Permit Fee�_�c�,y0
�y �, aoL30� -
Treasurer
Planning Dept. CONNECTED ACCOUNT
Date Definitive Plan Approved by Planning Board #
Historic-OKH Preservation/Hyannis
Project Street Address
Village
Owner (T� pl I�JV / Address
Telephone
Permit Request / �0ek'I ?� loxf6**,j
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District _ Flood Plain Groundwatgr Overlay
.1
Project Valuation 6,06 Construction Type J5� VYj
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 f3
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
o,Qber 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: 0 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 ❑No If yes, site plan review#
Current Use � Proposed Use
BUILDER INFORMATION
'Name, -l��L A /� Telephone Number "'
Address License# �lO Q05
Home Improvement Contractor# 1-0, q,9,
Worker's Compensation# LKIJ.�7 �'7� � �l
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO
SIGNATURE DATE �i�/
FOR OFFICIAL USE ONLY ;
' PERMIT NO.
' 1
' DATE ISSUED
r
MAP/PARCEL'NO. '
ADDRESS VILLAGE
OWNER :, . 06
DATE OF INSPECTION: /
FOUNDATION
FRAME
INSULATION
FIREPLACE
r
ELECTRICAL: ROUGH ,' FINAL
PLUMBING: ROUGH �� FINALS
f • T
GAS: ROUGH ��w FINALS
\J
FINAL BUILDING V
co
DATE CLOSED.OUT•
dr
ASSOCIATION-PLAN NO. O ,
E
1 I'
0
The Commonwealth of Massachusetts
---= ' Department of industrial Accidents
600 Washington Street "
Boston,Mass. 02111
' Workers' Com ensation Insurance Affidavit-General Businesses,
r,-�rrri r�i i err rriiiai
NNW/
ame: ,
address• .•
state• zi one# .. ..
work site location full address)---. "
e: • Retail Restaurant/Bar/Eating Establishment
❑ opn
I am a sole pretor and ha
ve no one Business Typ , ❑ ❑
working in any capacity. ❑Once[I Sales(including Real Estate,Autos etc.)
❑I am an em to er with, em 1 ees(full& art time). ❑Other / ��,�/��/�
�%//////r/rim///.%%/%//%%%///�%%%//O�7///%//r0/%%%%%%% /
am an employer providing workers' compensation for my employees working on this job.
coin �aav 33ame:
a'aat gas .;.
:%�.•!/ '• . .:;..•:;:
Z5
fnsuraace.co:•:
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.I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices:
:• :.
com SnY nam r..ti::::.:' •:
address:
• . .. •"�• • .� •;�' lone•#• �•� •
insurance co. - :.•._.. . .. ,.,.
'oliCY#
ME
comp any usaie ,u.. 'r•'
addressi ' ': .. •
hone
o7i6VV,,i >
_ irisurance�co.; ',' ./,�//////�/% •/�%/�%/,d/%%� /// % �//// / .:, .•:/.•. •:� .: ,//� •
Fallure to secure coverage as required under Section 25A of MGL 152 can lead tv the impas[tion of crlminalpenalties of a fine up to 51�00.00.`and/or.
one years'imprisonment as well as civil penalties la the form of a STOP R'ORK ORDER and a fine of 5100.00 a day against au. I anderatand that a
copy of this statement may be forwarded to the Ol�ce of Invnflgatiom of the DlAfor coverage verification.
I do hereby certify under the pains and penalties of perjury that the Information provided above is true and correct
Date
Signature
Phone#
Print name
official use only do not write in this area to be completed by city or town official
city or town, permittlicense# []Building Department
❑Licensing Board
❑checkilimmediate response is required ❑Selectmen's Office
❑EealthDepartment ,
"! hone#, ❑Other
eoatactperson• p � -
(revised Sept 2003)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers compensation for their
employees. As quoted from the"law", an employee is defined as every person in the service'of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or
trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of
another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please
supply l company name, address and phone numbers along with a certificate of insurancem
as all affidavits may be submitted
to the Department of industrial Accidents for confirmation of insurance coverage. .Also be sure to sign and date the
affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being
requested, not the Department of Industrial Accidents. Should you have any questions regarding the-"law"or if you are
required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure.that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the,
affidavit for you to fill out in the event-the Office of Investigations has to contact you regarding the applicant: Please...
be sure'to fill in permit/license number which will m
be used as a reference number. The affidavits, aybe returned to_
the Department by a10 or FAX unless other arrangements have been made.-
The Office of Investigations would like to thank yvu in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
/%/. ///%/ / /%i % ////�
The Department's address,telephone and fax number
The Commonwealth Of Massachusetts
Department of Industrial Accidents
off["of leltosfigadons
600 Washington Street
' Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617) 727-4900 ext:406
RESIDENTIAL:
SHEDS -POOLS-DECKS-OPEN PORCHES- GAZEBOS
FEE VALUE WORKSHEET
APPLICATION FEE: $50.00
BUILDING PERMIT FEES:
ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,etc.)
>120 sf-500 sf $ 35.00 $
>500 sf-750 sf 50.00 $
>750 sf- 1000 sf 75.00 $
>1000 sf- 1500 sf 100.00 $
>1500 sf—USE NEW BUILDING PERMIT APPLICATION
DECKS x$30.00= $
(Number)
PORCHES x$30.00= $
(Number)
IN GROUND SWIMMING POOL $60.00 $
ABOVE GROUND SWIMMING POOL $25.00 $
RELOCATION/MOVING $150.00 $
(Plus above fee if applicable)
C S p 00
PERMIT FEE $
Q:forms:dkcost
REV:063004
oF1194E ram, Town of Barnstable
Regulatory Services
* BAMSrABLE Thomas F.Geiler,Director
Building Division
lFD MP'�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date � /Z
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:
6j�? % / Estimated Cost
r
Address of Work:
Owner's Name:
Date of Application: An
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
El owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereb apply fora permit as the agent of thewwner:
Da Contractor Name Registration No.
OR
Date Owner's Name
Q:forms:homeaffidav
Oct 22 04 02:57p Jeffrey and Sue Manosh 508-473-9062 p.2
Friday.October 22,200411.33 AM George Gilsmore 50&477-7740 P.02
Town of Barnstable
f Reffilatory_Services
• ,�,� 'use B,c�a,Dtre�or .
