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HomeMy WebLinkAbout0076 COMPASS CIRCLE _ __ � 1 - � t ID LI) i 298700 V05 t 5 0f 5 Town of Barnstable OF'THE hy, Building Department Services Brian Florence, CBO DST Building Commissioner BARNSTABLE, BARNSTABI,E * 9 MASS. �irvn=a�.n 3�'�m-cm-`�u iss eiF i639 ,�$ 200 Main Street, Hyannis, MA 02601 1639-2014 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 AAAP Report To: Anna Brigham, Principle Planner From: Brian Florence, Building Commissioner Date: 10/31/2018 Re: 76 Compass Circle, Hyannis, MA Building Official: Brian Florence, Building Commissioner Inspection Date: 10/19/2018 Bedrooms(Unit): 1 Minimum Size: Fail Emergency Egress Windows: Fail Window Height: Fail Number of Egress Doors: Fail Smoke/CO/Heat Detectors: Fail Tenant Separation: Fail Egress Component(s): Doors Fail Stairs/Deck/Landing/Balcony: Fail Guard Rails/Hand Rails: Fail Egress Path to Area of Refuge: Fail Notes and Other Compliance Requirements: The inspection conducted was a,pre-construction inspection of an unfinished basement. Component failures of the space is to be expected. In order for an AAAP to be established the owner will need to construct an apartment. Difficulties associated with the apartment include, headroom (this will require a variance from the Commonwealth—Board of Building Code Appeals),tenant separation,two means of egress from the space and an emergency escape window. But with a variance and some specialty construction for tenant separation and egress components the space should be adequate for an AAAP The building components listed above do not represent the totality of 780 CMR,the Massachusetts State building codes requirements. Other Code related matters may be listed as Notes and Other Compliance Requirements(above)and may be included on a separate page where needed by the code official. gY CERTIFY T�l�T MIS.FOUNDATION t LOCATED'ON'.THE L()? AS.S w. UF;elF:l.GN�srAt.St� - NS.REGAitpIMt3 SETBACKS fRObi'',$TREET. LINES AND Q LINES, ol T � d 24 k H Q, ' R- irko .; I i tv 1 o a J Engineer;; Map 7,3 1 rj Parcel (40 1 . Permit# 3�'� i House# c0�6 Date Issued 3 Blkd of Health(3rd floor)(8:15 -9:30/.1:00- ) Fee Congervation Office(4th floor)(8:30-9:30/1:00-2:00) - 9 Z Planning Dept. 1� t floor/School Admin. Bldg.) INSTALL 61 � ;,r i�a� 1T1 lTim Definitiv Ian A roved by Planning Board 19 6�R+S11V��9� ; t LE. ION REGul,� TOWN Ok-BARNSTABLE ' Buildin Permit Application ' Project Street AAdress 76 co M pA'S S 6'1 Village ` i Owner M 14 gy h o t-Tom <`� Address Telephone " -7 -Permit Request U 2` (�1 P 01T'!o N FX is T ( ED 1P- o First Floor Q Z.. square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size l O, 1 (00 Grandfathered ❑Yes ❑No Dwelling Type: Single Family 0--�Two Family p Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Leo On Old King's Highway ❑Yes 6<0 Basement Type: ❑Full ❑Crawl ❑Walkout . ❑Other,A , Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing �_ New No.of Bedrooms: Existing ' New '. -w Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other Central Air p Yes 2<0 Fireplaces: Existing New 5 Existing wood/coal stove ❑Yes 610 Garage: p Detached(size) ��� �( Z Z Other Detached Structures: ❑Pool(size) ttached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization p Appeal# Recorded❑ Ceinmercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name �1j, -�� 1'f -'r l Telephone Number 50- 46" 7 7"3 ( 4 8 Address 76 ��� Ca0 17 License# 05-6 S'60 4 Z 6 Home Improvement Contractor# 1 Z 1 1-7 1 Worker's Compensation# V A , 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 0 �� SIGNATURE DATE T a BVII,DING PERMIT ENIED FW THE O LOWING REASON(S) FOR OFFICIAL USE ONLY _ PERMIT NO. is - _ - • � � ' - .. - ,;r...__ � ' .. _. �' . DATE ISSUED MAP/PARCEL NO. ADDRESS .VILLAGE OWNER DATE OF'INSPECTION: FOUNDATION i k FRAME ` (0 17 INSULATION " %� �3 g' 7. _ _ # FIREPLACEy - Z� ELECTRICAL: ,_ ROUGH; FINAL r PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL FINAL BUILDING DATE CLOSEDOUT ASSOCIATION PLAN NO. » t f 1 s I '•r , i f I . x s _ � p a o 3 �-- --- I A ; I t � I Li t 0 c•� 0 �o�1'oN ��sl1��t�rJE ADD�11bN -1'0 �xI�t1NG� �B���ooM 91�619a R,A,� cb M F A5S :c,rt �I Y A�1N15,t�A;otbor ^Q- Isli JL- � � o i i 60L.IrOA ADnr�(ioN -ro l?i6fK& WUOM lhilia 12AF, ,� cAMPA�S ci R L9r1' 519E EL NATI0N 'INLI'-o" LA }�IA-NKN7,M , OZLZI I �1 C�1 ' 4 �-- - - -- gbt,TOh( RE51 DEN;f AVD1110N-'r0 f,X6-fIN6r 15�jofDOM g116h6 CAA ,e CoMPt c�R_ BURR 419W gt6VA'f16N ���-I'�i" 5 F{l�gN1115 MA, d2.b61 - I s � R� o UN L S f' _"c yZ- sz s N C � S i5; CD o t cz� o, G 1 ' - �� S I �► r ' 00UrON (991DMC9. PrDlDlT1O14 Jr0 9M5TIWA BEDROOM 1116118 U.r, �6 co Mr s ciR. rLOOR PLA1,1 0" H6rl =°I-�1�AN�uS Ma a2�bl 2ko Po �{n N SII \it a A 1 C� 1 � l ✓ �Ci- p� d;C mr— o UOD =_ dl P s -cazy �P! �► o� 414 vs� mkz vp L •� CD OO CD P t c is <a zj\ .1x z .Z.