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HomeMy WebLinkAbout0043 MARSH LANE � - -�. 1 �� �I� �- _ _ N, N r 37 L►� q ----------------- z g � • 6� LOT 3g 5 2t 105. 00' 1 i 4 z. ,� 3 PREPARED FOR PETER JOHNSON CERTIRED PL 0T PLAN LOCATION MAs�2:_.._ SCAL E_1-4� DA TE5 13-8 7____ f REFERENCE: LOT 38 P. B. P. r A,. r FLOOD ZONE��.�� I HEREBY CERTIFY THAT THE BUILDING o 27 07 SHOWN ON THIS PLAN IS LOCATED ON THE THAT r GROUND AS SHOWN HEREON AN D T HA � gES CONFORM TO THE ZONING fit. O��Su�`��°' BY-LAWS OF THE TOWN OF-KNST AFL E i WHEN CONSTRUCTED. i.0W A. WELLER, INC. 7/4 MA/N S T REE T YARMOUTH, MASS. DA TL s-�-rev a 6- g jj Assessor's map and lot number ........................................ Q..�STNEtp�y Sewage Permit number ����6� rr BTL� S BARNSTABLE, -� House number ..........—�.� s MABL p� k c �oi6Y3pY9�C �e�®p �� 9��L CCD VIN A PPFoVFTOWN OF BARNSB E a\0 0 I 11 sta')le Core v t J:i lssiori d —(ad—, I�LDIH G INSPECTOR S fine �StB APPLICATION•FOR PERMIT TO ..:.av�` S! � '" +� �� �-G �............... ....................'. �... ...'' .....................'�....... ............ TYPE OF CONSTRUCTION ...t� � — ...................................................................................... ................. .................19..4 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: /Zo l 37 Location .../f ............../!7? s� 4V. - ............................ ........ .............................................. .......................................... ProposedUse ... 5P ....... "z<.!!j'................................................................................................................................. Zoning District .......... ... ....... .1J........................ ............Fire District ............C ............. /-XV, -Uis i -e_ Nameof Owner .... ' ... .......Address ........................................................ ............:.......:... Name of Builder ddress6 �" r Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................Foundation ..VK3.9�.......................................................... Exterior .... 0.,i�..................................................Roofing ... ............................................................. FloorsGt14. v.........................................................................Interior .................................................................................... Heating .........................................Plumbing ��i2 .................................. p ...��?!�.�........................................................Approximate. Cost ..��...�.�.�..........'............ Fireplace .................. . Definitive Plan Approved by Planning Board ________________________________19________. Area ......./��... ................................ Diagram of Lot and Building with Dimensions Fee Cr'........................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH Ilk OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS_ I hereby agree to conform to all the Rules and Regulations o the Town of Barns able r ardinglfhe above construction. Name ' ..... .l. . ...... Construction-Supervisor's Li .............. .,"JOHNSON, WALTER Permit for 9- 11 S ory............ ....... Single Fami!14y.. ' ET-11ing............ ............. ...................... ..pw..z.......... TotS Location ....:��...........#.3.7 -3 8 �3 Marsh Lane ............