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Home My WebLink About0065 OCEAN AVENUE t.. if +i Project Name: DMb wl 0 C --1-ruvi'� �1 Address: OU0 A flyl t Permit#: Permit Date: _�/N o i°� M/P:_ LARGE ROLLED PLAINS ARE IN: 'BOX: - SLOT. _ 7/ Date entered in MAPS program on: By: � 1 T Town of Barnstable 01V a •1 • 1 .. Post ThesCard So That�rt,ts�Uis�ble;Fro,m tFe Street,-Approved Plans=Must be Retamed�on Job and this Card Must�be Kept '' eu�a Where a Certtfieate ofOceu ant as Requred�such�Bu�ldmg�shallxNot=«be.Occupied�until a Final Inspection:has been made� Permit Permit No. B-20-1119 Applicant Name: Steve Reale Approvals Date issued: 04/30/2020 Current Use: Structure Permit Type: Building-Pool-Inground Expiration Date: 10/30/2020 Foundation: Location: 65 OCEAN AVENUE,HYANNIS Map/Lot: 287-120 Zoning District: RF-1 Sheathing: Owner on Record: WHELAN,DAMES F&SUSAN H �g Contractor Name `-CUSTOM QUALITY POOLS INC. Framing: 1 Address: 86 CENTRE STREET contractor License;' 105084 2 DOVER, MA 02030 Est Project Cost: $60;600.00 Chimney: Description: 20x4O'Gunite swimming pool with an attached T radial spa and an Permit Fee: $ 175.00 automatic safety cover on the pool per ASTMistandards Fool to be x Insulation: enclosed with a 6'high code compliant safety ni ce with self- Fee PaitlF' $ 175.00 closing,self-latching gates. Date 4/30/2020 Final: Project Review Req: �ikPlumbing/Gas N a Rough Plumbing: .. _.. ' Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterassuance. All work authorized by this permit shall conform to the approved application and the approved construction documents or which t permit has been granted. Rough Gas: fi Il{ a in compliance with the local zonm b lawsvand codes. All construction alterations and changes of use of an building and structures,a b p, g Y , g Y g Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. g u s Electrical Tpt The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are�provided on thisVermit. Service: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing ` Rough: 2.Sheathing Inspection �. P 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final.: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Town of Barnstable Building t eAaNsrne Post This Ca"rd So That it is Visible From the Street-Approved Plans Must°be Retained on Job and this Card Must be Kept t65 � Posted Until-Final Inspection Has Been Made. Permit ° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied,until a„Final Inspection has been made � . Permit No. B-19-1090 Applicant Name: KENDALL&WELCH CONSTRUCTION Approvals Date Issued: 05/03/2019 Current Use: Structure Permit Type: Building-New Construction-Rebuild After Expiration Dater 11/03/2019 Foundation: Teardown Map/Lot: 287-120 Zoning District: RF-1 Sheathing: Location: 65 OCEAN AVENUE, HYANNIS } Contractor Name",�,§KENDALL&WELCH Framing: 1 Owner on Record: WHELAN,JAMES F&SUSAN H CONSTRUCTION 2 Address: 86 CENTRE STREET l Contractor License: 128405 ., Chimney: DOVER, MA 02030 Est. Project Cost: $2,666,000.00 Description: Rebuild new(6) bedroom Home ,Permit Fee: $ 13,721.60 Insulation: Project Review Req; 'AS BUILT'SURVEY REQUIRED BEFORE START OFTRAME. •' Fee Paid: $ 13,721.60 Final: �. Date:^t< . 5/3/2019 Plumbing/Gas ' J '✓ Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for.which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. --es g" '` '{ Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: art Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) &Insulation 7.Final Inspection before Occupancy Low Voltage Final: Health 'Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ,1 r ----- ------ ---- -------- .......... . MA 0 ApplicationNumber............................................................. 21 . �.�..OtherFee..... .... ...MASS. Permit Fee..�..°��/ .......... 03 TotalFee Paid ................................................................ ...... TOWN OF BARNSTABLE Permit Approval by.... Lrk...................on... /3�1 ...... BUILDING PERA41T Map........................................Parcel...... ................................... . APPLICATION Section 1 — Owner's Information and Project Location Project Address 5 ocean live— Village IS Owners Name.Ja/l,of F q/tJ Set 541i H CWA e Owners Legal Address 0 Z, 4>J?Z5 City ovvPz State Owners Cell# E-mail—A+f— L,,) e- CL Q-0 I CO 01) Section 2 —Use of Structure Use GrOUP----V gWING DEPT. ❑ Commercial Structure over 35,000 cubic feet APR ❑ -Commercial Stnicture under 35,000 cubic feet Single/Two Family Dwelling TOWN Section 3 — Type of Permit ❑ New Construction E] Move/Relocate ❑ Accessory Structure ❑ Change of use Demo/(entire structure) ❑ Fini x sh Basement ❑ Family/Amnesty El Fire Alarm Rebuild El Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall Fj Solar El- Renovation ❑ Pool El Insulation Other—Specify Section 4 - Work Description 00 ge b ct Last updated. 11/15/2018 Application Number................... . ........... ............... Section 5—Detail - Cost of Proposed Construction l,� c, 6,000 Square Footage of Project Age of Structure cloq . Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist (Design Section 6-Project Specifics Wiring ! * '` ❑ Oil Tank Storage I Smoke Detectors 3 r'APIumbing Gas ❑ Fire Suppression ® Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Lzw Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: be� W 3?-e I am using a crane ❑ Yes 101 No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes IN No ❑ f,= Section 8—Zoning Information Zoning District F, Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required 34::�7 Proposed �f 0 Rear Yard Required Proposed Side Yard Required j Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 J Application Number........................................... ` Section 9- Construction Supervisor Name ►lYt,on �2 � I ( Telephone Number 6 6 S 3 u D n � Address 5 ` "'- City q FWm y�4,State f W Zip !2 2— License Number CS —D 200&icense Type G-s Expiration Date Contractors Email 5614 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and w documentation re ed by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date �11312o' cT I P Section 10—Home Improvement Contractor Y ai �� Name 12q4n Telephone Number 5- 69( Address Po-'go'(, 1010 City 2- �r CPC State Zip 0.2 gl, .5"� Registration Number 12? `Yoh Expiration Date Ol/ /O f Z I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. 'I understand the construction inspection procedures,specific inspections and documentation re . ed by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... / Signature 1 Date '-[ `03l 2 G r Section 11 —Home Owners License Exemption Home ers Name: t Telephone Number Cell r umber t I understand my responsibilities under es and regulations for Licensed Constru sor in accordance with 780 CMR the Massachusetts Sta ding Code. I understand the construction inspection procedures,spec ons and documentation re y 780 CMR and the Town of Barnstable. j' - signature Date APPLICANT SIGNATURE l G � , Signature Date / �,+ Print Name 0, 11Z gel b �� Telephone Number 5ee- 66,6 -/�f l E-mail permit to: Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ x Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ - Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization i S44 . 1'tl � , as Owner of the subject property hereby authorize _d4 to act on my behalf, in all matters relative to work /uthforizedb)y 's building permit application for: (Address of job) i Signature of Owner date /Y. G&/1YI,�L-17 Print Name i _ a Last updated. 11/15/2018 Mckechnie, Robert From: Mckechnie, Robert Sent: Wednesday,April 17, 2019 12:26 PM To: 'damon@kendallandwelch.com' Subject: Application T13-19-1089, T13-19-1090, 65 Ocean Avenue, Hyannis Good Afternoon, Your aication has been denied for the following reasons: �� rJ &11.) A plan stamped by an architect or engineer is required. i/) The actual square footage of the upland portion of the parcel is not shown. 