+�C'.�' rn. �d o3 bXs P01,T0N MO1iGE NUOITION --'6 EX15flO CfDOOM_ qA6 98 RA - � -�oMPA%.c,1�,- _ C.I�055..5 G110N I tivl A�A _ 114"iv, 50F 6 r sFlo 4 Ln T-7�a LN it cat gN � r o a � rA o W v � T if Ito-011 gouroni kolD�Nbg AvornoN m 6Xi5riN(A- omwom molib R,Afr, �� eAMnASs e�� (I,�D& �'KAMIN�(x4 �oaflNbr P(, Tl 106r6 N Y RKH15� M A,o 21d71 �k x4 1"Min,air space clearance to enclosure 49°'. f' min.window placement; ROUGH FRAMING DIMENSIONS 42—min. recessed • NOV ": height - 345/8"; cavity depth - 195/8"; width - 35". shelf or Ma�tet inoperable NOVUS 33": 1'ight - 345/s"; cavity depth - 19518"; width - 38:. window CLEAR TO SURROUND/COMBUSTIBLES , i Min. (height • Minimum window height - 49" , minimum mantel height - 41". 345/e" • Minimum recessed shelf or frame of inoperable window height - 42"*. ! P • Top of standoffs - 0"; Floor - 0"; Back and sides of fireplace - 1/2"; 195/ Ceiling - 30 CERTIFICATIONS 8----. • Certi ied or fnstallcrtion in bedroom bed sittin rooms and mohile homes.` O --v2° .f__f _ -_. _ / _ _g • Consult local building codes for local installations and operational guidelines. GENERAL; CONSIDERATIONS Model A B1::& r• The roughframing dimensions shown above represent the 30"Series 35" 341/8 distance from stud to stud only and do not take into consid-i 33"Series . _38" 3G1/4" 511/4" eration the addition of sheetrock/drywall. - • The top header may touch the standoffs, but the dimension shown here allows 1/8" to position the fireplace if framing is constructed prior to the placement of the unit. • For best results, do not construct the framing until the unit is in place. • A hearth extension is not required. *These dimensions can only be obtained by using a TB2 low clearance vent kit. q tau 26'Max. --{ ® ® ® 16' I Soffit H - Venting can ' only terminate 18°Min:from HORIZONTAL TERMINATION CLEARANCES 25'Max. within this ventilated soffit; 12'Min.from • 3" clearance required above horizontal vent; 2" clearance required area. unventilated above vent when using a TB2. 2 soffit • 1" clearance required along bottom and sides of vent. Min. Min.to „ t top of • 1 clearance required around the vent on vertical installations. exterior hole o Maximum horizontal run in horizontal termination: 26'. .-163/4„Min",— • Maximum vertical run in horizontal termination: 25'. 3'Max. Standard horizontal termination " • Required rise: 1/4"for every 1' of horizontal run. • Required vent supports: one support for every 3' of horizontal run. soffit • Required pipe overlap: 11/4° ail Min.from ventilated • Effect of additional 900 elbows: reduces maximum horizontal distance by 3'. soffit;12"Min,from unventilated soffit` • A standard horizontal termination requires the top of the termination cap to have an 18" minimum clearance to a ventilated soffit and 12" minimum 63/4" 42° clearance to an unventilated soffit. to top of exterior VERTICAL TERMINATION CLEARANCES hole •. Maximum straight unsupported rise: 25'. 141/4 NIm. ' • Maximum height: 40'from the base of the appliance; minimum height: 12'. ``217/e°Max• Horizontal termination using T62 � • Every 1' of horizontal run requires 2' of vertical rise. s � re- -4 00 o � z � o - 0 60L-foN f,951v9R65 ADDi11oN -r0 EK1�1'ING� B�D�ooM g1�619a R,A.� 7(o Ga M F A5S -OLf k +�YA�IN�S,rlA,ozbo� �Kot�rv��1N ����A�101�1 CR � O Isl- c r — j . I . j AVOI-009 -tro WC flg& YOM* 06116 IZAF, 2,o�6 l�Y A�N,�t15,1'�iPs. bL(�61 a . i EI I ! ! t I l -7ri T'*L��tt-tZj F KE51 P91ACZ AD0I-rlOt4'r0 -&MY1INGr IM0160M 17/16198 CAA F�1�AK111`� ?�1A. 62.b61 X 91 cT, 3 r _ %N _ L C z I —'.