�v n ............... ��n........ ............................. Walter`-Johns&n Owner ...................�..............3............................. Type of Construction Fr.............. ...................................... ........ ......................... ............................. Plot ............................ Lot ................................ -Permit Granted .......Ma -2,0 ....19 Date of Inspection ..... ........................... 1 9�j -Date Completed ......... ....2-3..............i qd Assessor's map and lot number ." ............................................ THE Sewage Permit number .......... .. ..... .,.. A Z BAB39TeBLE, i House number 9 MABa GD 1 639 'Fp MAY a` TOWN OF B.ARNSTABLE A � � ��� BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... U'/ sy ................ �"' ............... ...................... TYPE OF CONSTRUCTION ..... 0. .. .K-.-- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..^ /�Ji ................ Grl�ril" ProposedUse ....t-�1 ....... " .f!!......... .. ' ......................................................................................................... Zoning District ......................T�.....�.....................................Fire District ...............7�/4/................................................... Name of Owner ....Ji c7 ?`t / !`! '..Address ....! �". ` �i /rf ��,/-,o tf Name of Builder ...... - .. )'. ddress ..(, v 31 .............. .,M1 ,.., ......................... Name of Architect ....Address Number of Rooms Foundation .. S�!Y r''d .................................................................. .......................................................... Exterior .... G ..................... ........................... Roofng ...4?�f,, . ............................................................. Floors40eMo�.........................................................................Interior ................ Heating f,CftJC. ' ................Plumbing ..... C: �r ..Gr'y� `".................................. r � Fireplace ...MA: iv A Approximate. Cost ........ ..v�> oo . ............ ................ ...................................... Definitive Plan Approved by Planning Board ------------------------ - -------19--------. Area ............... Diagram`of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS f I hereby agree to conform to all the Rules and Regulations of;, the Town of Barnstable regarding the above construction. Name .... .....................7. .........,.rJ Construction Supervisor's License{.��......... �....._.. JOHNS�N, WALTER A=306-21.5 No 30762 permit for 12 Story ................. ............ Single Family Dwelling ............................................................................... Location .Lots 37 & 38 , 43 Marsh Lane .............................................................. Hyannis Walter Johnson Owner .................................................................. Type of Construction Frame ............................................................................... Plot .....................:...... Lot ................................ Permit Granted .MaY...ZQ..................19 87 � Date of Inspection ....................................19 Date Completed ......................................19 f 4;: �! DATE )"u=� Gt){ O 197 PERMIT tywrii Yfd W'f1Er 1`APPLICANT ADDRESS r (NO.) (STREET) Owner I� - (CONTR'S LICENSE) PERMIT TO Ouild dWeiliftl. 