Bn-Wng Division
Zbm Petty,Htdidfa� .
200 Men Street,$yu*MA 02601
wonvAmn beYwftW &=
Off= 50MO-4038 Fax: 508-7WG230
Property Owner Must
Complete and Sign This Section
If Using ABWder
as Oaner of the subject pmPenY
hmby wahatim 6, 141 ,h'X0 t-4E to act on mybebA
in Z mutes rehtive to work authorized byt6 btttI&S penuit application for.
AAdddres5rea of jo —T°'—
Slgaau=of Owner Date '
Priztt IJeme
' J
�:FORMS:OWNS1tP>tZtML9StON
i
fee-OPanvmaiuuea�� a�./�aaaa�uQelta '.
BOARp QF BUtLI)I'NG REGULATI'ON:S
h
I ' License: C3QQRSTRUCTIDN SUPERVISOR i;
Num?ber'� 068433
ur 0 6 Tr.no: 25522
i.
Re
2
I GEORGE R GILD
COTUIT, MFA 0263 �
Commissioner
lee-� e..vea/,� o�✓�aczc/zuQet�6 ,
� Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration` 423494
' �RI?'e��an '2/76/2005
yy ,
.pate Corporatioh
` ore Marine CQrirae}rrtg Irc,
G $e Gillmore
37; owdoin Rd 4 /
Iashpee,MA 02649 `b
V Administrator
RESIDENTIAL
ADDITIONS OR ALTERATIONS
If located:
North of Route 6- any work visible from outside-needs approval from OKH
In Hyannis-If work visible from outside- Check to see if it's included in the
' Hyannis Historic Waterfront District-if so it needs approval from them
If ZB relief(Special Permit or Variance is required for project:
❑ opy of ZBA Decision
ocumentation proving that decision was recorded at the Registry of Deeds w/in one year of
A of
date.
APPLICATION PACKAGE MUST INCLUDE:
f Map/parcel number
Approval Sign-offs from:
[�' Health
Conservation(if exterior work)
❑ Tax Collector
❑ Treasurer
Street address
Owner's name& address
[� Permit request- full description of proposed project)
Square footage-proposed project
L�J Estimated project cost
Complete Dwelling information for Assessor's Office
[� Builder's information
Signature
Plot plan(shows location& setbacks of house)
lans—5 sets measuring 11"x 17" fully dimensionlized with foundation, floor plan, cross
section, framing schedule & smokes, with a Red S (SB or SH)
Home Improvement Contractor's Affidavit
Worker's Comp form must include: Insurance Company's name&Worker's Comp. policy
number. Copy of Insurance Compliance-Certificate must be on file.
Energy Compliance Form
Copy of Construction Supervisor's License &Home Improvement Specialist's License
OR
❑ Homeowner's License Exemption Form.
Application Fee ❑ Permit Fee
Property Owner must sign Property Owner Letter of Permission.
CHIMNEYS
❑ Need Home Improvement License
❑ No plot plan required
RS & DOCKS
PPI
Need Construction Super license AND Home Improvement License
Owner cannot pull own permit
q-fbm1s:permits l
rev.082704
Massachusetts Department of Environmental Protection
Bureau of.Resource Protection - Waterways Regulation Program Transmittal No.
Chapter 91 Waterways License Application -310 CMR 9.00
Simplified,Water-Dependent,Nonwater-Dependent,Amendment
G. Municipal Zoning Certificate
500an ma"S4 _ I's ; The murew 'rust
Name of Applicant 3.
$6 C-h-av►nxi Point Rout Mu l s TAnc- Harbor W!AL nw:
Project street address Waterway City/Town
Description of use or change in use:
Alo t-eca+a_rricie/ deeie/na ar./ Noah o aee-a.ss ,6 rtaumm" t fybrs
J
To be completed
p eted by municipal clerk or appropriate municipal official: .
"I hereby certify that the project described above and more fully detailed in the applicant's waterways
license application and plans is not in violation of local zoning ordinances and bylaws."
7740 _'D 4
Pri ted'ABPn Municipal ici t/ Date
g ure nicip a Offici I itle City/Town
CHMpp.doc
Rev.01/31/02 Page 6 of 17
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Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 5 - Order of Conditions SE3-3920
vNLASS. $ Provided by DEP
i63¢ .0 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
�fD MPy�
and Town of Barnstable Ordinances Article XXVII
A. General Information
Important:
When filling From:
out forms on Barnstable
the computer, Conservation Commission
use only the
tab key to This issuance if for(check one):
move your
cursor-do ® Order of Conditions
not use the
return key. ❑ Amended Order of Conditions
To: Applicant: Property Owner(if different from applicant):
It Ar The Murray Trust; Susan Manosh Trs.
moo,
Name Name
15 Packard Road
Mailing Address Mailing Address
Milford MA 01757
6 aty/Town State Zip Code City/Town State Zip Code
Z_
z Un 1. Project Location:
u.)
ccW
� 86 Channel Point Road Hyannis
L11 Street Address City/Town
326 075
=Z Assessors Map/Plat Number Parcel/Lot Number
LU
--� 2. Property recorded at the Registry of Deeds for:
ZC'4 Barnstable 6942 176
LU
County Book Page
LL1 0
Certificate(if registered land)
ID
3. Dates:
January 25, 2002 May 14, 2002 - MAY 3 0 2002
Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance
4. Final Approved Plans and Other Documents (attach additional plan references as needed):
Site Plan . Jan. 16,2002
Title Date
i� Title Date
M
_f
Title Date
'�J 5. Final Plans and Documents Signed and Stamped by:
Stephen Wilson, PE
Name
6. Total Fee:
$895.00
(from Appendix B:Welland Fee Transmittal Form)
Wpaform5-doc•rev.5/16/02 Page 1 of 7
Massachusetts Department of Environmental Protection DEP File Number:
Bureau rf of Resource Protection -Wetlands
WPA Form 5 - Order of Conditions SE3-3920
r Muss Provided by DEP
059.. Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and Town of Barnstable Ordinances Article XXVII
B. Findings
Findings pursuant to the Massachusetts Wetlands Protection Act:
Following the review of the above-referenced Notice of Intent and based on the information provided in
this application and presented at the public hearing, this Commission finds that the areas in which work is
proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply:
❑ Public Water Supply Land Containing Shellfish ® Prevention of Pollution
❑ Private Water Supply ® Fisheries Protection of Wildlife Habitat
❑ Groundwater Supply Storm Damage Prevention Flood Control
Furthermore,this Commission hereby finds the project,as proposed, is: (check one of the following boxes)
Approved subject to:
the following conditions which are necessary, in accordance with the performance standards set forth
in the wetlands regulations, to protect those interests checked above. This Commission orders that all
work shall be performed in accordance with the Notice of Intent referenced above, the following
General Conditions, and any other special conditions attached to this Order.To the extent that the
following conditions modify or differ from the plans, specifications, or other proposals submitted with
the Notice of Intent,these conditions shall control.