<3 3t CiQl � o W � A --- � n &1,70N (991DSNC9 Afford 04 -`ra EX1511N6t f�D900M 1116118 R.A.r, rLooR PLAq ��`=1'o'' N6r1 _. I-�Y�Nt1l5 M14, aZlbl a1 dz. i� hJ Ne a &fit - a t N in z,�l -To dim %r- Z. r�W� �I Q S G �rCS- Z p�S N. ( 1 � ZOAt %: Qmy a xa ,I a LA TV cn b 7es Z _ 01.101�_ �5lD��GE _ AUOCTION --0 EX15U6c MOO q/,o 98 R�A� 61 � s�4 9 X-�F ccr ' a SK G r l�? aR u1 C i Z , W=b" s (�ot,�'oN, ��51 D�N�E � AvO1TtoN�'0 �K15�'INGr 13�1JROof�i 9/ial9b R,�,� �ID CAIOO65 alto (L60& rKANWur4 rOOflN6r r&N 'Nt5l--6" 106rL NYA�ruS� Ms,o2LDi I ;; "•, 1"Min.air space e;`e1V'1l n # clearance to onclosure 49" min.window placement; ROUGH FRAMING DIMENSIONS 42"'min. recessed • NOVLIS 30": hii,�ht - 34'/,ti'."; cavilt/ d"plh - I)''/,ti"; 70ir(111 - 35 1 shelf or Ma�10 inoperable it __ `� . NUVLIS_ 33 rci�ht - ,34'% ";'iliz illj ili pllr - IJ''/s"; zc irijli-3ti": window CLEARANC TO SURROUND/COMBUSTIBLES Min. framing • Minitrrurn zoindoul 49"*; nrinirnnrrr n/auh•1 hciNltt - 41 • MirrirrrntrI rcc�cssed sh"If or frautc of inop"rahl" zniudozn lu'i;,Irt - 42"* �! P� • Tot, of standoffs - 0"; Floor - 0"; Rack and sides of l7riplace - 1/z"; is�/ Ceding - 30" CERTIFICATIONS �—B Ccrlitirrl"f„i i7r lirllnlir,ri in fi,Y;(r,,,;nr, Inv'1/sillin� iooru; null rirobile Itunrr�.� Consult 111c'al huildhi,, codas 101- local inslallatiuns Hurl ojrc'rotionrrl �uirlrlinis. GENERAL CONSIDERATIONS Model n B C ° "1'Iri rou1h frnruin1> diurinsions shozon above rcpresc'irt Nre 30"Series 1 35" 1 341/8" 48t/4" dishntcc /"corn slrrcl to Stull "rill/ ant' rlo 11"1 luk" inl" ccnrsid-�33"Series­ 38 36'1/4" 51'1%4"'N cratzorr Ntc atlditiorr "/ slrc'c'trn�k/rlrt/znrrll. '1'hc lot, header' hurl/ tozrclr the Slunrluf/s, Irrrl the rlirnc'usiorr slrozon Irc I-c till"zos r/S" Ill position Ilrc firc'jrluce i/. rrrurin is c"rrslr 1 ' , -' , ; uc cd itc r Ic llic laccrnrnl u � . I ( J Ihi urrtl. • For hest r"sulfs, Ito not iunslru"t llrr lrrrruin;, until Ih" rural is in plac". ° A IIir7Yth extension is not rcgnired. *These dimensions can null/ hi obtained by using a TP2 Into c`II•rrrrrnrc` 7WIll kil. w '` - 26'Max. ® ' ..' 0 16"-•—• Soffit \ Venting can HORIZONTAL TERMINATIONCLEARANCES 25'Max. \only terminate 18"Min.from ventilated soffit; within this 12"Min.from • 3" clearance required above horizon IitI vent; 2" clearance rec aired area. unventilated 1 above vent zvhen using*a 7'132. - soffit 21 12" 481/2" • 1 " clearance rquircd along hotthrrrr and sides of vent. Min. Min.to f top of • 7" clear'ancc rrgnirctl around Ih" veal on vc'rlic'trl inslallalions. exterior hole • Maximum horizontal run in horizontal Icrrninution: 26'. 163/4"Min.,-- • Maxinturn vertical run in horizontal h'rnrirratiort: 2 5'. 8'Max. Standard horizontal termination • Rrgnir"i! list: 1/4"jirr rvcrt/ 1' a/�horiznrrlul run. • R"guircd vent supports: one suppor-t far evict/ 3' of horizontal rurr. Soffit ° Regrtircd pipe overlap: 11/4" t 18"Min.from ventilated L,fji'd of additional 90' ilbozaS: rcduccs nuaxiurnrn horizontal distance bi/ 3'. soffit;12"Min.from unventilated soffit • n standard horizontal Iirurittatiort rrltuiris Iltc lop of the lcrutinafion cap to havi.rin "IR" rnininruur ilcarancc to it vinlilaWit soffit and 12" Ill ill i Ill lrill 63/4" 42" cicartnlcc to all nuvcnlilirlid soffit. - to top of exterior VERTICAL TERMINATION CLEARANCES Hole • Maxirrrtrrrt strrri,011 unsupported rise: 2 5'. 141/4"Min. • Maxirnuru height: 40' from Ill" has" of the aptrlittnci; rninintuur hci;,lrl: 12 . 217/8"Max. 1-:sell I ' " 'horizonlal rrtu rcr uires 2 Horizontal termination usingTB2 ,l l j ' "/'v"rlical risr. ' I u� :`. °r. fi=W.T '��"'"�•* + - `-r. p F �T °� ►�' J �iFo TOOaJalflO9t ✓�faa�aci4uae�2J�cc�utelld r HOME IMPROVEMENT CONTRACTOR DEPARTHENT OF PUBLIC SAYS TF ` a Registration" 121779' CONSTRUCTION SUPERVISOR LICENSE Type - INDIVIDUAL r � t� � _ ,. f Number: Expires: 1 I iv,` , Restricted To: 00 RICHARD A. FITZPATRICK - -- a 70 EECHWOOD DR MA 026�9 G��aw,co RICHARD A FITZPATRICK { HPEE +►�ADMINISTRATOR 10 BEECHWOOD DR , ka I ?° N�SHPEE, HA 02649 I Tlie Conrnu n-caltb of Massachusetts �. '�_•" '' ' De arinzent of Industrial Accidents 600 !f aylli igion Street Boston,Mass. 02111 Workers' Compensation Insurance-AffidavitHOW in _ '•'— NT'lc tbiv• . . . J n.�IDt: 1� �Ci��lr1<✓� �1TyQTS�!� � -— /location -10 Get" � o�� �`�•• �f G �t rl I am a homeowner erforming all work myself. �1 am a sole proprietor and have no one working in any capacity 0 lam an employer providing workers' compensation for my employees working on this Job. city: phone#r • neficv# . inatmince co I am a sole proprietor,general contractor,or homeowner(ctrde one)and have hired the contractors listed below who i- the following workers' compensation polices: COMDanv address: phone#- insurance co neiicv# - _ �-- - � -:--;�-•.--- re,..ar+�..sawr'n*'s'r'r"T�'^si"�rFs �IAr °,�''��'�." COmIlinv na e• ad ress, .h phone#- "grance co. :Attach additionat•sheet irIIteWtir ,, '�"� i w*��- �� •"'r' rt s�� ~�'. failure to scare coverage as required under section" of AIGL 152 can lead to the imposition of criminal peawdes of a line up to SIS00.00 and une years,imprisonment as well as civil penalties is the form of a STOP WORK ORDER and a.Qtte ofS100.00 a day against me. I understand the copy of this statement may be forwarded to the Orrice of Investigations of the D1A for coverage verification. do hereby certij•unr • Nye p 'ns a d penalties ojperjurr that the infomutdon ptw►titfed above is true and con%ecL / Date9z /(?