1 ] c ' t NUMBER OF ( z) STORY_ J1 ilgle- "'amity d��re11.l (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) DWELLING UNITS_ I J U •� i E (LOCATION lots o > 7 (N0.) .37 IS, 3U 43 I�tcir ti i L.'-ne {� ann�is ZONING _ ` (STREET) DISTRICT. kf� EEN .. .. (CROSS STREET)- AND ' (CROSS STREET) SUBDIVISION` LOT LOT BLOCK SIZE BUILDING'IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: r S�'dt�;is ?If{J-jiSJ Gianigt.- madt-r l I ' AREA OR �.1Gi.I ;('; .. BOND VOLUME �� >,.L� ESTIMATED COST J•00,000 PERMIT $ -39. 75 (CUBIC/50UARE FEET) - FEE ' OWNER, l_ ..i iCOE.iI ADDRESS - tlyf?;s1��!)7`r"` r, j BUILDING DEPT. BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR* PERMANENTLY.. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTEDUNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION.,STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED .EROM THE DEPARTMENT OF.PUBLIC WORKS. THE ISSUANCE OF THIS.PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS �� ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS�R REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR I. FOUNDATIONS'OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. PLUMBING AND 2. PRI*OR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3• FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST.THIS CARD SO IT IS VISIBLE FROM STREET �-- BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS r 1 O h•{ a ELECTRICAL INSPECTION APPROVALS _p 2 R — 3 a: I (' H EATING INSPECT) N APPROVALS ENGINEERING DEPARTMENT OTHER BOARD OF TH O w -- yAr'�OV 4 `� ECC-< yULL AND Nk VOID IF CONSTRUCTION f INSPECT IONS INDICATED ON THIS.CARD CAN 8Ila VTR sl r MONTHS OF DATE THE ARRANGED FOR BY•TELEPHONE OR WRITTEN B0VE:' � m N TI I�.,,. 0 CATION. I '� , `�.,� °�•'� TOWN OF BARNSTABLE BUILDING DEPARTMENT ! 11ARIVITAU : TOWN OFFICE BUILDING � rUL HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #.........`3��76..`..,.. .......................................................................................... ........................................................ issued to ...1..�............. �.�1/ S"D ............... �J��iy�� `t, ........................... w. _.... Please release the performance bond. I�.-... ,.,,,r-r'.�-'^i•f�-`-....-.....�'f:erP,�'*{�'..'"r''s'K^:"--...�,;+•"=ai'= -'L•.••T-- 'n4°gp•lkelmr,—�-�..�r«.-.a..r•q�•.�-,.r,�...�'..-r�^4Wu if;�:e'"•ac� �C+eswv;�±?l...w•:.'. rn;�^1v'Y�•.-f•.i.-r�.0 ,,.. .,:�^ � .�, � -r -�,"-"lrY't �r of � TOWN OF BARNSTABLE Permit No. .. 307.62 BUILDING DEPARTMENT aeaan TOWN OFFICE BUILDING Cash 7 .59 °'ta■�r� �-"HYANNIS,MASS.02601 Bond ......X. CERTIFICATE OF USE AND OCCUPANCY Issued to Walter Johnson Address Lots #37 & 38, 43 Marsh Lane Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. November 19..... 23, 87 ............ ........................................... Building Inspector r oFtHE T Town of Barnstable *Permit# P� �{ Expires 6 months from issue date Regulatory Services Fee C S7 * BAMSTABLY, 9cb 6.5 Thomas F.Geiler,Director ATEp�,ta Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address _?