3.) The actual size of each floor(square_ feet). Includes basement, 15t, 2"a and 3`a je,"4-.) A plan that is readable. We will reopen the application if this information is received in a timely manner and proceed with the review. Thank you, Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 ram_ 4 1 1 aP j f og Department of Public Works avoid Yarmouth Rd. P.O.Box 326. Water.Supply Division Hyannis,Mn. 02601.0326 biffrA LE: TEL. 508=77$4068 Hyannis Water System Operations Rqx:sob-"0.1313 APRIL 3, 2019 Town of Barnstable Building Inspector Town Hall Hyannis,-MA 0260.1 RE: 65.00EAR AVE ACCOUNT#602195-2. Dear Sir: A Please be advised that the above water;service was shut off'and the meter#92451486 removed. The owner:has informed us of plans to demolish the building. Sincerely;: . ammy:Deese Hyannis Water System tM/nttitNYt7M'•:i'aaMQlruck . Operated and Maintained by WhIleWater.Inc.and Pennlchuck Water Services Corp. s v ® 247 Station Drive EVE. ' .9U �' Westwood,Massachusetts 02090 ENERGY r FebruaryQ2, 2019 i t i' Susan H Whelan is 65 Ocean Ave, Hyanisport, Ma 02647 i, RE: 65 Ocean Ave, Hyanisport, Ma 02647 Dear Susan H Whelan: At Eversource, we're committed to delivering great service This t confirmation Ma 02647hh beetat, as 02em2ovedthe electric service#o 65, Ocean Ave, Ryan sport I Based on this information, there is no electric power at this address and you:may s proceed with the demolition. If you have any questions,;please contact meat ' (888) 6333797 Since W y3 ` s I, har, ame1 s �f Eleq c Services Support Center E jl l l� ;4 it iE 508394110w 07;57:56 03-28-2019 1 /1 national ri March 28,2019 Kendall and Welch Parker Rd Osterville To Whom It May Concern RE: 65 Ocean Av,Hyannisport This letter is to confirm that National Grid cut and capped the gas service on this property. I can be reached directly at 508-760-7484 should there be any further questions. Patti eldon nationalgrid Senior Acct Mgr,Customer Connections i 127 White's Path S.Yarmouth,MA. 02664 508-760-7484 desk 508-400-5051 —cell 508-394-1109-fax patncia.weldon i nationalarid.com I IECC 2015 Performance Compliance Property Organization 65 Ocean Ave Home Energy Raters, LLC Hyannis Port, MA 02601 508-833-3100 Inspection Status Chris Mazzola Results are projected Ocean Avenue 65 Ocean Ave 65-x25azQy2 Builder Kendall Welch Annual Energy Cost Design IECC 2015 Performance As Designed Heating $3,225 $2,874 Cooling $224 $176 Water Heating $321 $321 SubTotal-Used to determine compliance $3 770 $3,371 Lights&Appliances $1,716 $1,693 Onsite generation $0 $0 Total $5,4t37 $5,Ufi4 Requirements 405.3 Performance-based compliance passes by 10.6"! 402.4.1.2 Air Leakage Testing Air sealing is 2.00 ACH at 50 Pa.It must not exceed 3.00 ACH at 50 Pa. � 402.5 Area-weighYdd average fenestration SHGC 4025 Area-weighted average fenestration 11~Fador 404 Lighting Equipment Efficiency R403.6.1 Mechanical ventilation Efficacy Mandatory code requirements that are not Mandatory Checklist checked by Ekotrope must be,met ., R405.2 Duct Insulation Design exceeds requirements for IECC 2015 Performance compliance by 10.6%. 5 As a 3rd party extension of the code jurisdiction utilizing these reports,I certify that this energy code compliance document has been created In accordance with the requirements of Chapter 4 of the adopted international Energy Conservation Code based on Climate zone 5.it rating is Projected,i certify that the building design described herein is consistent with the building plans, specifications, and other calculations submitted with the permit application. If rating is Confirmed, I certify that the address referenced above has been inspectedrtested and that the mandatory provisions of the IECC have been installed to meet or exceed the intent of the IECC or will be verified as such by another party. Name: Chris Mazzola Signature: Organization: Home Energy Raters, LLC Date: 2l4f19 at 3:20 PM Ekotrope RATER-Version 3.1.0.2101 IECC 2015 Performance compliance results calculated using Ekotrope's energy algorithm,which is a RESNET Accredited HERS Rating Tool. Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azQy2 Builder Kendall Welch General Building Inforn anon k Numberbf Bedrooms Number Of Floors 2 Conditioned Floor-Area[sq.ft.j: 6,803- "Unconditioned,attached garage?Yes Conditioned Volume[cu.ft.j 169,257 Total Units in Building 1 �, Residence Type Single'family defached Model 'Community Climate Zone 5A m Basement'Wall s -4 , u None Present _ a Basement Wall Library Last None Present Slab None Present Blab Library List w , . a None Present 7 Framed Floor , . A Name Library Type Carpet R Floor Grade Surface Area Location >basement: R34;FG,10x16,G2 1 Above Grade; 4,37OA sq.ft. Uninsutaled Unconditioned; Basement >basement stair R19,FG,10x16,G3 1 Above Grade 142.0 sq.ft. Uninsulated Unconditioned' stringer Basement; Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-)(25azQy2 Builder Kendall Welch Framed Floor Library List, Name R.v.17 1119,FG,10.16,G3r- 15.535 R30.FG,10x16,G2i 214191 7�, 0-% V 'Rim Joist Name Library Type Surface Area Location >ambient, R20� 358.0 sq.ft. Exposed Exterior >garageq, R201 I&D sq.ft. Unconditioned,attached garage' AiiTi Joist Library List- -- Name R-value R201 20.001, 7 Wall Z.... Name Library type Surface Color Surface Area Location --3,979.0 s Exposed Exterior >ambient R21,FG,6xl6,Gl Medium, >garage R21,FG,6x16,GV Medium 147.0 sq.kA Unconditioned,attached garage >unfinished basement 'i R15,FG,4x16,G1i Medium 356.0 sq,ft.!Uninsulated Unconditioned Basement I I I gable walls, R21,FG,6,16,Gf Medium 2,756.0 sq.W Exposed Exterior 2 Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azQy2 Builder Kendall Welch TWT-V Wall Library List `'11�"''* ft Ix I'll 0 W ""-'o wr' Name R-value R15,FG,4x16,G1l 13.029 R21,FG,6x16,G1 17.507 blazing a 7 Name Ubrary Type Wall Assignment Basement wait Overhang Depth Overhang Ft To Overhang.FlTo Orientation Surface Area Assignment Top tt.. of--O' 0 South 151.5 sq.ft. Front 70.35,i�;dC.O.30 >ambient Front awning'U:0.30,SHGC:0.30, >ambienf OE South 21.7 sq.ft. Front gable dh,U:0.30,SHGC:0.30 gable walls" 0 0, 0 South 492 sq.ft. Left U:0.30,SHGC:0.3Q >ambient, 01 O� 0 West 61.7 sq.ft. Left awning U:0.30,SHGC:0.36 >ambient; 0 0: 0 West 5.6 sq.ft. Rear U:0.30,SHGC:0301 >amblenti f ol 0I 0 North 128.9 sq.k Rear awning U:0.30,SHGC.0.30', >ambient 0 0 0 North 22.2 sq,R. 1 1 ; Rear gable dh�U:0.30,SHGC:0.3(Y gable walls', 0 0 0 North 193.6 sq.ft. Rear shaded dh'II U:0.30,SHGC:0.30 I' >ambient 121 0 6.3 North 220.8 sq.ft. Rear shaded slider.1.1:0.30,SHGC:0.30 >ambient� 5 2.5 9.1 North 40.0 sq.ft. Right;U:0.30,SHGC:0.30, >ambient! 0 O� 0 East 75.5 sq.ft. Right gable awning U:0.30,SHGQ0.3Q gable wails 01 O 0 East 6.7 sq. . � ft 7. GlazinO UWAry List m sae -........ m "k" Name Shgc 1.1-factor U:0.30,SHGr,-.0.301 03 0,300 Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azOy2 Builder Kendall Welch Skylight "I A qv Q, None Present Skylighttibrary Ust,m 4, None Present 9paque DoorMw a mot» ,0& Name Library Type Wall Assignment Basement Wall Emittance Solar Surface Color Surface Area Location Assignment Absorplance >Left,ThlmacT—w'Opaqut >ambient 0.9' T7e, Medium 40.0 sq.ft. Exposed Exterior —r W)2 side lites >Rear ThermaTru Opaqui >ambient] 0.9, 0.75 Medium 22.1 sq.ft. Exposed Exterior w/2 side litess' >Right ThermaTru Opaqui >ambient' 0.9, 0.76 Medium 18.7 sq.ft. Exposed Exterior w/2 side dies` > basement'Wood panel,l 318", >unfinished' 0.9, 0.75 Medium 18.0 sq.ft. Exposed Exterior basementi tt >fron ffhermaTru,Opaqui >ambient, 0.9, 0,75 Medium 20.0 sq.ft. Exposed Exterior i w)2 side Rail >garage jThermaTru,Opaqui >garagel 0.9 015 Medium 18.7 sq.ft, Exposed Exterior quo Door Lib A 0 USt Library J, .......... .0 Name R-value ThermaTru,Opaquer 7.1431 ThermaTru,Opaque w/2 side lites 5.435 Wood paneIJ 318l' 1.33 w "n, "sp ,�\....... .4,ft, Name Library Type Attic Exterior Area Clay or Concrete Roof Surface Color Surface Area Location Tiles sloped ceiling R41,FG,lOxl6,G2,.3,C 7�538� No Medium 7.5�8 0 sq.ft. Vaulted Roof F 4 Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508.833.3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azgy2 Builder Kendall Mich Roof Insulation Library Lis '41 o . , m „ e • 0 a m, Name Has Radiant Barrier R-value R41,FG,lOxl6,G2,+3,C ~� N 32.949 Whole House,Infiltration' a .fie asp - �, e. W d ,w t� >, ,� .•. •.k a a w i3 a,,, w P Infiltration Measurement Type Shelter Class 2 ACH at 50 Pa Blower-door tested, 4 echanioal Ventilatlolt T r, +& 4 Ventilation Type Ventilation Rate[Cubic Feet Operational hours per day Fan Watts Runs once every three Energy Recovery Percent /Minute) hours ERV[_ � 24F 3 Yesf 66 Exhaust Only 411 241 81 Yes %Interior Fluorescent %Interior LED Lighting %Exterior Fluorescent %Exterior LED Lighting %Garage Fluorescent %Garage LED Lighting Lighting Lighting Lighting 0 100+! 0� 10tI� 070t3 II i t[ „ m .. .yam p q .� ,M. •.� �� .,� .. ,.. iJ 1 FiGeneration d ,w 1W,. Ai. -7 rrow vvs: None Present �;� .. �. „ x , �° ,+� * ��nay +�..' � o a o ��: �•,,; <as3� �t Onstle Geneta io"t iOrdry List"' 0, mn' , . None Present 5 Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azQy2 Builder Kendall Welch Soler Generation .. ..� n t , t None Present Solar Generatlan LlbfAiV L l t , a s ,;,,,.� A,'ab 4 0 m None Present Conditioning Equipment . - W _ , Name Library Type Heating Percent Load Cooling Percent Load Hot Water Percent Load AC(1)j ACC,24k,13SEERrr 0% 0( 0% F 6 ! AC(2)' ACC,24k,13SEER! 0% 50%," a°!o E I DHWJ INSTANTANEOUS,EF82.0,NG a% 0%, 1000/0 11 Furnace(1) FURNACE,AFUE95:0,NGi' 01W, 0% Furnace(2) FURNACE,AFUE95.0>NGf 50% 0%° 0% . .