(g Signature of r OAP Print name 9 hone# ofticiat•use oniv. do not write in this area to be completed by city or town oflit ial city or town: permitBieense# illuilding Department Ot.ieeasiag nluard check if immediate response is required011 ea p Department phone#: —Other_ contact person- t information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for employees. As quoted from the "law", an empint►ee is defined as every person in the service of another under an% contract of hire, express or implied. on. or written• `!�a' ...,}l..�.S t ^;'fit� ...- •'-..i �. Ye '�,'. �. �P.,�, +'i '! An enrplore►r is defined as an individual. partnership, association, corporation or other`�eal cnttty or any two or n ,the f0cuoina engaged in a joint enterprise, and including t'lie legal representati%.cs of k Jcccascd employer, or the ' 'rccci,er or trusiee of an individual partnership. association or other'legal ent,ity,,emplayinfi em.plovees. However owner of a dweiIinL house having not more than three apartments and who resides thereik or the becupant of the dwc1lin house of another who employs persons to do maintenance, construction or repair wort: on suptl d�veilin or on the ;,,rounds or buiiding appurtenant thereto shall not because of such employment be deemed to bean emple c 2 ,,• '' also states that every state or local licensing agency shall withhold the issuance or MGL chapter i S_ section _5 _ g g P g wealth for any • ' too crate a business or to construct buildings tlrc common renewal of license or permit p � 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 chapt: been presented to the contracting authority. t �•. -._+...��.. r�w+.�. ,�. 'f.t;:�.t: . .��+a'::. ... W• j^� �.�J.C,�J• 4.'.•n �.'w.:�.i.Y '5.Fi }"J•l..:a►� ::''e• • Applicants Please 911 in the workers' compensation affidavit completely, by checking the box that applies to your situation an supplying company names. address and phone numbers 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 tiie Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are requi: 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 bottorr the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. F be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be mt=E 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 quest: please do not hesi gate,to�;;i�►e us a call. r .:..�., R. ...•�.. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts `s Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhone #: (617) 7274900 cst. 406, 409 or 375 r � nF SkF T� The Town of Barnstable + BARMABL& + ' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. / /' �y / Type of Work: L�4!P�{ s���(�1 � � ` l Estimated C/A 00 0. /Address of Work: ci e-. )%J(,S 14-. O 0 1 /Owner's Name: IM A e-y f5 0 LSa M "Date of Application: Z I hereby certify that: Registration is not required for the following reason(s): O Work excluded by law Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby-apply for a permit as the agent of the owner: __ Zr 4 Z 17 79 DailContractor Name ..Registration No. OR Date Owner's Name q:forms:Affidav I 7N0MApPm dia! Table J=b(condoned) ps em pdre Paekages for dam mad Two-Faady ResidmtW Baiidials Sated with Foait Fads MAXIMUM MINIMUM ' . M alarm cciun wan ROW Basement Slab xis da Areas cK) U valuw R valuer It value, wvaiucJ wall P� � � p� R-valrr� R-valve' 5"1 to 6500 Heads;Degree Dare' Q 12% 0.40 31 13 19 to 6 Normal R 12% 032 30 19 19 10 6 Normal S 12•A 030 31 13 19 10 6 JU AFUE T 15'}'ri 0.311 31 13 23 WA WA Nona u 13% 0.46 31 19 19 10 6 Normal V IVA 0.44 31 13 23 WA WA tlAM W 15% a52 30 19 19 10 6 13AFUE X 19% 032 31 13 25 WA WA Normal Y 11A 142 31 19 2S WA WA Normal Z 12% 0.42 31 13 19 10 6 �AFUE AA 11'/. Mo 30 19 19 10 6 �AfiJE 1. ADDRESS OF PROPERTY: 76 010M f N5 �) 9YA Las- M4. v wl 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. /o GLAZING'AREA(#3 DIVIDED BY#Z): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-090303 a I�` 780 CMR Appendix J Footnotes to Table J5.7_1b: ' Glaring area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall arcs,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. "Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall. For example, an R-19 requirement could be met EITHER by R 19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-vaIue requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. 