> �cS� residential Value'of Work , cm Dr)Minimum fee of$25.00 for work under$6 .00 S r Owner's Name&Address � Y)c7)rc) -• �iJ IC,1 n c j n a� MQNC�s L2 Lam f Au a 0 Contractor's Name C " 1 Telephone Number _5QL� Z�j�C/S �{ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) , etkman's Compensation Insurance ' NOV _ 9 200g Check one: TO ❑ I am a sole proprietor N OF SARNSTABLE ❑..I am the Homeowner ve Worker's Compensation Insurance —'7 Insurance Company Name Workman's Comp.Policy# C Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) KRe-roof(stripping old shingles) All construction debris will be taken to ` . (—Jf n ` t ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: A_�rehuirej perty Own must sign Property Owner Letter of Permission. opy of t me Improvement Contractors License&Construction Supervisors License is SIGNATURE: Q:\WPFILES\FORMS\building permi form\EXPRESS.doc Revised 090809 Page 7 of 7 CAPIZZI HOME IMPROVEMENT INC. SPECIFICATIONS AND ESTIMATES STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT 2c Y OWN THE PROPERTY LOCATED AT � J l-n IN ,MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR,THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit,MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: i �1. &.111"id Board of Building Regulations and Standards License or registration valid for individ,.ul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards ReglstrAfiab; 100740 One Ashburton Place Rm 1301 r�a pr` 'qn-�23/2010 -_` ,7I Boston,Ma.02108 [.. lement Card CAPIZZI HOME,. FV.. M_kNT1°,� tARY GUSTAFSON,�� 1645 Newton Rd. Cotuit, MA 02635 Administrator lYo vali itho.t nature `ri,r•.;:li'liti ct[ Depi►l-tillcrlt of Public Safi t1 -- - — A f3otr•tl t►l'f3uiittin�:, Reotilations ;ttarl Standards }i Construction Supervisor' License License: CS 74640 r z , Resfricted to: 00 GARY .GUSTAFSON' ` 8 SHORT 1NAY � SANQWiCH,`MA02563 - . . Expiratia>r;; 11/29/2010 rrz': 7755 f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.govfdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: (�Zf2k 0-a City/State/Zip: 1-.-) Phone.#: yeou an employer? Check the ap r priate box: Type of project(required):. a employer with 4• Q I am a general contractor and Imployees(full and/or p -time).* have hired the sub-contractors 6. Q New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Q Remodeling ship and have no employees These sub-contractors have g• Q Demolition working for me in any capacity. employees and have workers' comp. insurance.$. 9• ❑Building addition [No workers' comp.insurance p• required.] 5. Q We are a corporation and its' 10.0 Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. tther� oof repairs insurance required.]t ,c. 152, §1(4),and we have no employees. [No workers' 13;` comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and-then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. l Insurance Company Name:_ �(� , Policy#or Self-ins.Lic.#: G 6 9 G Expiration Date: Job Site Address: 1 atle�s lei _ It aft V a City/State/Zip: 4111j/(jam yl+ �01 Attach a copy of the workers' compensation policy declaration page(showing the policy numbmbe(r'and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment;-as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for Lance covers a verification. ' I-do hereby c-ertify - -der,.-th in�and enaltiey--ofperjug4hat-the-infor-mation-pro-vided-aboue-is-true-and-cor-r-ert Si mature: Date: Phone#: %— FOther only. Do not write in this area,to be completed by city or town official n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: ACORD. CERTIFICATE OF:LIABILITY INSURANCE 0DATE 5/07/9D � •PRODIPCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Rogers&Gray Ins.