Denied because:
❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland
regulations to protect those interests checked above. Therefore, work on this project may not go
forward unless and until a new Notice of Intent is submitted which provides measures which are
adequate to protect these interests, and a final Order of Conditions is issued.
❑ the information submitted by the applicant is not sufficient.to describe the site, the work, or the effect
of the work on the interests identified in the Wetlands Protection Act.Therefore,work on this project
may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient
information and includes measures which are adequate to protect the Act's interests, and a final
Order of Conditions is issued. A description of the specific information which is lacking and why it is
necessary is attached to this Order as per 310 CMR 10.05(.6)(c).
General Conditions (only applicable to approved projects)
1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory .
measures, shall be deemed cause to revoke or modify this Order.
2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any
injury to private property or invasion of private rights.
3. This Order does not relieve the permittee or any other person of the necessity of complying with all
other applicable federal, state, or local statutes, ordinances, bylaws, or regulations.
Wpaform5.doc•rev.5/3/02 Page 2 of 7
�ti
Massachusetts Department of Environmental Protection DEP File Number:
�y`���\,��, Bureau� of Resource Protection _Wetlands
WPA Form 5 - Order of Conditions SE3-3920
v MASS.
8 Provided by DEP
E1659- Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
and Town of Barnstable Ordinances Article XXVII
B. Findings (cont.)
4. The work authorized hereunder shall be completed within three years from the date of this Order
unless either of the following apply:
a. the work is a maintenance dredging project as provided for in the Act; or
b. the time for completion has been extended to a specified date more than three years, but less
than five years,from the date of issuance. If this Order is intended.to be valid for more than three
years, the extension date and the special circumstances warranting the extended time period are
set forth as a special condition in this Order.
5. This Order may be extended by the issuing authority for one or more periods of up to three years each
upon application to the issuing authority at least 30 days prior to the expiration date of the Order.
6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse,
rubbish, or debris, including but not limited to lumber, bricks, plaster,wire, lath, paper, cardboard,
pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing.
7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such
an appeal has been taken, until all proceedings before the Department have been completed.
8. No work shall be undertaken until the Order has become final and then has been recorded in the
Registry of Deeds or the Land Court for the district in which the land is located,within the chain of title
of the affected property. In the case of recorded land, the Final Order shall also be noted in the
Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to
be done. In the case of the registered land, the Final Order shall also be noted on the Land Court
Certificate of Title of the owner of the land upon which the proposed work is done. The recording
information shall be submitted to this Conservation Commission on the form at the end of this Order,
which form must be stamped by the Registry of Deeds, prior to the commencement of work.
9. A sign shall be displayed at the site not less then two square feet or more than three square feet in
size bearing the words,
"Massachusetts Department of Environmental Protection" [or, "MA DEP"]
"File Number SE3-3920 "
10. Where the Department of Environmental Protection is requested to issue a Superseding Order,the
Conservation Commission shall be a party to all agency proceedings and hearings before DEP.
11. Upon completion of the work described herein,the applicant shall submit a Request for Certificate of
Compliance(WPA Form 8A)to the Conservation Commission.
12. The work shall conform to the plans and special conditions referenced in this order.
13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the
Conservation Commission in writing whether the change is significant enough to require the filing of a
new Notice of Intent.
14. The Agent or members of the Conservation Commission and the Department of Environmental
Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours
to evaluate compliance with the conditions stated in this Order, and may require the submittal of any
data deemed necessary by the Conservation Commission or Department for that evaluation.
Wpaform5.doc•rev.5/16/02 Page 3 of 7
Massachusetts Department of Environmental Protection
t' DEP File Number:
Bureau of Resource Protection _Wetlands
WPA Form 5 - Order of Conditions SE3-3920
v� 16, 9.
Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
and Town of Barnstable Ordinances Article XXVII
B. Findings (cost.)
15. This Order of Conditions shall apply to any successor in interest or successor in control of the
property subject to this Order and to any contractor or other person performing work conditioned by
this Order.
16. Prior to the start of work, and if the project involves work adjacent to a Bordering Vegetated Wetland,
the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden
stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a
Certificate of Compliance has been issued by the Conservation Commission.
17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully
stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or
water body. During construction, the applicant or his/her designee shall inspect the erosion controls
on a daily basis and shall remove accumulated sediments as needed. The applicant shall immediately
control any erosion problems that occur at the site and shall also immediately notify the Conservation
Commission, which reserves the right to require additional erosion and/or damage prevention controls
it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of
work line has been approved by this Order.
see attached
Finding
s as to municipal bylaw or ordinance
Furthermore, the Barnstable hereby finds (check one that applies):
Conservation Commission
❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal
ordinance or bylaw specifically:
Municipal Ordinance or Bylaw Citation
Therefore,work on this project may not go forward unless and until a revised Notice of Intent is
submitted which provides measures which are adequate to meet these standards, and a final Order of
Conditions is issued.
® that the following additional conditions are necessary to comply with a municipal ordinance or bylaw,
specifically:
Article 27 of Town Ordinances
Municipal Ordinance or Bylaw Citation
The Commission orders that all work shall be performed in accordance with the said additional
conditions and with the Notice of Intent referenced above. To the extent that the following conditions
modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent,
the conditions shall control.
Wpafonn5.doc•rev.5/16/02 Page 4 of 7
SE3-3920 Murray Trust
Approved Plan=January 16,2002 Site Plan by Stephen Wilson,PE
Special Conditions of Approval:
Coastal Projects
I. Preface
Caution:Failure to comply with all Conditions of this Order of Conditions can have serious consequences.
The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted
structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance,
and more.