� F Equipment Type: ACC Mk,1 5i~ER YFuel_Type Eleotrie Disiribution Type Forced Air fJiator Types PSC(Single Speed} Cooling Efficiency 13 SEER CoolingmCapacity[kBtUN 24 Equipment Type:,FUR! CE;AFUE95.QiNG Fuel Typed '�Naturai'Gas� �,' Distribution Type Forced Air Motor Type PSC(Single$peed} Heating Efficiency 95 AFUE Heating Capacity fl!t hj 66 Use default EAE Yes 6 Building Summary Property Organization 65 Ocean Ave Home Energy Raters,LLC Hyannis Port,MA 02601 508-8333100 Chns Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25azOy2 Builder Kendall Welch Uw* Equipment Type: NSTANTANE0US EF82.0iNC w Fuel Type m Natural Gas Distribution Type Hydronic Delivery 'Hot Water Efficiency 0.62 Energy Factor �Tankless? Yes Distribution System 4 w Distribution Type Forced-Air Heating Equipment Furnace(1) ::Goofing Equipment AC.(1}...-.,....�....-.-.._�,.� ....�m,..�....,�.- Sq.Feet Served 4370 '#'Return Gri(Ies 2 Supply Duct R Value 6 _Return Duct R Vatue B Supply Duct Area[sq.ft.] 1179.9 •-Re e -.D-uturn uct Area[sq ft J Duct Leakage to Outdoors(CFM25) 172 Total Leakage 172 Total Leakage Duct Test Conditions Post-Construction Use Default Flow Ftate Yes Duct 1 Duct Location Baserrtent{#nsulated basement ceiling) Percent Supply Area 100 -Percent Return Area 1_0 .Duct 2 F.�...m,.,m.�...�_.�-n... .a... Duct Location Conditioned Space. Percent Supply Area 0 Percent Return Area 0 Duct 3 _DucfLocation Conditioned.Space Percent Supply Area 0 Percent_Return Area 0 Duct 4 ''Duct Location `" Conditioned Space Percent Supply Area 0 'Pe w rcent Return Area 0 Duct 5 Duct Location ConditionedSpace_ � Percent Supply Area 0 Percent Return Area 0 r Duct&�� Duct Location Conditioned Space Percent Supply Area 0 �Percent'Return Area 0 7 Building Summary Property Organization 65 Ocean Ave Home Energy Raters„LLC Hyannis Port,MA 02601 508-a33-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65•x25azQy2 Builder Kendall Welch Distribution System „ . 'Distribution Type Forced Air Heating Equipment Furnace(2) "Cooling Equipment AC`{2} ASq.Feet Served 2233 r-Ret&urn--Grilles— � Supply Duct R Value 8�' _Return Duct'R Value 8 - - - Supply Duct Area[sq.ft.] 602.91 u _ ..._ `Refurn DucE Area[s�f!p]Duct Leakage to Outdoors(CFM25) 10 'Total Leakage _._.. 88 Total leakage Duct Test Conditions Post-Construction ' Use Detau[t Flow Rate., Yes Duct 1 "DU6f Location Conditioned Space Percent Supply Area 50 Percent Return Area 5f1 Duct 2 Duct Location Conditioned Space Percent Supply Area 50 `PercenCCReturn Area St) Duct 3 Duct Location Conditioned Space Percent Supply Area 0 - .&t Percentr-Retu- rn Area 0 Duct 4 Duct Location Conditioned Space Percent Supply Area 0 �PercentReturn Area � ATp Duct 5� Duct Location Conditioned Space Percent Supply Area 0 Percent Return. Duct 6 Duct Location Conditioned Space Percent Supply Area 0 Percent Return Area 0 Ceiling FA .� Has Ceiling Fart Na Cfm Per Watt 70.42254 WatieD Wributlor v . . � :'Water Fixture.Type Standard _ __ Use Default Hot Water Pipe Length Yes At Least R3 Pipe Insulation? Yes Hot Water Recirculation System? No Recirculation System Ripe Loop Lengtti[ft] 170 • Drain Water Heat Recovery? No 8 Building Summary Property Organization 65 Ocean Ave home Energy Raters,LLC Hyannis Port,MA 02601 508-833-3100 Chris Mazzola Inspection Status Ocean Avenue 65 Results are projected Ocean Ave 65-x25az4y2 Builder Kendall Welch Clothes Dryer f ' � � ` ,� rFuei Type �# Electric Cif� 2.617 e _6 ,»- '-Field Utilizatio Timer—r Con ntrols Clothes Washer. . .• . . .. 4. (..abet Energy Rating 704 kWft/Year Electric Rate $0.081kWh -.. � Annual`Gas Cosf Gas Rate $0.58l7herm Capacity 2.614 imet 0.33053 h Appliances and Contro : " M . ti Programmable thermostat?" Yes Dishwasher Size Standard ... sh_washer Efficiency Range/Oven Fuel Electric _Gonvecfion_Oven? Nn Induction Range? No Refrigerator Consumption 727 kWfilyear: Notes Errors and Warnings have been Rater Reviewed, 9 f Inspection Schedule ,�; .� Request for inspections — two-week lead-time! Home Energy Raters will be unable to perform any final, Code Compliance Inspections or Diagnostic Testing on any project that has not had an insulation or duct test. Our third party quality control process mandated by RESNET is very specific and allows no exceptions. Pre-emptive duct and frame inspection This onsite visit is not a requirement, but can be beneficial to identify any issues that could present a problem at the final inspection. Contact us when you anticipate the duct system being 100% roughed in. (All Duct systems must be tested to receive rebates—maximum total duct leakage is 6%regardless of system location) Mandatory insulation inspection Contact our office to arrange for the mandatory insulation inspection. A few days notice. is preferable in order for us to schedule a timely inspection and avoid delays with the wallboard installation. An initial LED light bulb order will be placed, based on what fixtures we see during the insulation inspection. Additional LEDs can be ordered up to the final inspection Mandatory Final Inspection Includes blower door and duct test (unless ducts had been previously tested) The home does not have to be 100% completed, only the items below. • All insulation and major air sealing details completed • Mechanical systems in place • 24-HR Bath fan control in place and power to bath fans • LEDs installed. Additional bulbs are available until final paperwork is processed • Energy Star Refrigerator and Dishwasher in place. • Permanent utility meter(s) must be in place. Please be aware of the building code that is being enforced in your town. Reaching the mandatory infiltration rates are difficult and require advanced air sealing. As a builder you must hire a insulation or weatherization contractor that will guarantee you will pass. Good Luck! Re-inspections are invoiced $250 per visit—Failure to comply with all requirements $700 incentive fee repayment. Please call to confirm the status of your project. Your account representative can be reached at 508-833-3100 I , t 4. r ....... ..". I Qom 14 329�v 24 0 +09- ? �, 84R. $TABLE LANDS 'COURT 'REGISTRY 9 S • t d f , i t E x � ;.Massachusetts Department ofEnvironmenta!Protection Provided by:MassbEP" Bureau of Resource Protection =Wetlands; SE3=5497 MassDEP File;# r WPA Farm 5`- Orden of ,Conditions " :Massachusetts Wetlands;Protection ACt M G"L,c, 131, §40, eDEPTransactwn BARNSTABLE - CitylTown r A. General Information, Please note:. 'BARNSTABLE thfsform has �.From" ,.,: w _.._ _- _. _ , ._ : ., •,j fieen modffied= Conservation Commission;. r rtn added 2 This Issuance is 6r space to a ®Order of,C011dltlon$ b Amended Order dt Ondltions.., " accommodate: (Check ogle):, - the Registry j of Deeds 3 To Applicant Requlrements' James F.&-Susan H;. __ Whelan Important:: ,t I ng a fi, rst Name b Last Name When out forms on_:the c.Organization computer; A6 Centre Street" _ usebrily the 73.'Maihng Address tab`key.to Dover MA... 02030 i, .move your , e,C !town j dy ., .. _ *.f.State` g Z�prCode hotCurs se Ye: P nY . ( PP retum ke a Pro a Owner if different from a, lieant v - r ab a;:First N_aine -Co Last•Name: c Organization �nm ". f d Mailing Address R 3; e:'City/Touun x g { 5 Project Location; ` 65 Ocean`AVenue' Hyannis. 4 a:Street Address, b:City/Towri i 287 120 c:Assessors Map/Plat Number d-Tarcel/Lot Number" ' Latitudeca nd Longitude,if known:: 41.d634m796s 70.d296m1.56s - d.Latitude 'e.Longitude: c wpaforms doc• rev.wi w2m _ Page 1 of n i' F Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 MassDEP File# WPA Form 5 - Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/7own A. General Information (cont.) 6. Property recorded at the Registry,of Deeds for(attach additional information if more than one parcel): BARNSTABLE. C 207961, LCP 20316-A a.County b.Certificate Number(if registered land) c..Book d.Page 7. . Dates: 7/25/2017 8/8/2017 8/21/2017 a.Date Notice of intent Filed b.Date Public Hearing Closed c.Date of Issuance a. Final Approved Plans and Other Documents(attach additional,plan or document references as needed): Site Plan a.Plan Title Sullivan Engineering &Consult., Inc. John C. O'Dea, P.E. i b.Prepared By c.Signed and Stamped by i July 24,2017 1" 20' d.Final Revision Date e.Scale f.Additional Plan or Document Title g.Date B. Findings 1. 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(the Act). Check all that apply: ' ❑ Public Water Supply b. ❑ Land Containing Shellfish c. ® Prevention of a. Pollution d. El Private Water Supply e. f. ® Protection of pp y ❑ Fisheries Wildlife Habitat g. ❑ Groundwater Supply h. ❑ Storm Damage Prevention I. ® Flood Control 2. This Commission hereby finds the project,as proposed, is:(check one of the following boxes) Approved subject to: a. ® the following conditions which are necessary in accordance with the performance standards set forth in the wetlands regulations.