-So. Dennis ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 434 Route 134 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O.Box 1601 South Dennis,MA 02660-1601 ` INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Mutual Insurance Co. Capizzi Home Improvement,Inc. INSURERB: NATIONAL UNION FIRE INS. Capizzi Enterprises,Inc. INSURER C: 1645 Newtown Road INSURER D: Cotuit,MA 02635 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED-BY PAID CLAIMS. INSR D TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR DATE MM/DD DATEIMMIDDIM LIMITS A. GENERAL LIABILITY MPB1075H 06/08/09 06/0811 O EACH OCCURRENCE $1,000,000 ncom MERCIAL GENERAL LIABILITY DAMAGE PREMISES Ea ONCCE D ce $500 OOO CLAIMS MADE 51 OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2 000 000 POLICY X JET LOC A AUTOMOBILE LIABILITY BP010786 06/08/09 06/08/1 O COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $500,000 } ALL OWNED AUTOS ' BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ A EXCESSIUMBRELLA LIABILITY CUB1076H 06/08/09 06/08/10 EACH OCCURRENCE $5 000 000 X OCCUR FI CLAIMS MADE # AGGREGATE $5 000 000 HDEDUCTIBLE $ X RETENTION $10000 $ B WORKERS COMPENSATION AND WC006957000 12/25/08 12/25/09 X WC STATULIMIT-IRY O R EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Carpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN 200 Main Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL t Hyannis,MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR>!' REPRESENTATIVES. r AUTHORIZED REPRESENTATIVE ACORD 25(2001/08)1 of 2 #S43470/M43449 KW © ACORD CORPORATION 1988 I Y in ®� �� .g 'I Town of Barnstable *Permit#. aU�0 UI Expires 6 months froze date SO ' Regulatory Services . Fee 04 Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 3bu /Z Z Property Address Q.6 'v41—q— !Vim//5 Residential Value of WooJ.� Minimum fee of$25.00 for work.under.$6000.00 Owner's Name&Address �j? Iga U54 �C( XV Contractor's Name.JQ[ �✓ 1i la �`r'�J Telephone Number; Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) C ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner l'nave Worker's Compensation Insurance Insurance Company Name �� f>� f �( K Workman's Comp.Policy## C 6 ✓ �� Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ��jj�� eplacement Wfndotv��rs7s5liders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the.Home Improv ent Contractors License is required. SIGNATURE: r- Q:Fonns:expmtrg Revise061306 The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston;MA 02111 , ' www.mass.gov/dia Workers"Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyffilly Name(Business/Organizetion/Individual):. O-.((—��W�erg �Ul �( ,� � yt •Address: City/State/Zip: Are pu an employer? Check the appropriate box: -Type of project(required):• a i a employer with 4. ❑ I am a general contractor and I employees(full and/ gi� have hired the stab-contractors 6. ❑New construction . 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. Remodeling ship and have no employee 7AFF-11'Demolition s These sub-contractors have working for me in any capacity. employees and have workers' 9 Buildin addition [No workers' comp.insurance comp.insurance.$, g required.] 5. ❑ We are a corporation and its 101-1 Electrical repairs or additions 1.❑ I am a homeowner doing all work . officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 1 Other l' comp. insurance required.] 