1f you plan to install more than one piece of heating.equipment;or' more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the'efliciency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.I a NOTES: ' ` a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are•for.insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested accordance with the NFRC test procedure or taken from the door U-value and documented b the manufacturer in a y in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from-this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall basement wall,slab-edge, or crawl space wall component includes two or more areas with floor, different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- vaiue of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 'd. TOWN OF 1BARNsTABLE Permit.No. __20736 ,IUnST� Building Inspector _ cash mum 3 --x .sag f°yp• OCCUPANCY PERMIT Bond _ No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Cedar Acres Realty Trust Address Great Pond Dr;, So.. Yarmouth lot #15A 76 Compass Circle, livannis Wiring Inspector _._ Inspection date � � . Plumbing Inspector Inspection date d Gas Inspector , � Inspection date Engineering Department ��/ �������r - Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 77 7 `/ ........................_. t.. .........., ...............f�. Building Inspector _....._................... OTIFY r FNlS,Fal�PBEr,�-rION t., LtJCR;'E' '�Tf>t�'f{-EE L•svT AS ySE•�VuiVl;.�acij>. Qy[IV GlItA NS REGARDING SET13ACKSfit •, "� . o' . ky yit Lry �. �. /7l ��" r1 �� ��_ C ��'S EM / p Assessor's map and lot number ....� .�.®........®!. Mt UST 9 INSTALLED li COMPLIANCE � G�� - • 7�• �/� .� O .•/< ` y"�P - �� _ .�V. 63 e �'ITI� ARTICLE i6 STATE Sewage Permit number ................. ........ - gIVITgPY CODE AND TOWN REGULATIONS.M LATIONS. TOWN' OF �= °BAI� NSTABLE BARB9TAML i FF a pYa�e� BUILDINGS, INSPECTOR APPLICATION FOR PERMIT TO .............. . .. ... ....... ..... ................................... ......... TYPE OF CONSTRUCTION .....144 �1 ...,..... .r /•`�iYe,✓L�d� 74 ................ .....19. .�� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for aperrmit according to the following information: Location Location .. . ......../Ky*...... .... /.l...l�... �(✓ ....................... ProposedUse .......... . .,<!! .. ..................... ................. ... ......................................................... ' ZoningDistrict .................................................... ..................Fire District ............................................................................... Name of Owner (✓5� � �.�? ...... [�`��... 'e� .........��.... C �' 2 L .......... Name of Builder .Al r?...hY.!1 .... ress ................. .... .e.z.- .. Name of Architect :Address .....:.......... C .. . Number of Rooms ..... l R............................................Foundation .... �..�•.. ... ..-�..:.:...�:...4r..(./... Exterior .... ! l•L 'r..0 � .. . . ...Roofing .... ..... Floors C ... :: e' ....................................:Interior ........ ,.... s �� ... . ........................... WHeating .........Plumbing •• .. ;fir •• Fireplace ............. •M ..................................................Approximate Cost ............. ... .. ............ t Definitive Plan Approved by Planning Board ---------------____-----------19________ . Area .: ©.............. Diagram of Lot and Building with Dimensions Fee � ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Q` Xis , .i( CRi I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A Name ,�........... � ' r Cedar Acres Realty Trust Wo 2Q7.3b i;:: Permit`for :. ...Q1).Q..stQP.y.:....... ......single.family. dial J.a.ng...................... t, Location ,76.CQm�as`s..>✓irc� ............. _ ..........................H..yann i s..................I.................... Owner ......C.edar...Acnez..Realty:.Txxldst....... Type of Construction ..............fx.am ...... ,. f ........................n............................... * ......... Y • ` ' Plot .................. ...... Lot -4151 A.......... � y October 23 78 Permit Granted - Date of Inspection ....... ............................` 19 Date Completed ,1 !...� ... 19 PERMIT REFUSED ......................................... .................... 19 .............................................,x: ................................. I ♦ .'