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. wpafcrm5.doc- rev.6/16/2015 Page 2 of 12 I f Massachusetts Department of Environmental Protection. Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 MassDEP File# .WPA Form 5 — Order of Conditions 1 Massachusetts Wetlands Protection Act M.G.I.. c. 131, §40 eDEP Transaction# BARNSTABLE Citylrown B. Findings (cont.) Denied.because: b. ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations. 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 the interests of the Act, and a final Order of Conditions is issued.A description of the performance standards which the proposed work cannot meet is attached to this Order. c. ❑ 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). 3. ® Buffer Zone Impacts:.Shortest distance between limit of project 0 disturbance and the wetland resource area specified in 310 CMR 10.02(1)(a) a.linear feet Inland Resource Area Impacts:Check all that apply below. (For Approvals Only) Resource Area Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 4. ❑ Bank a.linear feet b.linear feet c.linearfeet d.linear feet s. ❑ Bordering Vegetated Wetland a.square feet b,square feet c.square feet d.square feet 6. ❑ Land Under Waterbodies and a.square feet b.square feet c.square feet d,square feet Waterways e.c/y dredged f.c/y dredged 7. ❑ Bordering Land Subject to Flooding a.square feet b,square feet c.square feet d.square feet Cubic Feet Flood Storage e,cubic feet f.cubic feet g.cubic feet h.cubic feet 8. ❑ Isolated Land Subject to Flooding a,square feet b,square feet Cubic Feet Flood Storage c.cubic feet d.cubic feet e.cubic feet f.cubic feet 9. ❑ Riverfront Area a.total sq.feet b,total sq.feet Sq ft within 100 ft c.square feet d.square feet e.square feet f.square feet Sq ft between 100- 200 ft g.square feet h.square feet i.square feet J.square feet wpaform8.doc•rev.6116I201b Page 3 of Q Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 WPA Form 5 — Order o Conditions'Condition MassDEP File# Massachusetts Wetlands Protection Act M.G.L.Ll c. 131, §40 eDEP Transaction# BARNSTABLE Cityrrown B. Findings (cont.) Coastal Resource Area Impacts: Check all that apply below. .(For Approvals Only) Proposed Permitted Proposed Permitted Alteration Alteration Replacement Replacement 10. ❑ Designated Port Indicate size under Land Under the Ocean, below Areas 11. ❑ Land Under the Ocean a.square feet b.square.feet c.c/y dredged d.c/y dredged 12. ❑ Barrier Beaches Indicate size under Coastal Beaches and/or Coastal Dunes below 13. ❑ Coastal Beaches' cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 14. ❑ Coastal Dunes cu yd cu yd a.square feet b.square feet c.nourishment d.nourishment 15. ❑ Coastal Banks a. linear feet b.linearfeet 16. ❑ Rocky Intertidal Shares a.square feet b.square feet 17. ❑ Salt Marshes a.square feet b.square feet c.square Net d.square feet 18. ❑ Land Under Salt Ponds a.square feet b.square feet c.c/y dredged d.c/y dredged 19. ❑ Land Containing Shellfish a.square feet b.square feet a square feet d,square feet 20. ❑ Fish Runs Indicate size under Coastal Banks, Inland Bank, Land Under the Ocean, and/or inland Land Under Watefbodies and Waterways,above a.c/y dredged b.cry dredged 21. ❑ Land Subject to Coastal Storm a.square feet b.square feet Flowage 22. ❑ Riverfront Area a.total sq.feet b.total sq.feet Sq ft within 100 ft c.square feet d,square feet e.square feet f.square feet . Sq ft between 100- 200 ft g:square feet h.square feet i.square feet 1,square feet wpaform5.dac• rev.6/16/2015 Page 4 of 12 Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 WPA Form 5 — Order of Conditions MassDEP File 4 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE Citylrown B. Findings (cunt.) 023,If the 23. ❑ Restoration/Enhancement"": project is for the purpose of . restoring or a.square feet of BWV b.square feet of salt marsh enhancing a wetland resource area 24. ❑ Stream Crossing(s): in addition to the square footage that a.number of new stream crossings b,number of replacement stream crossings has been C. General Conditions Under Massachusetts Wetlands Protection Act entered in Section 6.5.c (BV%N)or The following conditions are only applicable to Approved projects. B.17.c(Salt Marsh)above, 1 Failure to comply with all conditions stated herein, and with all related statutes and other please enter regulatory measures the additional 9 Y , shall be deemed cause to revoke or modify this Order. amount here, 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. 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: i c. If the work is for a Test Project, this Order of Conditions shall be valid for no more than j one year. 5. This Order may be extended by the issuing authority for one or more periods of up to three j years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. An Order of Conditions for a Test Project may be extended for one additional year only upon written application by the applicant,subject to the,provisions of 310 CMR 10.05(11)(f). 6. If this Order constitutes an Amended Order of Conditions, this Amended Order of Conditions does not extend the issuance date of the original Final Order of Conditions and j the Order will expire on 8/2112020 unless extended in writing by the Department. 7. 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. wpaform5.doc•rev.6/16/2016 Page 5 of 12 I i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 MassDEP File# Ll WPA Form 5 —*Order of Conditions Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE CityrFown C. General Conditions Under Massachusetts Wetlands Protection Act 8. 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. 9. 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 the 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. 10. 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, I "Massachusetts Department of Environmental Protection"[or, "MassDEP"] "File Number SE3-5497 " 11. 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 MassDEP. 12. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance(WPA Form 8A)to the Conservation Commission. 13. The work shall conform to the plans and special conditions referenced in thiscorder. 14. Any change to the plans identified in Condition 913 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_ 15. 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 i Commission or Department for that evaluation. 16. 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. j wpaform5.doc+ rev.6M6P2M Page 6 of V i I Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 Ll WPA Form 5 - Order'of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town C. General Conditions Under Massachusetts Wetlands Protection Act.(cunt.) 17. 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, 18. 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. I 19. The work associated with this Order(the"Project") (1) ❑ is subject to the Massachusetts Stormwater Standards (2) ® is NOT subject to the Massachusetts Stormwater Standards If the work is subject to the Stormwater Standards,then the project is subject to the following conditions: a) All work, including site preparation, land disturbance, construction and redevelopment, shall be implemented in accordance with the construction period pollution prevention and erosion and sedimentation control plan and, if applicable,the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Construction General Permit as required by Stormwater Condition 8. Construction period erosion, sedimentation and pollution control measures and best management practices (BMPs) shall remain in place until the site is fully stabilized. i b) No stormwater runoff may be discharged to the post-construction stormwater BMPs unless and until a Registered Professional Engineer provides a Certification that: L all construction period BMPs have been removed or will be removed by a date certain specified in the Certification. For any construction period BMPs intended to be converted to post construction operation for stormwater attenuation, recharge, and/or treatment,the conversion is allowed by the MassDEP Stormwater Handbook BMP specifications and that i the BMP has been properly cleaned or prepared for post construction operation, including removal of all construction period sediment trapped in inlet and outlet control structures; /i. as-built final construction BMP plans are included,signed and stamped by a Registered Professional Engineer, certifying the site is fully stabilized; W any illicit discharges to the stormwater management system have been removed, as per the requirements of Stormwater Standard 10; wparorm5.doc• rev.6/16/2016 page?of 12 i i f Massachusetts Department of Environmental Protection Provided by MassDEP; Bureau of Resource Protection -Wetlands SE3-5497 WPA Form 5 — Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEPTransactionLl # BARNSTABLE City/Town C. General Conditions Under Massachusetts Wetlands Protection Act(cont.) iv.all post-construction stormwater BMPs are installed in accordance with the plans (including all planting plans)approved by the issuing authority, and have been inspected to ensure that they are not damaged and that they are in proper working condition; v. any vegetation associated with post-construction BMPs is suitably established to withstand erosion. c) The landowner is responsible for BMP maintenance until the issuing authority is notified that another party has legally assumed responsibility for BMP maintenance. 