77 *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. TContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not entities have employees. If the sub-contractors trove employees,they must providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. hisurance Company Name: '`q-1- I Policy#or Self-ins,Lic.M. 44 Expiration Data: � Job Site Address:i}��. d//LCt,V5 /Cd/"-P City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy numb -and expiration date), Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against tho violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the BIA.for insurance coyerate verification I do hereby certify' der the pains•and pen Ities ofperjury that the information provided above ' true a d correct: Sienature: Date: Q Phone#: 7 d L ial use only, Da not wr'e in area,'to be completedby city or town acial or Town: Permit/License# g Authority(circle one): ard of Health 2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector her ct Person: - Phone#: u '.. Boar�ouiingegu 7at ns and tan aids One Ashburton Place - Room-1301 Boston, Massachusetts 02108 Home Improvementt-1-o tractor Registration = q' Registration: 145832 Type: DBA Expiration:. 3/4/2009 �Tr# 127455 NORTH SIDE HOME IMPROVEMENTS WALTER WARREN JR. F r - 40 ALEXANDER DR. _4 F tfi • I YARMOUTHPORT, MA 02675 .r ZI Update Address and return card.Mark reason for change. Address _] Renewal Employment Lost Card FS-CA, a Sol-O&W.*a9a Boa Ado Bu��'Zre�ns�nd tandarrds License or registration valid for individul use only ` HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration 145832 Board of Building Regulations and Standards Ex iratro One Ashburton Place Rm 1301 p �/4/2009 Tr# 127455 Boston,Ma.02108 NORTH SIDE HOE � LE1GtEN f WALTER WARREN'J� �� 40 ALEXANDER DR YARMOOTHPORT,MA b2 7 Administrator Not valid withou re . BTU 5r rya bEt t' rrthdate. 930t195 At TEf2 V,nRREN At E omhil J • GRANITE STATE .INSURANCE COMPANY 92252-0000 WC 24o-69-91 --------------------------------------------- 13102 013-66-0507-00 •• - , PENNSYLVANIA WALTER R WARREN JR. Member Companies of 40 .ALEXANDER DR YARMOUTHPORT, MA 02675-0000 FU American international Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.V. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 i.D# • HUB INTERNATIONAL NEW ENGLAND LLC WORKERS COMPENSATION ARID EMPLOYERS 437 STATION AVE LIABILITY POLICY INFORMATION PAGE SOUTH YARMOUTH, MA 02664-0000 INSURED IS PREVIOUS POLICY NUMBER INDIVIDUAL RENEWAL oo8 4 223 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6io ITEM 2 POLICY PERIOD 12A1 A.M.standard time at the Insured's mailing address FROM 05/19/07 TO 05/19/o8 REM 3 A. Workers Compensation Insurance. Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Wab€city Insurance: Part Two of the policy applies to the work In each state listed in item 3.A. The limits of our liability under Part Two are: 100,000 each accident Bodily Injury by Accident $ Bodily Injury by Disease $ 5Q0:000 policy limit . Bodily injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: . SEE ENDORSEMENT - WC200306A REM 4 The premium for this policy Will be determined by our Manuals of Rules, Cia$SMCStions, Rates and Rating Plans.. All information required below is subject to verification and change by audit, Estimated Total Rate Per Estimated Remuneration Premium Classifications - Code Number Sit>ti OF Re- Annual®3 Year