The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special
Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your.compliance.
II. , Prior to the start of work,the following conditions shall be satisfied:
1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work
approved herein,General Condition number 8(recording requirement)on page 3 shall be complied with.
2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure
that all conditions of this Order are complied with. The applicant shall provide copies of the Order of
Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start
of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the
Commission prior to the start of work.
3. General Condition 9 on page 3 (sign requirement)shall be complied with.
4. The Conservation Commission shall receive written notice 1 week in advance of the start of work.
5. The Natural Resources Dept. shall be notified at least 21 working days prior.to the start of work at the site,
to inspect the areas for shellfish_ If deemed necessary by the
Shellfish Constable,shellfish shall be removed from the work area to a suitable site and/or replanted at the
locus following construction. The foregoing measures for shellfish protection shall ensue at the expense of
the applicant.
p.4.1
J
6. The applicant shall obtain a building permit for the proposed pier from the Town Building Commissioner.
III. The following additional conditions shall govern the project once work begins.
7. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with.
8. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for
compliance with the provisions of this Order of Conditions.
9. This permit is valid for 3 years from the date of issuance,unless extended by the Commission at the request
of the applicant.
16. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission
jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer shall be applied. Over-fertilizing
shall be avoided.
11. No creosote treated materials shall be used.
12. Deck plank spacing shall be at least one half inch.
13. A post-dredging bathymetric survey shall be performed by the project engineer and results submitted to the
Conservation Commission for compliance review purposes.
14. Work shall occur during the off-season only: October 15 through May 1.
15. Dredge spoils shall be appropriately dewatered and deposited in conformance with DEP Water Pollution
Control protocol. Spoils shall not be deposited within Conservation Commission jurisdiction without prior
board authorization. The applicant shall consult in advance with the Conservation Dept.regarding the
method of dewatering.
16. The seasonal storage of floats shall be at a suitable upland site. Floats shall not be stored on banks,marshes
or dunes.
17. No boat shall be berthed and operated at this pier(and its floats)such that at any time less than one foot of
water resides between the bottom of the boat(or engine in drive position)and the substrate.
18. Any desired pier lighting shall receive prior approval of the Conservation Commission or Department.
19. Lead piling caps shall not be used.
20. Work on the pier shall ensue mid-tide rising to mid-tide falling or as otherwise necessary to prevent the j
grounding of the work barge on the substrate.
p.4.2
IV. After all work is completed,the following condition shall be promptly met;
21. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a
Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C
shall be completed and returned with the request for a Certificate of Compliance Where a project has been
completed in accordance with plans stamped by a registered professional engineer,architect,landscape
architect or land surveyor,a written statement by such a professional person certifying substantial
compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in
the Order shall accompany the request for a Certificate of Compliance.At the time of the request for a
Certificate of Compliance an updated sequence of color photographs of the undisturbed buffer zone shall
be also submitted.
p.4.3
bt VIE rig Massachusetts Department of Environmental Protection
tom DEP File Number:
Bureau of Resource Protection -Wetlands
i YARNSTWM_ WPA Form 5 - Order of Conditions sE3-3920
�
9cb i639, `0�EDMpy� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
and Town of Barnstable Ordinances Article XXVII
B. Findings (cost.)
Additional conditions relating to municipal ordinance or bylaw:
see attached
This Order is valid for three years, unless otherwise specified as a special condition pursuant to General
Conditions#4, from the date of issuance.
Date
This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by
certified mail (return receipt requested)or hand delivered to the applicant. A copy also must be mailed or
hand delivered at the same time to the appropriate Department of Environmental Protection Regional
Office (see Appendix A)and the property owner(if different from applicant).
gnatur
On o Of rn Al �L(M:
Day Month and Year `
before me personally appeared
Qcj
to me known to be the person described in and who executed the foregoing instrument and-
acknowledged that he/she executed the same as his/her free act and deed.
Notary Public My Commission Efxpires
4 - This Order is issued to the applicant as follows:
❑ by hand delivery on by certified mail, return receipt requested, on
VJpaform5.doc-rev.2125102 MAY 3 0 2002
Page 5 of 7
1HEMassachusetts Department of Environmental Protection
��" ,. Bureau of Resource Protection -Wetlands DEP 39File Number:
WPA Form -- SE3-3920
5 Order of Conditions 9`b i639' Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP
and Town of Barnstable Ordinances Article XXVII
C. Appeals
The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject
to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of
their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions.
The request must be made by certified mail or hand delivery to the Department, with the appropriate filing
fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in
310 CMR 10.03(7)within ten business days from the date of issuance of this Order. A copy of the request
shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to
the applicant, if he/she is not the appellant.
The request shall state clearly and concisely the objections to the Order which is being appealed and how
the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands
Protection Act, (M.G.L. c. 131, §40)and is inconsistent with the wetlands regulations (310 CMR 10.00).
To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts
Wetlands Protection Act or regulations, the Department has no appellate jurisdiction.
D. Recording Information
This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in
which the land is located,within the chain of title of the affected property. In the case of recorded land, the
Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land
subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court
Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information
on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below.
Barnstable
Conservation Commission .
Wpaform5.doc•rev.5/16/02 Page 6 of 7
ofTay Massachusetts Department of Environmental Protection DEP File Number:
Bureau of Resource Protection -Wetlands
WPA Form 5 - Order of Condi i n sE3-3920
v � 2 O S Provided by DEP
1639. .0 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40
QED MAC A
and Town of Barnstable Ordinances Article XXVII
D. Recording Information (cont.)
Detach on dotted line, have stamped by the Registry of Deeds and submit to the Conservation: Commission.