'Prior to requesting a Certificate of Compliance, or Partial Certificate of Compliance, the responsible party(defined in General Condition 18(e))shall execute and submit to the issuing authority an Operation and Maintenance Compliance Statement("O&M Statement)for the Stormwater BMPs identifying the party responsible for implementing the stormwater BMP Operation and Maintenance Plan("O&M Plan")and certifying the following: i.)the 0&M Plan is complete and will be implemented upon receipt of the Certificate of Compliance, and ii.)the future responsible parties shall be notified in writing of their ongoing legal responsibility to operate and maintain the stormwater management BMPs and implement the Stormwater Pollution Prevention Plan. d) Post-construction pollution prevention and source control shall be implemented in accordance with the long-term pollution prevention plan section of the approved Stormwater Report and,if applicable,the Stormwater Pollution Prevention Plan required by the National Pollution Discharge Elimination System Multi-Sector General Permit. e) Unless and until another party accepts responsibility, the landowner, or owner of any drainage easement, assumes responsibility for maintaining each BMP. To overcome this presumption,the landowner of the property must submit to the issuing authority a legally binding agreement of record,acceptable to the issuing authority, evidencing that another entity has accepted responsibility for maintaining the BMP, and that the proposed responsible party shall be treated as a permittee for purposes of implementing the requirements of-Conditions.18(f)through 18(k)with respect to that BMP. Any failure of the i proposed responsible party to implement the requirements of Conditions 18(f)through 18(k)with respect to that BMP shall be a violation of the Order of Conditions or Certificate of Compliance. In the case of stormwater BMPs that are serving more than one lot,the legally binding agreement shall also identify the lots that will be serviced by the stormwater BMPs. A plan and easement deed that grants the responsible party access to perform the required operation and maintenance must be submitted along with the legally binding agreement. f) The responsible party shall operate and maintain all stormwater BMPs in accordance with the design plans, the O&M Plan,and the requirements of the Massachusetts Stormwater Handbook. i wpaform5Aac•rev.611612016 Page 8 of 12 i i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-5497 WPA Form. 5 — Order of Conditions MassDEP File# ILI Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE City/Town C. General Conditions Under Massachusetts Wetlands Protection Act (cunt.) g) The responsible party shall: 1. Maintain an operation and maintenance log for the last three(3)consecutive calendar years of inspections, repairs, maintenance and/or replacement of the stormwater management system'or any part thereof, and disposal(for disposal the log shall indicate the type of material and the disposal location); 2. Make the maintenance log available to MassDEP and the Conservation Commission ("Commission")upon request; and 3. Allow members and agents of the MassDEP and the Commission to enter and inspect the site to evaluate and ensure that the responsible party is in compliance with the requirements for each BMP established in the O&M Plan approved by the issuing authority.. h) All sediment or other contaminants removed from stormwater BMPs shall be disposed of in accordance with all applicable federal, state, and local laws and regulations.. i) Illicit discharges to the stormwater management system as defined in 310 CMR 10.04 i are prohibited. j) The stormwater management system approved in the Order of Conditions shall not be j changed without the prior written approval of the issuing authority. k) Areas designated as qualifying pervious areas for the purpose of.the Low Impact Site Design Credit(as defined in the MassDEP Stormwater Handbook,Volume 3, Chapter 1, Low Impact Development Site Design Credits)shall not be altered without the prior written approval of the issuing authority. 1) Access for maintenance, repair, and/or replacement of BMPs shall not be withheld. Any fencing constructed around stormwater BMPs shall include access gates and shall be at least six inches above grade to allow for wildlife passage. Special Conditions(if you need more space for additional conditions, please attach a text document): I 20. For Test Projects subject to 310 CMR 10.05(11), the applicant shall also implement the monitoring plan and the restoration plan submitted with the Notice of Intent. if the conservation commission or Department determines that the Test Project threatens the public health, safety or the environment,the applicant shall implement the removal plan submitted with the Notice of Intent or modify the project as directed by the conservation icommission or the Department. . wpakrmldoc. rev.6/16/2015 Page 9 of 12 I ' I a Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands MassDEP File Ll I WPA Form 5 — Order of Conditions assDE Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 eDEP Transaction# BARNSTABLE Citylrown D. Findings Under Municipal Wetlands Bylaw or Ordinance 1. Is a municipal wetlands bylaw or ordinance applicable? ® Yes ❑ No 2. The hereby finds(check one that applies): Conservation Commission a. ❑that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw, specifically: 1.Municipal Ordinance or Bylaw 2.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. b. ®that the following additional conditions are necessary to comply with a municipal ordinance or bylaw: BARNSTABLE S.237-1 - 1.Municipal Ordinance or Bylaw 237-14 3. The Commission orders that all work shall be performed in accordance with the following 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. The special conditions relating to municipal ordinance or bylaw are as follows(if you need more space for additional conditions, attach a text document): See Pages 10.1, 10.2, and 10.3 I wpa1arrrt5.dcc-mev.W6=15 Paige 10 of 12 SE3-5497 Name: James F. & Susan H.Whelan , Approved Plan= July 24,2017 Site Plan by John C.O'Dea,P.E. Special Conditions of Approval 1. Preface Caution: Failure to comply with all Conditions of this Order of Conditions may have serious consequences. Consequences may include: issuance of a Stop Work Order;fines;requirement to remove un-permitted 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 5 and continue through Page 9. The Special Conditions contained herein and all Conditions require your compliance. H. 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 9(recording requirement)shall be complied with. 2. It is the respons''biilk 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 mUleted and returned to the Commission Division prior to the start of work. 3. General Condition Number 10(sign requirement)shall be complied with. 4. The Conservation Commission shall receive written notice one(1)week in advance of the start of work. 5. The work-limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. 6. Staked strawbaies backed by trenched-in siltation fencing shall be set along the approved work-limit line. Wattles may be used instead,following consultation with the Conservation Agent.Where authorized for use,wattles shall be 12 inches in height at minimum.Effective sediment controls shall remain until the site is stabilized with vegetation,then they shall be removed. 10.1 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. ote: The strawbales and siltation fence(or wattles,where approved)must show in the foreground(or bottom)of the photographs. M. The following additional Conditions shall govern the project once work begins. Note, especially,Special Condition Number 15,requiring verification of the locations of the foundation and strawbale line. 8. General Conditions,Numbers 13 and 14(changes in plan)shall be complied with. 9. General Condition Number 18(maintaining sediment controls)shall be complied with. 10. The construction work limit shown on the approved plan shall be strictly observed. 