muneration Annual ❑3 Year SEE EXTENSION OF INFORMATION PAGE - WC77.:54 .TAXES/ASSESSMENTS/SURCHARGES $23 EXCEPT WHERE APPLICABLE BY STATE-EXPENSE CONSTANT( ) $284 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $828 f indicated below,interim adjustments of premium shell be-made: Semi-Annually Quarterly 0 Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 i D5/15/07 ASSIGNED RISK 66 issue Date Issuing Office Authorized Representkilve WC 00 00 01 t Oft i HE> yo . : Town of.Barnstable. Regulatory Services �nx�vsreBr�, +` y Mnss $ Thomas F. Geller,Director Building]division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "w.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This .Section If Using ABuilder Ro r 0 !0 as Owner of the subject property hereby authorize �,()eaLter' Warr �� to act on my behalf, in all matters relative to,work authorized by this building permit application for: , n US (Address of Job) Sig tore of er Date f . ro t L0 C) Print Name . Q:1'ORMIS:OWNMERMIS SION It PIT DATA. INDICATES INDICATES SEPTIC TANK DETAIL: oo © DISTRIBUTION BOX DETAIL: LEACHING PIT DETAIL: REVISIONS: P"t4140 �- GROUNDED TEST GROUNDWATER A TE R NOT TO SCALE NOT TO SCALE NOT TO SCALE NO DATE TEST NOTES: I. SEPTIC TANK SHALL BE STEEL 4. INLET AND OUTLET TEES TO BE CAST IRON OR f ._ NO. OF OUTLETS: -7 MANHOLE COVER LOAM t3 SEED 1 ,_ +C. A'D'DE D TP TP TP TP REINFORCED CONCRETE. SCHEQ 40 PVC. TEES TO BE CENTERED UNDER BROUGHT TO FINISH GRADE OR PAVEMENT NOTES: MANHOLE COVER. __ __ �\� r _ GIRD. EL. 18. 5 GRD. EL. GRD• EL. 1 GIRD. EL. 2. SEPTIC TANK TO WITHSTAND H-IO LOADING �_�_ UNLESS UNDER PAVEMENT, DRIVES OR I. DIST. BOX TO WITHSTAND H-10 LOADING 2 MIN.OF 1/8" GW- EL. GW. EL. GW. EL. GW EL. TRAVELED WAYS,WHEREIN H-20 LOADING I I UNLESS UNDER PAVEMENT, DRIVES OR TO 1/2" 12"MIN. FILL A SHALL APPLY 1 PRECAST I TRAVELED WAYS WHEREIN H-20 LOADING WASHED I tJ V +� T O P�,C3 IL I I DIST I I SHALL APPLY. STONE r 1 2 _.-_ 1(1 (; 3. ALL PIPE CONNECTIONS AND CONCRETE MANHOLE COVER j I 8o w i�1 �°+N>dY' Re W►.1 SANvy CONSTRUCTION TO BE WATERTIGHT. BROUGHT TO FINISH GRADE BOX I 2. PROVIDE INLET TEE OR BAFFLE WHERE SLOPE OF p Q -o o .� o aU S D Il. I 1 INLET PIPE EXCEEDS O.OS FT/FT. OR IN PVC INLET PIPE Q Q p L: 50 IL rr I I PUMPED SYSTEM. 12"MIN. L'---r--1---J d o o O C7 O Q p Q ❑ a1J COVER 3. FIRST TWO FEET OF PIPE OUT OF DIST = o ,, v o J NOTE: PIT TO ��� GENERAL NOTES: C� BOX TO BE LAID LEVEL. a o �o� 0 Q o 0 0 o Q Cla ,�� o WITHSTAND H-10 LOADING • PLAN VIEW ; I. THIS PLAN IS FOR DESIGN AND NORMAL WATER LEVEL REMOVEASLE-\ PRECAST , T � UNLESS UNDER PAVEMENT,DRIVE OR CONSTRUCTION OF THE SEWAGE -T-_ COVER w 3/4"TO 1-1/2" ❑ o o » = Q Q o ❑ - - , ` TRAVELEDWAY WHEREIN DISPOSAL FACILITY ONLY. 7 / DOUBLE LE ACHING PIT oo H 20 LOADING SMALL MLT�I V I I �; c� WASHED APPLY. 2 ALL CONSTRUCTION METHODS AND IVA c-D (� "� PROVIDE ►. w ❑ ci a o o Q o o ❑ a° • .. .. ., w STONE o MATERIALS SHALL CONFORM TO MASS. (no f ines D.E.O.E. TITLE 5 AND LOCAL BOARD �AhiL% I I INLET TEE ET WATERTIGHT _ I „I w 1 ❑ a o n c- 0 0 0 ❑ g4 OF HEALTH REGULATIONS. 5Ar.1C _ ^ 4'-0"MIN. OUTLET 5 f l !EE I.