----------------------------------------- ---------------------------------------
---------------------------------
i
To:
Barnstable
Conservation Commission
Please be advised that the Order of Conditions for the Project at:
86 Channel Point Road, Hyannis SE3-3920
Project Location DEP File Number
Has been recorded at the Registry of Deeds of:
U
Z
County Book Page
QLJ-
C9 UJ for:
Z Property Owner
LU
�y
ZN�
W and has been noted in the chain of title of the affected property in:
Q OD i—
LU Book Page
m
In accordance with the Order of Conditions issued on:
Date
If recorded land, the instrument number identifying this transaction is:
Instrument Number
If registered land, the document number identifying this transaction is:
Document Number
Signature of Applicant
Wpaform5.doc-rev.5/16102 Page 7 of 7
TOWN OF BARNSTABLE
BUILDING PERMIT
PARCEL ID 326 075 GEOBASE ID 24046
ADDRESS 86 CHANNEL POINT ROAD PHONE
HYANNIS ZIP —
LOT BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT NY
PERMIT 36533 DESCRIPTION REROOF/RESIDE/REPLACE WINDOWS
PERMIT TYPE BREMOD TITLE RESIDENTIAL ALT/CONV
CONTRACTORS: MICHAEL MCCARTHY Department of Health Safety
ARCHITECTS: P ,
TOTAL FEES: $25.00 and Environmental Services
BOND $.00 per
CONSTRUCTION COSTS $5,000.00
434 RESID ADD/ALT/CONV 1 PRIVATE •
• E ARN3TABLE, +'
MASS.
039.
D
BUILD D VISION
BY
DATE ISSUED 02/17/1999 EXPIRATION DATE
/- 2-
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map~ Parcel O 7 5 v Permit# �53,2_
Zctiv � ���q� I
Health Division Date Issued � �9• i
tian-Division Fee OG
Tax Collector- %-4kb a I ex .VN42RAJ `/
'
Treasurer I ` ' a
P6rk@-Dept.
Date-Deffnitiw-Plan'Approved by Planning Board 4
Historic-OKH Preservation/Hyannis -� a � ����� rr�.
.Project Street Address D G`In Ce n1t4_ C O pv RT
Village. ..,-,A,
Owner -FR f1 .s % ' dr ss '
� n /
Telephone I` c S1 d e r/'oc 4 f3CXct. �'�-�I e_ L-, Fit-
Permit Request / G � o L sl�1L 'e-a ro. U %v n all—
Y %;(-Q& -7
mc_7 Sam SIB ck^d
_�--fiSquare feet: 1st floor:existing proposed 2nd floor:existing proposed Total new
r Estimated Project Cost ���
t f Zoning District Flood Plain - Groundwater Overlay
Construction Type
rf Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation.
Dwelling Type: Single Family t - Two Family ❑ Multi-Family(#units)
Age of Existing Structure J Historic House: ❑Yes MVo On Old King's Highway: ❑Yes arlgo
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
1 Number of Baths: Full: existing �� new ® Half:existing new
c
Number of Bedrooms: existing new.
Total Room Count(not including baths):existing new First Floor Room Count
t Heat Type and Fuel: ZGas ❑Oil ❑ Electric ❑Other
i Central Air: ❑Yes - �A o Fireplaces_: Existing New r Existing wood/coal stove: ❑Yes ❑ No
j
I Detached garage:❑existing ❑new. size Pool: ❑existing ❑new size' Barn:❑existing ❑new. size
t. Attached garage:❑existing Q new size Shed:❑existing ❑new size Other:
t
s
Zoning Board of Appeals Authorization El Appeal# Recorded❑
« Commercial ❑Yes F3No If yes,•site plan review#
Current Use j� s'� P� i�l� Proposed Use S&q
BUILDER INFORMATION
v' / f
Name i G 61 CC�,f� PI C60- � ""Telephone•Number f Y7/ 6 S
Address 2 License# d ae'2 7
Go Law�. �
�a'-3 ? � Home Improvement Contractor 3o2-S
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 00_. rb CC G(
SI LATU GE
4 r
FOR OFFICIAL,USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS i VILLAGE <
OWNER
DATE OF INSPECTION •
FOUNDATION
FRAME
INSULATION . f
FIREPLACE
ELECTRICAL: ROUGH —FINAL-, n t `a a ,•
PLUMBING: ROUGH FINAL
1
GAS: ROUGH FINAL, i'
FINAL BUILDING ►� I �•_`'y� �# 3
DATE CLOSED OUT
ASSOCIATION PLAN NO. e `r
• .
i
Hyannis Main Street Waterfront
BAMRMM = Historic District Commission.
1679. ♦�
EDMP�6 230 South Street
Hyannis,Massachusetts 02601
508-790-6270--FAX:508-790-6288-
Hyannis Main Street Waterfront Historic District Commission
in the Town of Barnstable fora
CERTIFICATE OF APPROPRIATENESS
Application is hereby made, in triplicate, for the issuance of a Certificate of Appropriateness under
M. G. L. Chapter 40C, The Historic Districts Act for proposed work.as described below and on plans,
drawings or photographs accompanying this application for:
PLEASE CHECK ALL CATEGORIES THAT APPLY:
1. Exterior Building Construction: ❑ New Building Addition ❑ Alteration
Indicate type of building: House Garage D Commercial
['Other P& �'i`" ¢ /le-w UXr-4,Ja S
2. Exterior Painting:
3.Signs or Billboards: New sign Existing sign ❑ Repainting existing sign
4.Structure: Fence . Wall Flagpole 0 Other
5. Parking Lot D New Building [j Addition Alteration
(Please see the guidelines for explanation and requirements)
TYPE OR PRINT LEGIBLY DATE
86 CH&WQ Pi RD
ADDRESS OF PROPOSED WORK )4-1 AN N z S ASSESSORS MAP NO. 3A 6
OWNER '(N E M U AO-y -rA U / ASSESSORS LOT NO. 0)7 5
HOME ADDRESS fA(,KF*R b AJ� TEL.NO.56 73 9 6 a
M 3;Lr-dA'b MA 0)75-7
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS.Include name of adjacent property
owners across any public street or way.(Attach additional sheet if necessary).
RohML-bf A01EKSo�j 17C04NOEL PTI
1
lb& c48N;64, C'JU,
AGENT OR CONTRACTOR �� � TEL.NO. 7 WY,$`7(• 3 C 3
ADDRESS S7— R o G 4 LG--t40,/17ce.
C�a-3 Zv
DETAILED DESCRIPTION OF PROPOSED WORK:
Give all particulars of work to be done, including detailed data on such architectural features as:
foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters-
leaders,roofing and paint color, including materials to be used, if specifications do not accompany plans.
In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach
additional sheet,if necessary). _
' lop � T4 Io"sue w
02� roa r
a S y c.a,4' c.sa.,"1 w Lti: c 31 �. 5 y c5
( r &J'W
RE i>[ FRaN-r -i- B9-< K G w,f WH:2VIe CEDAR
Signedl` Owner-Contractor-Agent
RECEIVE
Space below line for Commission use
Received by HMSwHDC NOV 2 0 1998
TOWN OF BARNSTABLE
HISTORIC PRESERVATION DIV.