11. There shall be no disturbance of the site,including cutting of vegetation,beyond the work lunit. This condition shall continue over time. The only exception would be those disturbances with specific prior approval. 12. The Conservation Commission,its employees and its agents shall have a right of entry to inspect for compliance the provisions of this Order of Conditions. I 13. Unless extended,this permit is valid for three ears from the date of issuance. P Y 14. An Amended Order does not change the original date of expiration of this Order of Conditions. 15. Upon completion of the foundation,the project surveyor or engineer shall verify in writing or by plan to the Commission the correct location of the foundation and work-limit line,and note any discrepancies from the approved plan. If verification is in the form of an"as-built"plan,the plan provided shall be drawn at the same scale as the approved plan. 16. Drywells,or graveled trenches along the drip lines shall be installed to accommodate roof-runoff. i 17. Pool and spa shall be disinfected by ozone injection or alternate method,as approved by the Conservation Commission. Drawdown water shall be sent to an appropriately sized leaching basin. Upon installation,a letter shall be submitted by the installer verifying that disinfection and leaching basin requirements have i been met.The location and capacity of the basin shall be verified and the means by which drawdown will i be directed to the basin shall be described. 18. During construction,no area shall be left un-mulched or un vegetated for more than thirty(30)days. All areas disturbed during construction shall be re-vegetated immediately following completion of work at the site, Mulching shall not serve as a substitute for the requirement to re-vegetate disturbed areas at the ` conclusion of work. 10.2 t 19. All proposed lawn areas shall be underlain with a minimum of six(6)inches of loam. 20. Removal of hazardous trees along the path is permitted. 21. The path shall be maintained no wider than four-feet in width within the 50-foot buffer of the Town coastal bank. 22. Work limit markers(wood stakes)shall remain in place until a Certificate of Compliance is issued for this project. 23. Tree removal within the 50—100-foot buffer zone must first be reviewed and approved by staff(once the dwelling is constructed)during a vista pruning site visit. 24. Proposed vista-pruning shall be done in accordance with Conservation Commission guidelines. Advance consultation with the Conservation Agent is required. 25. The Conservation Commission requests the applicant to consider saving the specimen maple tree near the proposed house. IV. After all work is completed,the following condition must be promptly met: 26. 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 returrved.along with the request for a Certificate of Compliance and appropriate fee. 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 shall be submitted,certifying substantial compliance with the plans,setting forth what deviation(s),if any,exists with the record plans approved in the Order. This statement shall accompany the request for a Certificate of Compliance and fee,along with an updated sequence of color photographs of the undisturbed buffer i i zone. i {i 10.3 i i i i Massachusetts Department of Environmental Protection Provided by MassDEP: Bureau of Resource Protection -Wetlands SE3-6497 WPA Form 5 - Order of Conditions MassDEP File# Massachusetts Wetlands Protection Act M.G,L. c. 131, §40 eDEPTransactionLl # Barnstable Cityfrown E: Signatures Important:When This Order is valid for three years,unless otherwise specified as a special AUG 2 1 2017 filling out forms condition pursuant to General Conditions#4,from the date of issuance. 1.Date of I uance on the computer, use only the tab Please indicate the number of members who will sign this form, key to move your This Order must be signed by a majority of the Conservation Commission. 2.Number of Signers cursor-do not use the return The Order must be mailed by certified mail(return receipt requested)or hand delivered to key the applicant.A copy must be mailed, hand delivered or file lectronically at the same time with the appropriate MassDEP Regional Office. r� Signatures: ok I � . ❑ by hand delivery on ® by certified mail, return receipt requested,on AUG 2 1 2017 Date' Date F. 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 resident's of the city or town in which such land is located, are hereby notified of their right to request the appropriate MassDEP 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 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. I i Any appellants seeking to appeal the Department's Superseding Order associated with this I appeal will be required to demonstrate prior participation in the review of this project.Previous participation in the permit proceeding means the submission of written information to the Conservation Commission prior to the close of the public hearing, requesting a i Superseding.Order, or providing written information to the Department prior to issuance of a Superseding Order. The request shall state clearly and concisely the.objections to the Order which is being i 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. i wpa5si s.doc• rev.02r2512010 Page if od-2— I � T Town of Barnstable .us �� Building Post This Ca"rd So That it is Visible From;the Street-Approved Plans Must be Retained on Job and'this CardyMust be Kept Posted Until Final Inspection Has Been Made.*,,-',;" er it f6;q w ot a Where a Certificate of.Occupancy;is,Required,such.Building shall N beOccupied until a Final Inspection has been hi—cl' . � m.-.+e+:=ra�,i.R%.W.mnF..�ew4 d'.F^....+.lwx«✓... .bx+8.�� ........iwt.+....d.ah✓ w.vw.b-MawdYJ' Permit NO. B-19-3411 Applicant Name: KENDALL&WELCH CONSTRUCTION Approvals Date Issued: 10/30/2019 Current Use: Structure Permit Type: Building-Detached Accessory Structure- Expiration Date: 04/30/2020 Foundation: Residential Map/Lot: 287-120 Zoning District: RF-1 Sheathing: Location: 65 OCEAN AVENUE,HYANNIS y Contractor Name: DAMON L KENDALL Framing: - Owner on Record: WHELAN,JAMES F&SUSAN H Contractor License CS-070086 2 t Address: 86 CENTRE STREET '= Est Project Cost: $30,000.00 Chimney: DOVER, MA 02030 Permit Fe $253.00 Description: 20x20 POOL CABANA WITH LOUNGE BATH AND KITCHENETTE + 9 Insulation: Fee Paidr $253.00 Project Review Req: � ' Date 10/30/2019 Final: Plumbing/Gas Ye Rough Plumbing: llff This permit shall be deemed abandoned and invalid unless the work authorized by thisperm�t�is commenced'withm sa"moriths after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application<and the'approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures'shall be in with the local zoning by-laws a,nd codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or;:road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ¢ a Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures' the Buildingand-Fire-Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Service: 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue-lining is'installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons ;kth unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: _ Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: U I L-�W I D E PT, Application Number .........1............................................ 7 ',;SH + sARM + a6 OCT 1.- 2019 Permit Fee........................:... 59• Other Fee,....................... N �A ♦ ps iY�� F(F`�EJ iYiS'J .^��' ,-'-s-�...:..-x�lA�L.�t � • 6 Total Fee Paid.............................................................:. ...... TOWN OF BARNSTABLE Permit Approval by...,"Ove G�.....On......��yy< BUILDING PERMIT kMap........:P-� .........Parcel............ .................. APPLICATION Section 1 — Owner's Information and Project Location I Project Address 0c-eo/X Aye. Village Mli 1 Id Owners Name ToyME ��An Owners Legal Address_,�R F cl&rue �jt City—z/& WV State H4 Zip ®Z- I Owners Cell# E-mail F— Section 2 —Use of Structure . Use Group 'ice ❑ Commercial Structure over 35,000 cubic feet El Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3 —Type of Permit &,New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment � Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar y ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description iK22 LnPIlle Tact nndonrl- 11/1 V701 R i Application Number.................................................... Section 5—Detail Cost of Proposed Construction n,p.P Square Footage of Project f'l D D Age,of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) V 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist 9-Design Section 6—Project Specifics j i Wiring ❑ Oil Tank Storage Smoke Detectors Plumbing [K Gas ❑ Fire Suppression EA-Heating System ElMasonry Chimney ❑ Add/relocate bedroom Water Supply A—Public ❑ Private Sewage Disposal ❑ Municipal 9LOn Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: W4.