`d. _ M' _ �•l ......................... } ........................ . .......... ....................... ......... ........ rr Approved ..........................................:..... .19 ..............:.............................................................. .................... .................................... ... " ........: Assessor's "map and lot ,number . :!' • t Sewage Permit .number .. .. yo�TN Toy` TO N of BARINSTABLE ii i BASB9TODL i rasa D"UILDI,NG. ; INSPECTO:R. ; APPLICATION';FOR PERMIT TO ..... .................................... ..... .. ..................... ........................................... f= TYPE OF, ,CONSTRUCTION ...........//l � ................... r� ,_ ............................. y'; .!f ................................ TO THE INSPECTOR 'OF BUILDINGS: The undersigned1 hereby /applies for<a permit according .to the following information: ` Location f f'r l � ........ Lr ..r"'... '� r - /.. .�I. ......................................................... ProposedUse ........... _ _,.._ _ .� .. ..................................... ......... . .... .. .................................... Zoning ,District, ..................................................../ ....Fire District ........................... .... .............. ............... Name of Olwner f �Jri��a .�i........ ��, ,� /�'/ Address) :�.............. a^/.;;;1 - rrA;?L1.1............................... � Name_ of Builder -!..?r :;s ... ..•/... �,.,A?4. 1K .Address ................. I� ..f �. . .... ..... .:% ...... Name"of Architect Address ................... .......�.......:-:—......... - Number of Rooms ........................................................... Foundation !Exierior: ' _ 1 '! ...Roofng ..1 � A"fi ,;!� ' ..l r'f a ! Floors' •"..................................... ................� l „fr.i'7 ` �� Interior ........:.. �d r! !�'!'? /?ter rf/ ,! l ri "�, •�r0 i , Heating - ..r.. ....... ...... ....... .. ....... ....% :...............Plumbing ......... Fireplace ..... ....... ...................................................Approximate Cost ........................ ' !7 ;u= �......! . Definitive Plan Approved' by Planning Board -------------------___________19 Area' .,...... ........� ................. ,Diagram of Lot and Building with Dimensions Fee SUBJECT TO,APPROVAL OF' BOARD OF HEALTH k' d ' A ,hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above .� construction. �! _ Name ...... .. e....... . ..::"!:�.. . ' ' -Cedar Acres Realty Trust ' &�3lU~A�� ��- � ~ � No __.2Q?�]�Permitfor ......DAQ..Pt;}V.y.......... ..................... . Location ......?6&PRIPA#�l.��rQI�..................... ~~... ...~ ' Plot 8 .Oc/ter 23 Date Completed19PERMIT EFUSED,; --'' f~— . ':' -- ` ................... .. / ........... . � �r ----~----^1�----~7^................................. / —'—~^—`^--'-~^--~^`^`^^—'—`'~'^'`^---- Approved ................................................ lg ' -------------^—^^---^^^—'—'—^— '----------.--~------..~^..,.-_. | - / Engineering Dept. (3rd floor) Map I 0 Parcel .. y 0 I Permit# House# ] Date BL Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) �8- Fee.I T,gLL�O tConservation Office(4th floor)(8:30-9:30/1:00 .2:00) q 1 Elvvl �YITLE S LIANOZ Plij m g ep st- c -dmin:Bldg.-� 7`00Z. AND e oard 19 N$ _ r BARN STAMA BLE. ` ti r RFD 39. c TOWN OYBARNSTABLE. Building Permit Application Project Street Address ffl ` 6 # 02,b® 1 Village Owner Address Telephone r t t Permit Request Nil 0 IAA T f /Q�?® ro osaje First Floor a36 square feet Second Floor square feet Construction Type WM 0 L I 09-° 14) A46S r7YPF4-1 Estimated Project Cost $ /61 Qud Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I M— n- Historic House ❑Yes to On Old King's Highway ❑Yes V4.18— Basement Type: A'full ❑Crawl ❑Walkout ❑Other G Basement Finished Area(sq.ft.) 4!V Basement Unfinished Area(sq.ft) Number of Baths:- Full: Existing /. New_0 Half: Existing �_ New _ No.of Bedrooms: Existing r New 0 Total Room Count(not including baths): Existing New _�First Floor Room Count Heat Type and Fuel: ZGas ❑Oil ❑Electric ❑Other Central Air ❑Yes 6/No Fireplaces: Existing New Existing wood/coal stove ❑Yes H<O Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ZAAttached(size) /�ax ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information . Name Telephone Number Address 76 ``���� (�C?