Date Time By
The Certificate is hereby:
Approved
Disapproved
r � .
Date
RAPORTA .If this Certificate is approved,approval is subject to the 20 day appeal period provided in
the Ordinance.
HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION
***SPECIFICATION SHEET***
tNliLl�L.JJ 17 Vl •awivua.✓":ivri.Y .._,_...... �_..,.....
a C hr A P FOUNDATION C 0#J C/t 7
SIDING TYPE VW N17 1 rC C f bA!� COLOR
No H,9A1(y CHIMNEY TYPE C (rX 15 T T U (y, COLOR (.
ROOF MATERIAL W N�1 f 3 TAB S H5A,�L f COLOR L— V1' f z
PITCH
WINDOW A��. CJ` 5 C��— �U u COLOR W tj P t
TRIM COLOR J.V �1 l
DOORS COLOR
� d
SHUTTERS
GUTTERS
DECK
GARAGE DOORS COLOR
NOTES: Fill out completely, including measurements and materials/colors to be used.
Three copies of this-form are required for submittal of an application,along with three copies
each of the plot plan,landscape plan and elevation plans,when applicable.The Plot plan need
not be "Certified",but should show all structures on the lot to scale.
PLEASE SUBMIT THE FOLLOWING INFORMATION AND/OR MATERIALS
WITH YOUR APPLICATION TO
THE HYANNIS MAIN STREET WATERFRONT HISTORIC DISTRICT COMMISSION.
THREE(3)OF EACH.IN THREE(3)SETS
APPLICATION:. All sections must be completed
SPEC SHEET: Complete applicable information
-lP'LGT PLAIN:- Show-ail-structures,an he-doted-an ,proposed - - -.
additions/changes. Certified plot plan for new homes only .-
�a
DRAWINGS: All Elevations and please include Landscaping plans for
changes in existing footprint and in new homes only..
ADDITIONALLY THE FOLLOWING MAY BE SUBMITTED: -
PICTURES: Of area(s)affected;Street view for additions/changes.
SAMPLES: Of materials/colors(i.e.color chart)
THE FOLLOWING FEES MUST BE SUBMITTED WITH THE APPLICATION UPON
FILING MADE PAYABLE TO TOWN OF BARNSTABLE
r
CERTIFICATE OF APPROPRIATENESS $20.00
CERTIFICATE OF EXEMPTION $10.00
CERTIFICATE FOR DEMOLITION OR REMOVAL $10.00
IF YOU HAVE ANY QUESTIONS REGARDING APPLICATIONS PLEASE CALL PAT ANDERSON
AT 790-6270 BETWEEN 8 A.M. AND 12 NOONM-F N14,,, �-��
-
;7ax� �w.nrftr ac my xet ns s..
:sms,:a�aela�roc �°":ittYfs�7Vm.
r.:ts�3ayif7c.�tSett3 �e�et.��sa.��a¢a�
;at6¢05:;Sala1�N� <' itJ�ShL15SnS85k:.
39¢F45��.::a:iSC3112C. - '3�E&�E':9HO�tYi�
.a9015ti::i&3�i`IL¢9Sfl's5t'' i ''�`L'd�Ci.1�1�"�-'7 NSd5a
oObog � 3iG1�IGiD!'AS�9uYl Si.
nXu7LG3afi:ta2mams: 0735i1t� Ff �efli9
'Nadia`umms" B:S�ii369Y0 Y0i07Ec�L
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�*'i ,' aitliri�atli!!' gp;at¢i)la
� i4' a4¢an��ata ra :�a�aa
� u rmntr tip xa�i �`
s The Town of Barnstable 0
m Department of 11=lth Safety and Environmental Se""
.., Building Division
367 Main Strom Hyannis MA MII
` Cra =
MR= Mg•790-6=7 �k
Far SOS.790-mo
For ofIIce use only
Permit ao.
Dare AFMAVIT
HOME nWPROVEMEIVI T•CONT11ACMR LAW
SUPPLEMENT TO PEIiMrr APPLICATION
MGL a t42A req uires that the "reconstracdan, siterztfons, reaovatton, repair, modemb tion•
conversion improvement, removal, demoMon, or construction of an addition to any pre-ezistiag
owner occupied building containing at least one but not more than tour dwelling units or tc
structures which are adjacent to such residence or building be done by registered contractars, with
certain C=cptions.along with other requirements.
Type of Work: Rf 9 00 F R�"S' G)q$L£S Est.Cast 5>
WQTO S
REPi�c Nam P,-)— Roo WYANN25 riA
Address of Work: �A
Owner's Name
� u�►R/�� T('lUs 1
Date of Permit Appil=tion:
I hereby certify that:
Registration is not required for the foilorning reason(s):
Work ezclnded by law
A, ' Job under 5I.00L
BuiWag not owner-oeeapied
owner pniIIag own permit
0WMMpuI�G� O`VN PERMIT OR DEALING WrM UNREGMTERED
O
CONZIIACTj3HS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO TSE ARBITRATION PRO G.W1 OR GUARANTY FUND UNDER MGL a.I42A
,,G= =ER pWALTIFS OF PERMY
I hereby upiy for 2.pgrntitthe agent of the owner.
Dam Cantrscsor lame motion f
OR
pwnees Name
I)SIe
. _�� The Commonwealth of Massachusetts
=- - - Department of Industrial Accidents '
0/flco oi/orestigat/oos `%%
600 Washington Street
"--- I Boston,Mass. 02111
Workers' Compensation Insurance Affidavit
name: 1V1% "X 2=oL— i l � �" �/
location: �5-o. al Y,�-L4 .5
city 12o-t 41&-tA /11 -, a 1;Z-2 `z C- phone# ?1?1 , 1 7(•(`3 G-
❑ I am a homeowner performing all work myself.
(9-I am a sole" rietor and have no one workingm' capacity
/G%��%% ///%%%%%/%%%%%%%//G%%%%%%���%%%% %%/%%%D%%%%%%%%%%%%%%%%%%%%%%%��/%//%%%%��%/O/O�%%%%�/%///////O/�1�''��011/�,
❑ I am an employer providing workers'compensation for my employeeXXXs working on this job.