✓ �e Fold V..,g4-T-rC I amusing a crane ❑ Yes allo Section 7—Flood Zone Flood Zone Designation a Within or adjacent to a wetland, coastal bank? Yes No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. ACry Total Frontage 22 c7 ' Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required Proposed D Rear Yard Required [ 5 Proposed r —Dv c( Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updated: 11/15/2018 Application Number............................................ Section 9= Construction Supervisor Name. ��n�zi([ Tel hone Number s0 S6�5 V 1 Address ��9i1•, �/-ISf �X- City�� Ft4 State Zip S.T,< License Numbers —o-WT 6 License Type �S ,Expiration Date I j / =(-, 2_y2 Contractors EmailOt2, 1 Kej�Al�1:��.tleY-%� ,00�h Cell # _ 0�5, 6 5��/ I understand my responsibilities under the'rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re uired by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date l�G'►`- s� 2G/ Section 10—Home Improvement Contractor Name y' Amon A e/kJ/-�( � Telephone Number s06�' Address ? /o'� [ D City �S' e/'�i( f State Zip Registration Number Expiration Date D 1-2_0> Zl I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation aired by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signatur Date 7 . Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations_for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. ' Signature Date APPLICANT SIGNATURE a Signature tDate ( j 2 Print Name Telephone Number ;j611-0 57 q, E-mail permit to: e,,dA [ f�n�vj�(C s ® . Last updated: 11/15/2018 Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department « ❑ R Conservation For commercial work,please take your plans directly to the fire department for approval, Section 13 — Owner's Authorization i I, , as Owner of the subject property hereby authorize <. to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner , date Print Name V f 1 Last updated: 11/15/2018 II , f Cf)MmdnWealth 6t IVIa9SAhus2tts Division of professional Lif:ensUre `Board of auilding Regulations and Standards Cg9VA-a o0"yttgeryisol CS�67t�08fi 1. $- tpiresi�11121/2020 DAMON L KWAL «- 48 KOMPASS DRIy€ €SST FALMOUTH MA 08536 -k- r aw locimehisslOhdir Office of Consumer Affairs and E36siness Regulation 1000 Washington Street e Suite 710 Boston, Ma6sachusetts 02110 Dome Improvem�e�nfC41- ©ntractor Registration - Type: Partnership Registration: 128405 KENDALL&WELCH CONSTRUCTION ' t Expiration: 04/05/2021 P.O.BOX 490 *� , OSTERVILLE,-MA 02655 ("I .- - A 4 a ...- _.a.- -. • ------ t \ w� Update Address and Return Card." SCA 1 6 20M•05117 • .�n� �I'h1I)�Mlll.Oifll//h f-.'��Flola7«�Yllidf✓�sl I Ili Office of Consumer Affairs 4 pusiness Regulation' , I OM F Im PROVigmVNT CONTRACTOR Registration valid for individual use only TYVF—Parfnership before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation n"51- 84ii - 04%05/2021 1000 Washington Street Suite 710 9 KENDALL&WEL CONSTRUCTION . 6oston,MA_ 0211E `Y �t = DAMON .KENDALL `M-7- r'r 54 KOMPASS DRf\ �� `;� /Y, IGG.� A.' FALMOUTH,MA 02536'' Not vplid with-out sign@tore Undersecretary ems— CERTIFICATE OF LIABILITY INSURANCE =,MMIDZD) FTHIS CERTIFICATE I;l ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS N0 RIGHTS UPON THE.CERTIFICATE HOLDER. TF ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENP, EXTEND OR ALTER THE COVERAGE AFFORDED BY THEE POLICI, ELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZI REPRESENTATIVE OR PRODUCER,AN;-'."THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, fh'e poltcy(ies) must be endorsed, If SUBROGATION IS WAIVED,subject the terms and conditions of the policy,certain policies may require an'endorsement, A stateme certificate holder in lieu of such endorsement(s). nt on this certificate does not confer'rights to t PRODUCER CONTACT MURRAY& MACDONALD INSURANCE SERVICES INC NAME:o Suzanne Harrington ton PHONE • (508)289-4170 FAX EMAIL A(C No): 550 MACARTHURBLVD f ADDRESs: sharrington@mmisi.com BOURNE INSURER S AFFORDING COVERAGE INSURED MA 02532 INSURERA: HARTFORD UNDERWRITERS INS CO `AIC4 KENDALL &WELCH CONSTRUCTION INC INsuRERB: 3010� INSURER C PO BOX 490 INSURER D OSTERVILLE -INSURER E; COVERAGES - MA .02655 IJ INSURERF:THIS IS TO CERTIFY THAT THE POLICIES TOFICATE NUMBER: 36 INSURANCE LISTED BE OW HAVE BEEN INDICATED. NOTWITHSTANDING-ANY REQUIREMENT, TERM OR CONDITION C>F ANY CONTRACT OR OTHER REVISION NUMBER: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POL CIESTD O NSUf2ED NAMED ABOVE FOR THE POLICY PERIO( EXCLUSIONS AND CONDITIONS OF SUCH POLICLES.LIMITS SHOWN MAY HAVEIBEEN REDUCED CI PAID SCR EDOCUMENT WITH RESPECT TO WHICH THI; ILTR 4AI S. HEREIN IS SUBJECT TO ALL THE TERiVS LTR TYPE OF INSURANCE ADDL S BR COMMERCIAL GENERAL LIABILITY POLICY NUMBER POLICY EFF POLICY EXP _ _ MM/DD/YYYY MM/DD/YYyY CLAIMS-MADE ' LIMITS C_)OCCUR EACH OCCURREN CE � DAMAG $ • TO EN D PR EMISES SE S Ea occu GEN'L AGGREGATE LIMIT APpt.IES P N/A MED EXP(An one person) $ PRO-E ___ LOC PERSONAL&ADV INJURY POLICY❑ $ r GENERAL AGGREGATE OTHER: $ AUTOMOBILE LIABILITY _ PRODUCTS-COMP/OP AGG $ ANY AUTO COMBINED SINGLE LIMIT AUTOS $ ALL OWNED SCHEDULED (Ea accid_ ent AUTOS BODILY INJURY(Per person)• $ NON-OWNED N/A — HIREDAUTOS AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE UMBRELLA LIAR Per accident $ EXCESS LIAR OCCUR _ ()LA1MS-MADE $ RETENTIONS_ DED N/A EACH OCCURRENCE $r - RREN WORKERS COMPENSATION AGGREGATE' AND EMPLOYERS'LIABILITY $ ANYPROPRIETOR/PARTNER/EXE(,UTIVE„' Y/N - _ - A OFFICER/MEMBEREXCLUDECE $ -------- (mandatory inNH) N/A N/A N/A 6S60UB5033P43519 X S ATUTE ERH DESCRIPTION OF OPERATIONS below 02/06/2019 02/06/2020 E.L.EACH ACCIDENT E.L,DISEASE- $ 500,000 EA EMPLOYEE i— E.L. 500,00p .DISEASE• N/A d xr. POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCgTfONS/VEHICLE$(pCORD 101,Additional Workers'Compensation benefits cta/mS for benefits toe w'I/be paid t0 Remarks Schedule,ma mp/oyees in states other than Massachu ets employees the Y be attached If achusetts This certificate of insurances only;Purs(jant t0 E more space Is re issued holds the insured hires, ndorse required) ate of this certificate of insurance or h ho, WC 20 03 06 B Search toot policy in force on the as hired those em at www,mass.gov/Insu ) The status date that this ployeeS 0 10 allthbrizatio corkers-com of this covera Certificate was i Utsi n L given to pa pens ation/investi ge can be monitore' ssued(unless the de°f Massachusetts. y CERTIFICATE gations/, d daily by accessin expiration date on HOLDER — g the Proof the above `of Coverage-Cove Policy Prece Os the n Own of Barn CANCFj l.qN 67 Main StraPt Stable SHOULD ANY or THE ACCOROA IyAETlION DA ez HRH R1f3 p HEPOLICYP�p�ISDNSCECIWILE CAN CECLEDFFF DELIV�R NF '0 lQk The Commonwealth of Massachusetts , Department of IndustrialAccidents Office of Invesdgations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Orgmization/Individual): 6,,�i ( �' /l / Address: 1(2t ��fC°'��" City/State/Zip:05 eVC( *21- 5 Phone#: V2 °� ®� Are you an employer?Check the appropriate box: Type of project(required); 1,n I am a employer with- `'( 4.g_I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity.acit3'• employees and have workers' t 9. ❑Building addition [No workers'comp.insurance ' comp.insurance. . w r ed.] , 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their •11. Plumb' repairs or additions 3.❑ I am a homeowner doing all work ❑ right of exemption per MGL myself[No workers comp. 12.0 Roof repairs insurance required.]t c. 152,§1(4)9 and we have no employees.[No workers' 13.