�D ; �J� o q License# 04-6�6U q H�T!9 ► )VA � �/ Home Improvement Contractor# 1�1 �Z / Worker's Compensation#59, ft 6611-Of./4604 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 TAUN TO SIGNATURE DATE T RAT E F WING REASON(S) • - FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. b . : , — !• ._. _ Y '> i ADDRESS VILLAGE OWNER DATE OF-INSPECTION: . r _(� s all - __ ? � - � • - } ,� . FOUNDATION FRAME/ _ iI INSULATION 'FIREPLACE I ELECTRICAL: ROUGH FINAL PLUM_BING? ROUGH FINAL,. t , GAS: L lam"Y ROUGH .. FINAL - - FINAL,BUI I,G - a y DATE CLOS B lun tr ASSOCIATION PLAN NO. ' a. 1 . The Town of Barnstable ADS& Department of Health Safety and Environmental Services iro Mo+" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissione For office use only 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: �1�� Est.Cos�l6i �� YP - Address of Work: 6 Co M Al'o Q QZ,6®/ Owner's Names �&00 Date of Permit Application: J 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 G 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner '&h 7 4- /2! 777 D to Contractor Nam Registration No. OR Thc• Conrtlronivealth of Ifassacirusens Department ojlndustrial.4ccidetrts 1 y / Office of/nvesl19211offs " 151111 {{•uahin;;to►r Street Btuston, Man. 02111 ` Workers' Compensation Insurance Affidavit atirilic:intinttirmati�n _ ,PIciST PRINT name locntion• 7® Pa6gwo-o b —D a- Citv PI )KOtLef2c fflg � nhone H 1 a a homeowner perfo ing all work myself am a sole proprietor and have no one working in any capacity 7 1 am an empiover providing workers' compensation for my employees working on this job. coomanv ":tme: address• city: rhonc#• insurance rn. policy# 7 1 am a sole proprietor. general contractor, or homeowner(circle otte) and have hired the contractors listed below who have the following workers' compensation polices: enmrinny "line: 1ddreSt: phone#• insorinrr rn. nnliev# cmmpanv narnc: addresr. illy nhone#• insurance co. Attach additional sheet if neccasary �Section i "^_ "�i- Y y "" " '��' '^"''"r'-'O1j'• "� ~' __mow Failure to secure coverage as required under 5c cttioonn 25A of 111GL 153 an lead to the imposition of criminal penalties of a tine up to S1.500.0 ndiur unc%cars' imprisonment:is well as civil penalties in the form of a STOP NVOR1:ORDER and it fine of 5100.00 a day against me. 1 understand that a cope of this st:nentent mac be forwarded to the Orrice of Investigations of the DIA for coverage verification. 1 do herchv cerri J.un •r the wins and pe allies of per'un•111al the information provided above is true u id c(�rrect. Sit nature o Datc 7 Print name I `� ` 1 Phone>r .��77-25I'1 � •ofriciai use unly do not write in this area to be completed by city or town oRcial cit% or town: permitlliccnse# rnlluilding Department OLtcensing Board [� t check if immediate response is required Selectmen's Office t- C311c2ith Department .. phone#• lOther contact person: i. information and Instructions Massidiusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tJt employees. As quoted f rom,the "laws . an empinree is defined as every person in the service of another wider anv contract Mime. express or implied: braPl or written. \ r� An c�ilip, ,u � `is dafirrcd as ati,indii 'iduSl'. partncrship, association. corporationzoe.pthe'r.' 'gal cntit�, or anv two or me the forea,oing"enunued in a joint enterprise, and including the legal representatives of'a deceased employer. or the receiver or tnistee of an individual , partnership. association or other legal entity, employing employees. However:? owner of a dwellina house having not more than three apartments and who resides therein. or the occupant of the dwclling house of another who employs persons to do maintenance , construction or repair work on such dwelling_ ltc or oil the ;,rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioyc 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 an• applicant ,%vho has not produced acceptable evidence of compliance with the in coverage required. Additionaliv. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to;your situation and as all affidavits may be submitted to the Department of supplying_ company names. address and phone numbers 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 require. 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 tiie affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Departtnent,by mail or FAX uniess.other arrangements have been made. The Office of In��st.i_atiotis ���ould like to thank you in advance for you cooperation and should you have any questic please do itot hesitate roe;vive us a call. . .••_ar.. .+_ ..._ .�.v.... ...�:..:.�.�•...�..•. ._�-sue,......