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❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have `-
the following workers'compensation polices:
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in an name. .:.
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Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 zm/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
I do hereby=71,1
certify and penalties o perjury that the information provided above is trw.and tarred
tare r� /oag"sigmaHate < .
-1�1Print name G/Ce t /� /� ? -� 3
Gt z- � `- ,,/ �T Phone# 6-i! `, / .�
official use only do not write in this area to be completed by city or town official
city or town: perndt8lcense# ❑Building Department
OLicensing Board
❑checklf Immediate response is required ❑Selechnen'ss Once
. ❑Bealth Department
contact person: phoned; ❑Other
Ormed 9ro5 PJA)
® Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the "law", an employee is defined as every person in the service of another under any cots -" ,
of hire, express or implied, oral or written.
An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: c-
trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant,who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority. ,
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you
are required to obtain a workers' compensation policy, please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address,telephone and fax number-
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Oftice of Imlestlgatloas
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
phone #: (617) 727-4900 eat. 406, 409 or 375
jig
DEPARTMENT Of PUBLIC SAFETY "
`< < CONSTRUCTION SUPERVISOR LICENSE - I'
ti0K€ IEIHbVEt1E�# CIQB C t.
Number!
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MICiRELyP, CCRi4i � MICHAEL P MCCARTHY !, i
' 586 LIBERTY ST i
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ROCKLAND NA 01370 € .
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+10 14' X RAMP
EXISTING ELEV. 7.0' STAIRS 2-15' X 10' FLOATS ; " "
m �"`"y. a'r' '.e
BULKHEAD
ELEV. 5.0 4
R ,•
f y}
. MLw 0.0 �' h�^- ,� 1i�7
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a�
. _ . _ . _ . _ . _ . . _ . ._ `_ . _ . _ . _ . _ . � . _ LOCUS MAP
PROPOSED DREDGING TO -S.0 MLW NTS
-10 I C✓C.ifXISnN0 &Orr A
1 BAY • J ! ROF/�E
ou
9' OC 3 BAYS ® 12' OC = 36'
50 100 150
m
DOCK PROFILE
10 0 10 20
SCALE IN FEET
SCALE 1 "=10'
HORIZONTAL & VERTICAL
4.0 4" X 4" HANDRAIL (OPTIONAL)
-9.17
-14.42 existing Wharf 2"X 8" DECK (WOOD OR SYNTHETIC)
tau`a�t �BaXtersl - ( )
°X�Sti hp 1" SPACING TYP
tln9 rog 14.33 -14.84 ng w ,�
ec�s 3"X 12" JOISTS
-14.34 3„X 8"
ELECTRICAL SERVICE • -- . WATER SERVICE
-13.72(for outlets & lights) • •
•
•
2"X 10" CROSS BRACE (OPTIONAL)
DETAIL A A
N.T.S.
10'
0
-- TOP OF PILES = EL 12.0 ML W
a.
J W
z Q M.H.W. = 3.3'
. a
Q
Jr
U � 00
j y 2 .M.L.W. 0.0'
00
gm
z
zg
oa
0
to
rn
PROPOSED DREDGING
EL. _ -5.0' M.L.W
HYANNIS INNER . HARBOR
FLOAT DETAIL B-B
N.T.S.
x -13.4
x -13.3
--13.7
x -12..8-10.0 x -10.2 x -10.8
x --11.3
Y. -9.8 x -6.3
x -8.7 %• -8.5
-5.5 r: -8.1
ZONING DISTRICT: RB
4
x -4.
-4.1 x -4.2 x -4.8 OVERLAY DISTRICT: AP
x -3.0 -3.4x -5.1
x -4.7 g�• - ■ -3.5 BUILDING SETBACK REQUIREMENTS
MOORING FRONT= 20 SIDE= 10 REAR= 10
x -4.6
x -6.7
• -1.2
MOORING • 1.2 LOCUS PROPERTY IS COMPRISED OF:
W _ x _0.7 -1.0 Edo°t1�9 d° ASSESSORS MAP: 326 LOT: 75
-2.9 y x e W c DEED REFERENCE: BOOK 6942 PAGE 176
-3.8 x -0.8 1.4 x _0.9 4 PLAN REFERENCE: LAND COURT 7615H & T
X X -0.8
-0.8 -0.7 : 7.1
x -1.7 . r. -0.8
0.1 COMMUNITY PANEL NUMBER 250001 0006 D
F.I.R.M. MAP ZONE A9 & B
' 0 vvOp'( _. 0.0
DATUM: MEAN LOW WATER
Z .3
.1
1.8 �. ALL UNDERGROUND UTILITIES ARE APPROXIMATE AND
�. k -0.5 0 F�°P� x 1'0 W SHOULD BE VERIFIED IN THE FIELD PRIOR TO ANY
1.3 f. i �• CONSTRUCTION BY THE CONTRACTOR
r
aio 0. 3' X 14' MP cP
4 0.8 3.0
°per �° 0.5
,a f a 1x P�ZN OF Mq,
o a 3.0 / �c�, 'k
1.5 1.0 i' aoe .• o�' o
604* EPH 1.6 STAIRS FOR ,-�.� e
1 °Lr9 x 0.8 LATERAL ACCESS 6 7.1
wide . 0216 "'
XRE.0 REMOVE 3• 4 2 T" - A9or9 STE�c�
q fSTING 3• 70 86 Channel Point Road Fss/ONAL Ems`
.B of slope 1.8 .5 8 '
1• e of bea h bottom n 1.14 .1 ✓-" I/� Z
ed��,,,,. l'2 E STING BULKHEAD 0.8 ---- Hyannis, D
SE3-1524) 2,1, r •83 r''-"�-M gg H y i , Massachusetts
2.0
0.9 2.3 `- �•1. x g, - PREPARED FOR
4� _.'2.5 1.01 ' ;;: 11.2 10 - The Murray Trust
o^ •7 10. 1.8x 11.2 f� 10.2 aw
12.1 �` -M..�-.. TITLE
�..
12-7 r
�� `� PROPOSED DOCK DREDGING
7.5 12.9 f r` 1.1
5.59ovelo 12 - Baxter, Nye & Holmgren, Inc.