• I Do - (�° hA.. TI /� �- .I SEPTIC 1� LIQUID DEPTH TEE NOTE 2 � 1 � ) � ❑ Q Q Q O OVA Q q R / — TANK — I '4 -JD I 4" INLET l i - I I % • 0 3. ALL PIPES LOCATED UNDER PAVEMENT U h` (� I I •� �= °�LI�J- 4 OUTLET I e '� OR TRAVELED WAY SHALL BE �Cf�1� ) AW I I •�LZ--��-I Z ' _ o • 4° SCHEDULE 40 OR EQUAL. _ 4. PROPERTY LINE INFORMATION SHOWN I 1 � L i o:; ,' L �: — DIA. WAS COMPILED FROM LCC 17595 M .. , . , .: . .: . •. ►.. . , _ AND DOES NOT REPRESENT 5 BOTTOM ON LEVEL !TABLE BASE BOTTOM ON , CROSS-SECTION o' $ � isr � LEVEL STABLE �G DIA. - PLAN VIEWi�ii� CROSS-SECTION VIEW � BASE ACTUAL SURVEY ON THE GROUND. 5. WETLAND WAS LOCATED ON THE 144 V!(A1 ��r ��{„ ti� w - r CROSS-SECTION GROUND BY STADIA ON NOV. 13, 1985. INVERT ELEVATIONS. CONSTRUCTION NOTES: DATE: DATE: DATE: DATE: TEST BY: TEST BY: TEST BY: TEST BY: STC-VEM i4AA - 5T1;�IV BAA� INVERT AT BUILDING �� Z WITNESSED BY: WITNESSED BY: WITNESSED BY: WITNESSED BY: �� INVERT AT SEPTIC TANK(in) M. o-7 71�t ccMcorJ TIc� �.cNLQ � � JP INVERT AT SEPTIC TANK(out) PERC. RATE: PERC. RATE: PERC. RATE: PERC. RATE: 2 MINdINCH MIN./INCH MINJINCH MIN./INCH QQ`� INVERT AT DIST. BOX(in) INVERT AT DIST. BOX(out) 5-4 11 �� ` INVERT AT LEACHING PIT /3.z- DATUM: �\ BOTTOM OF LEACHING PIT q 60 W U.S.G.S. MAXIMUM GROUND VERTICAL DATUM: N. G. V. B. WATER ELEVATION BENCHMARK USED: RM 49 EL. = 9 . 80 P LOT 35 LOT 3 6 OBSERVED GROUNDWATER FOUND IN HYANNIS , ON OCEAN STREET , A BOLT TO O � o ELEVATION THE LEFT OF THE WORD "OPEN" ON A HYDRANT OQ �� o O 1 4 T7, 30' WEST OF POLE # 49/39 �,. _ _ 4 6} E 1 169.2 0' �. Uj 6 4° 05 **�*•�+'�,�,,,", _ coo o_ CEO . rn rn O O Ov y LO^ W w Ld DESIGN CRITERIA: LOT 37 x / .P N 0_ DESIGN FLOW: ° BEDROOMS AT //,0 G.P.B./D -�=_K- -P.D. to 1 . 70 AC± UPLANDOD r- ,°� CD 2. 09 AC.- WETLAND W � m CD If,el / n _ N/F o The BSC Group J ` � f dy � y ~� i p C.; R I C H A R D P. N t / �. "" <:� r� � REQUIRED SEPTIC TANK: C' HALLORAN r{ . ,� /� ✓ o, c GAL. i �O - Zoe p,�` o SEPTIC TANK PROVIDED: _ /,n GAL. fr \ - SIZE OF LEACHING FACILITY REQUIRED: ° 2 0- ��ti r z �'� Cape Cod Sunray Consultants /' / Q O p1a mow,• . m �, DESIGN PERC. RATE: _ G _ MINJNCH 3 ��P 0 ... f o ~ CO ,� 1 vr 3261 Main Street ��G P`' - ' '�' 6 $ ; '2 N Route 6A FiS} w o f CO Barnstable Village MA _ pF OQ ."�'' emu. , '... f -'�R �• / Q > 02630 V QQ� .+ht' 00` N 617 362 8133 %I W 91.92 '_' �' PROJECT TITLE: t o ✓,r'r' �, ° 0 ,,,� + v; f 6 17 21 SIZE OF LEACHING FACILITY PROVIDED: d "' IIY'''~ rJ "� .ca, �' yi f r•f, WAG BM „ � J '., ' ' - 4 :..,. ;,. K .•-' - N_ F N D I N .. _ F SYSTEM DESIGN U.P # 524 / 3 ATE �,.,. 3 " o/ E L. = 14.5 I OF PROFESSIONAL ENGINEER-CIVIL D ��` � r:�\ o_ a ', _ o�� j} �` ., � ��° 'f_ - LOTS 37 & 3 8 LLJ LOT 16 o14 ,,-,� N LOCUS PLAN: SCALE 1"_ 2,083'= , .. .�a N - .3 ..-- ., 1776_.3:3 - __T�-#•1 BA RN S TA B L E f_ 80 ° I 1� N , PRQFESS/ONAL LAND S VEYOR DATE ��/p,� 0'� / 18�5 "'�-* f.�+�a s>p-v� ` s ( H YA N N I S I 1 h' 120.00 '" - 6 0.00 ° /b ' _ 105. 00 CB/DH Aga S 760 29' 50 " 180.00 � 59 .64 ' FND " PREPARED FOR: N /F 3 +- S 75 ° 4 0 00 W , s,�� to• EUNICE H. IRELAND ET. UX. to LOT 2 l �' ANDREW N. JOA KI M B M ks fc\/ +1 LOT I TOP OF CB/DH FND LOT 3 LOT 4 a Gof E L. 19. 30 Oc\j p O Z y O . . I a " DATE: NOV. 19 , 19 85 a t , ZONE R B ° LOCUS �1 �Ew,S — O COMP;DESIGN: R L H/ G G M I � SETBACK : oSQe�'o gT. g^Y _ CHECK: S.A.W. PLAN VIEW y IL �¢ BAOK T 2�I �`eAN DRAWN: T P C / GGM t1 NDMIROUM U111 TKII WVK,D0��.� FROM AAA H;,.�lt. � SCALE: V = 30 SIDE 10 ' ��- - • FIELD: J V B / R L H ft=RQ PL.AW CW l tL ITY Mkt+ ES► AND Pt,li�„1� ,�1 i AND AME AMPROX IOA atY. �EF£!R� �� N Y A N►J I S N A R 8 O R FILE NO: - —_ -- DWG_ NO T� GAL.L>t 61$ � 11 • 111W- -44 44. 0 15 7�0 60 go FEET 7 ,