-_.�=..•r r�w.�.+w�a ... ..w...�.n:rr.7r•_��..w�y�...���. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street Boston,Ma. 02111 ' fax #: (617) 727-7749 n�nnn ij-. «t 71 777-.1900 fwvt_ .106. 409 or 375 I t::W REBY CERTIFY T44AT TNI; FOUNDATION �1 LDC/1TE7 ON .THE LpT AS S�V1lN,�u{i" . C!?NFIaRJ�iS'.70 j?itz.Rom' U F,aI�,G;v�srA�� 11bNS.REGARDING SETBACKS A tA6-0'-STREET. LINES AND LOT - M � Z o co a � 3 T ♦ • y Ln tJo CIS i � � :� ✓!� iJanvrnoncaea�. o ,1�,:,��uJecr HOME IMPROVEMENT CONTRACTOR a �k DEPARTMENT OF PUBLIC SAFETI• TION SUPERVISOR LICENSE' ICE CONSTRUCNSE Registration 121779 t Type - INDIVIDUAL �.I Number:t Expires: Restricted To: 00 RICIiARD A. FITIPATRICK , 1 70, BEECHWOOD DR ") RICHARD A FITZPATRIr.R 40Y, �,, ASHPEE MA 02649 . 10 BEECHWOOD DR ADMINISTRATOR lI t� HASHPEE, NA 02649 .0 3 P� Y J r' A-COA .< T a�, I S t'htsii Y,y h^P ROD ., 3Y CER� (M.7'.<6+ f THIS CERTIFICATE IS ISSUED AS A 'MATTER OF INFORMATION W.H. Fshba h ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE u9 znsnraz?ce Agency HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTENp OR 426 East Falmputh Hwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Falmouth, MA 02536 COMPANIES AFFORDING COVERAGE _ COMPANY INSURED -- — --'----- A United States Fidelity St Guaranty COMPANY ---� Ric2b],ard Fitzpatrick B W PO X 2243 Ir COMPANY --------------------- --.—____.-------- CenterVille, .NA, 02643 C ------------ COMPANY —'---------__ 5....... .. .. k>�,`<dw��+Sr. .� :34.£"<�i. '`(Zlt•�Zi. ::9,�'>�{S.{r3.ud'`'SA:::Ff{Of:4rs, tskt`{{�:'i%;: ws�:{5:£NF:kss.{,l:sTf' ,.N>s0f>•:+fs.t... .k\..<:v HIS :._..i ST C ERTIF Y THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEENfSSUED TO THE INSURED K'�Y�yw at INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED ERE N S83U E FOR THE POLICY PERIOD EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCER B_Y_PAID_CLAIMS. SUBJECT TO ALL THE TERMS, n RTYPEOF.INSURAN�E. POLICY EFFECTIVE POLICY EXPIRATION! `4 POLICYIAq�EF .,a-; - ---— I 'DATE(MWDD)YY) I DATE-(MMlOD/YY). I :- LIMITS PlENERALLIABILITY COMMERCIAL GENERAL LIABILITY BSC70004679802 ' 8-22-96 8-22-97 I NER GEAL AGGREGATE $2,QQQ�000 CLAIMS MADE [I OCCUR PRODUCTS-COMPlOP AGG $2,000,00� OWNER'S&CONTRACTOR'S.PROT00000066228 8'-22�-97 PERSONAL&ADV INJURY $1,0�� 000 — 5-22-98 EACH OCCURRENCE -------- $l,000,000 FIRE DAMAGE(Any one fire) S 50,o0d-- AUTOMOBILE LIABILITY '�-1------ MED EXP --- (An one person) $ l��(}�a ANY AUTO ALL OWNED AUTOS I COMBINED SINGLE LIMIT $ SCHEDULED AUTOS, BODILYPerson) JURY y HIRED AUTOS NON-OWNED AUTOS $ BODILY INJURY I I (Per accident)` �$ GARAGE LIABILITY PROPERTY DAMAGE '$ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: r— —�.-NL EACH ACCIDENT $ EXCESS LIABILITY — AGGREGATE $ UMBRELLA FORM I EACH OCCURRENCE $ i OTHER THAN UMBRELLA FORM I AGGREGATE WORXERS COMPENSATION'AND I w $ EMPLOYERS'LIABILITY f $ W�TATU- 7.QFILLl- ITi ° ,. THE PROPRIET OPARTNERS/EXECU/T IVE 'INCL _EGH ACCIDENT $ FFICERAE: - I I I EISEASE-POLICY LIMIT _ l EXCL L D_ $ OTHER I EL DISEASE-EA EMPLOYEE $ I I I I DESCRIPTION OF OPERATIONSJLOCATIONS/VEHICLES/SPECIAL ITEMS ----- : Mary Balton SHOULD ANY OF THE ABOVE DESCRIBED POLICIES .. • ...,.. ...:....> ......:: y a:...�.<SE�:ins`:�o, ai7i�)�•+.h £Si l BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL I Hy nnis,COMPa M Circle02601 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Hyannis, �26Q 13UT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. A M RID EpR EN I E 'F � ✓ M1 I .----�--_ a x. 1 II ' .i _t __ � i_� T� Ti_. { f(_ i T I -1 - I— - -� �Z_ . .! .T T J_ .� _ j � �, —_ _LA� �->-�i Erich - � r,—T 1 i r� I 1.a_ l� ..IS. . � 1 I _ � �,� ►Ii�J �L -� i I' : , I. i -�• _ i 1 Le 1✓T L-- t1 PvT 10 i� �RO NT t i_N Nf10 K I 10A T MR i� � � r✓xl<� , ItJa rZoat% ��1L Ld 7 tk Afib► 15 l-!T �. -. -- --� A5 �>✓� -r!�r g I Nfxs, 5 Ft 69 K C,[AA61" ____ `\ _ L•H , NtN VA- t C;r�s b 1 C P..b• 75s1 ' zy� `� I ✓ -- -- ---I r --- k __ - Ci•C,• _ _ tys _ r--AND606N 0.�1, I&I .. - :-_ - _._ D1�YY�I��L n1?. 1Jl'�D r ^� AN1t11�i LLrN2�_ . �. ! ZX(a rl��ii ,! ){ ► `� VdI�11'� G; DAR��1�1F�1.k`� 9 , �� Z X 9 C��t..l.�f..�Iffi � � 'lz"L�Y7'�.4G it vt RAD E _ 0 Tr t�1 tyi11 _ _ Y _ LCI _ L, N e3r..� t, `;4a �� u 4 roo1't n(� getK O 1 N X, H -o I \ A W K� f 6'-Ir��/ -r - - -� - - - - - �- +_ ► i � xl , � Ida ONE 1�0��r Fy ,�1�11 (i ('LN�i A -k LIP -1 Ill�,/ i I Lo i.06 I I !, 1 ,; A r� Iip / APPROVED BY SCALE: � = '"V DRAWN BY DATE _._. . 0 LfO bN DRAWING NUMBER Ny14NH15 �fpgyA(PROW MAST N C 1 6 a. 1 B r.14 r