Registered Professional
_ i f f y15 66 , �85 Engineers and Land Surveyors
00 �� �` 812 Main Street,Osterville,MA 02655
9, 13a8 Phone- (508)428-9131 Fax- (508)428-3750
215 �t �
� 4
14.82
5•13 20 0 20 40
SCALE IN FEET
0 a SCALE:1"=20' DATE-01/08/2002
AAA REV. DATE: REMARKS
0 1 -1- 1 16 02 Rev. As Per Client col
DRAWING NUMBER
H:\2001\2001 -039\survey\worksht\2001039WPP.dwg
JOB # 2001 -039
2002 92 :2£ :01 91 UPr paM 6Mp'ddM6£Oti002\1USMJOm\Al AunS\6£0-iOO2\1002\ :H
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,fT
4�' r{� t 3 {ir{{r( •a 0 :a .:q�yy44� k�.a xf" rvz_. r�e °
+10 14' X ' RAMP y ^,`* • w i
EXISTINGOA
2-15' X 10' FLOATS
STAIRS
BULKHEAD ELEV. 5.0'
..
0 MLW = 0.0 't M1�rr • r }rw �Y I laic
SEE DETAI �' ;.«r .'• R t f �. ��
-r ,
• • - • - • - • - • - • • - • - - - • - • - • - • LOCUS MAP
�ROPO$ED DREDGING TO -5.0 MLW NTS
exsn
I NO BOTTOM P
-10 1 BAY ® I ROFI�f
9' OC 3 BAYS ® 12' OC = 36' --�j
50 100 150
m
DOCK PROFILE
10 0 10 20
SCALE IN FEET
SCALE 1 "=10'
HORIZONTAL & VERTICAL
4.0' 4" X 4" HANDRAIL (OPTIONAL)
-9.17
-14.42 2"X 8" DECK (WOOD OR SYNTHETIC)
t �gaxterg� gc existing wharf
ex� 1" SPACING (TYP)
tO"'ar" Sf�n9 wharf
-14.33 -14.84
eitsZtnq yes � 3"X 12" JOISTS
3,rX 8rr
-14•34 ELECTRICAL SERVICE 0 . WATER SERVICE
-13.72(for outlets & lights) • •
.
s
2"X 10" CROSS BRACE (OPTIONAL)
DETAM A-A
N.T.S.
10'
0
o - TOP OF PILES = EL 12.0 ML W
o:
z �
o_
JW
w ¢ M.H.W. = 3.3'
za
z
v , UU-) 00 L--j Ll
_
j Y Z . .M.L.W - 0.0'
p0 0
gm
z
zg
o a
0
co
0)
PROPOSED DREDGING
EL. _ -5.0' M.L.W
HYANNIS INNER . HARBOR
FLOAT DETAIL,B-B
N.T.S.
x. -13.4
-13.3
-13.7
Y -12,8-10.0 Y -10.2 r -10.8
x -11.3
<. -9.8 u -8.3
:< -B.T x -8.5
-5.5 -6.1 ZONING DISTRICT: RB
-4 -4.4 X -4.2 -3
x -4.8 OVERLAY DISTRICT: AP
.1 � x .4><t -4.7 -3.0 -5.1 a -3.5 BUILDING SETBACK REQUIREMENTS
MOORING FRONT= 20 SIDE= 10 REAR= 10
x -8.7
MOORING -1•2 00 1.2 LOCUS PROPERTY IS COMPRISED OF:
k _ �%o -a.7 _1,0 f�oo<`n9 do°k ASSESSOR'S MAP: 326 LOT: 75
_2.g y X 6r w;ae o DEED REFERENCE: BOOK 6942 PAGE 176
-3.8 X -ox 1.4 X -0.9 / o
PLAN REFERENCE: LAND COURT 7615H & T
0 7 _ x -0.8
'. N '
7.1
n _�,7 -0.8 r 0.1 COMMUNITY PANEL NUMBER 250001 0006 D
�Sx�O• F.I.R.M. MAP ZONE A9 & B
0 vopA _ 0.0
- DATUM: MEAN LOW WATER
0.3
ALL UNDERGROUND UTILITIES ARE APPROXIMATE AND
1.8 -0.5 FLOP •a SHOULD BE VERIFIED IN THE FIELD PRIOR TO ANY
CONSTRUCTION BY THE CONTRACTOR
a ? 0. 3' X 14' RAMP cr
0.5 0.6 3.0
OF A
a /0 . 3.0 ,�
�� 1.5 1.0
aaeo� EPH y
oo� 1.6 STAIRS FOR a i�
°9 d X 0.8 LATERAL ACCESS i Ei 7.1 0216 y
• � e
1.5 6 \ 1. v o xR 1-0 3. 4.2/f ~- o�
3o EXISTING 3• 7.0 86 Channel Point Road FSS�ONAL E '/
1. .8 d e of beach/bottom of slope x 0.8 .14 •� .5
EXISTING BULKHEAD .03 ---- Hyannis, Massachusetts
(SE3-1524) 2.1 ., -.._. " y
A.
{ 0.9 2.3 •1- , PREPARED FOR
�� _�. f�--_1 • ,,. „•� ; �.___.__ - ,0 _ The Murray Trust
�. J 2.5. 1.01 11.1 co 10.2 a
10. 1.6 ; 11.2 4
0 S
,. oo TITLE
`" PROPOSED DOCK & DREDGING
r" -.-
7.5
337/73 g
5.590<0', 12 1'V
Baxter, Nye & Holmgren, Inc.
i
ex,SU�g� Registered Professional
"°1y 68 �e5$ Engineers and Land Surveyors
812 Main Street,Osterville,MA 02655
i9 13.76 � Phone-(508)428-9131 Fax-(508)428-3750
! 4 VL
5.13 20 0 20 40
14.62
SCALE IN FEET
€ p SCALEA"=20' DATE 01/08/2002
E go
REV. DATE: REMARKS
-1- 1 16 02 Rev. As Per Client
a� 55 4 Col
ti
J DRAWING NUMBER
E �9 H:\2001 2001 -039 surve worksht 2001039WPP.dw
JOB # 2001 -039
I
f
2002 92 :ZE :O>; 91 UI?P P@M 5MP'ddM6EO6002\;4SIJ0M\A]Au 1S\6EO-60C,~ ,;O�. �`