❑Other comp.insurance required.) *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submits new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractcrs and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their worker:comp.policy number. I am an employer that is providing workers compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 0 1 f G Policy-#or Self-ins.Lie.M 6 56 ' 5V J 0 � Expiration Date: l®6 ! Jt Job Site Address:61 OG� �//� City/State/Zip:�Yf�n�P�� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby under the pains and penalties rperjury that the information provided above is true and correct Si atnre: a^g191_ Date: �- C 7 Phone#• v Official use only. Do not write in this area,to be completed by city or town oj}icial City or Town: Permit%icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage reqnired" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insu rance license number on the appropriate line. City or Town Officials _ Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of hussar-used s Department of Industrial Accidents (lice of Investigations ` 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 VivMnlass.gvv/dia A6o CFERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD7PYYY) h� 03/04/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOY AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSt,4P,ANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND HE CERTIFICATE HOLDER. ` IMPORTANT: If the certificate.holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Linda Sullivan DOWLING &O'NEIL INSURANCE AGENCY P"�N o E • (508)775-1620 AC No: ADDRess: Iullivan@doins.com• 973IYANNOUGH RD _ INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B: DETAIL SIDING INC INSURERC: r INSURER D: 55 WOLLEY ROAD INSURER E: HYANNIS MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER: 374258 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS.SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/DDY/1 YFYY MMIDD� LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCEDAMAGE To RENTED $ _ CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: k GENERAL AGGREGATE $ 6 POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ s ~ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident) _ ANY AUTO - - BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Par .. $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLA1MS-MADE r N/A' • AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT ' $ 500,000 A OFFICER/MEMBER EXCLUDED? N/A NIA NIA VWC10060228502019A 01/25/2019 01/25/2020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ .500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at vaAw.mass.gov/lwd/workers-compensation/investigations/. -CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kendall & Welch Building & Remodeling ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 490 AUTHORIZED REPRESENTATIVE Osterville MA 02655 ® ETE(MMIDDIYYYY) CERTIFICATE ®F LIABILITY INSURANCEi13i2o19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ids) must be endorsed. If SUBROGATION IS WAIVED, subject 4o the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER CONTACT Karen Bernier NAME: Eastern Insurance Group IL:LC PHONE 774-213-0027 qIC No;781-586-7704 233 West Central St E-MAIL ']cbernier@easterninsurance.corn SS ADDRESS: • INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA Merchants Preferred Insurance INSURED INSURER 13 Merchants Insurance Group 23329 Rons Excavating Inc INSURER h: 81 Echo Road Unit #1 INSURERi): ' INSURER R ashpee MA 02649 INsuRERI COVERAGES _CERTIFICATE NUMBER:2018 2019 _ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN!ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY'CONTRACT OR OTHER DOCUMENT WITH RESPECT-fO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY T(,IE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N7R TYPE OF INSURANCE ADD S R POLICY EFF POLICY EXP - _ POLICY NUMBER f1MMIDD/Y MMIDDNYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE OCCUR DAMAGE Ea occurrence $ 100,000 CMP9148246 5/1/2019 5/1/2020 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,600 GEN'L AGGREGATE LIMIT APPLIES PER: 000 0'00 GENERAL AGGREGATE - $ 2,000,, X POLICY LJ PRO- LOG e -- JECT PRODUCTS-COMPIOPAGG $` 2,000, OTHER: _ _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ . Ea accident B ANY AUTO BODILY INJURY(Per person) $ 1,000,000 AUTOS Ix AUTOSSCHED LED MCA7013915 8/16/2018 8/16/2019 BODILY INJURY Per accident $ 1,000,000 AUTOS AUTOS ( )X HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ 1,000,000 _ MEDICAL PAYMENTS $ 5,000 - X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1 000 000 B EXCESS LIAB CLAIMS-MADE ' AGGREGATE $ 1,000,600 DIED I X I RETENTION$ . 101000 �CUP91417746 ;i/1/2019 5/1/2020 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N X STATUTE X 'ERH _ ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT $' 11000,000 B OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) WCA9094537 5/1/2019 5/1/2020 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT $ 11000,600 ESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) M1 ERTIFICATE HOLDER _ CANCELLATION ca.t.rina@kendallandwelch:co a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Kendall & Welch- THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 3.08 Parker Rd ACCORDANCE WITH THE POLICY PROVISIONS. Osterville, MA 02655 _ AUTHORIZED REPRESENTATIVE John Koiegel/KBERNI ©1988-2014 ACORD CORPORATION. All rights reserved. CORD 25(2014/01) The ACORD name and logo are registered marks of ACORD S025 1917114Mt DATE(MMIDDIYYYY) � LIABILITY INSURAN CE �►+�"��. :. CERTIFICATE OF 1o/o�+s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND J-,yE CERTIFICATE HOLDER- IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or bo endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME: JIM HINDMAN PHONE 508-771-8381 c No; 508-771.0663 Schlegel&Schlegel Ins Broker AIC No Ext 34 Main Street ADDREss: SCHLEGELINSURANCE@GMAIL,COM West Yarmouth,MA 02673 INSURER(G)AFFORDING COVQRAGE NAIC it INSURER A: NGM INSURANCE COMPANY 14788 INSURED iNbURER B: TRAVELERS CAPE COD SPRAY FOAM INSURERC: PROGRESSIVE 49 SISSON ROAD INSURER D: HARWICHPORT,MA 02645 INSURER E: INSURER F: REVISION NUMBER: COVERAGES CERTIFICATE NUMBI=i2: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 suojECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEE%REDUCED BY PAID CLAIMS. POLIG LTR POLICY NUMBFIt MryUD6 MM DO LIMBS Type OF INSURANCE WVD 1,000,004 $ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE r�c�-1:�� P HMISE5 Eeoccurr is 50010011 CLAIMS-MADE 1- OCCUR 1O O00 MED EXP One emOn � MPK9358X 11116/18 11/16/19 PERSONAL&AOV INJURY $ 1,000,001 . A GENERALAG(BREGATE s 2,01)0,001 OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,001 POLICY 7 jF'CT 7 LOC $ OTHER: COMBIN eOtSINGLE T $ 1,000,00 AUTOMOBILE LIABILITY BODILY INJURY(Per person) $ ANY AUTO BODILY INJURY(Per accident) $ OWNEO X SCHEDULED 07881543� 06108119 05/08/20 PROPERTY AnnAGE C AUTOS ONLY AUTOS $ HIRED NON-OWNED P r ccident AUT08 ONLY AUTOS ONLY Is EACH OCCURRENCE $ UMSRr;"A LIAR OCCUR AGGREGATE $ EXCESS LIAO CLAIMS MADE DED RETENTION$ OTH- WORK(ERS COMPRNBATION STATUTE ER AND EMPI-DYERS'LfARILITY Y I N El.EACH ACCIDENT $ 500,11I ANY PROPRIETORIPARTNERIEXECUTIVE NIA 6HUS6513035513 07/23119 07/23120 500,01 B OFHCERIMEMBER EXOLUDGD? a E.L,DISEASE-EA EMPLOYE $ (Mandatory In NH) 500,01 li qes,tlaacrlbe under E.L.DISEASE POLICY LIMIY $ DESCRIPTION OF OPERATION6 below DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLEB IAOORD 109,Addltlonal Rama�s Schedule,mvy be attecNed II mare space lb repulrad) CORPORATE OFFICERS HAVE ELECTED 70 BE COVERED UNDER THEIR CURRI=NT WORKERS COMP POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE aESCRIBED POLICIES 6E THE EXPIRATION DATE THEREOF,NOTICE WILL BE A LIVERED IN ED BEFOR ACCORDANCE WIYH THE POLICY PROVISIONS, KENDALL AND WELCH CONSTRUCTION 32 WIANNO AVE SUITE A5 AUTHORIZED REPaESENTATIV OSTERVILLE MA 02655 bookkeeperkandw@grnoil.com, fax 508-d28-4907 DPFUCCI-01 R IETTA r Q CERTIFICATE OF LIABIILITY INSURANCE DATE(MMIODIYYYY)12/18/2018 - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INS0=RANCE DOES NOT CONSTITUTE 'A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poliicy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the'policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such bndorsement(s). C NT PRODUCER ' ACT_ Almeida&Carlson Insurance Agency,Inc j PHONE 508 540-6161 (FAX ( ) PO Box 554 1 INC,No,Ext):( ) A/c,No: 508 457-7660 Falmouth,MA 02541 � 13Ess INSURERS AFFORDING COVERAGE NAIC# u tERA:ARBELLA PROTECTION INS CO 141360 INSURED I�NsuRER B:Hartford Underwriters Insurance Co D P Fuccillo Const Inc i INSURER C 548 Thomas Landers Rd - i INSURERD: E Falmouth,MA 02536 i 'I�NSUFtER E I INSURER F COVERAGES _ CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDEDi BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. t INSR TYPE OF INSURANCE ADS L SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A I X COMMERCIAL GENERAL LIAEIUTY I i i EACH OCCURRENCE $ 1,000,000 j CLAIMS-MADE C OCCUR 18500045173 1 10/20/2018 i 10120/2019 De nce) 300,000t- -LANKET ADD'L INSURE i I 5,000 _ MED�MED E person) I$ PERSONAL&ADV INJURY 1'000'000 I 2 000 000 i I i GEN'L AGGREGATE LIMIT APPLIES PER: j ENERALAGGREGATE r r POLICY PR� 'LOC I` PRODUCTS-COMP/OP AGG !$ 2,000,000 OTHER: E AUTOMOBILE LIABILITY COM�BINdED SINGLE LIMIT (EaANY AUTO BODILY INJURY Perperson) is —�OWNED SCHEDULED ! AUTOS ONLY AUTOS ; I BODILY INJURY(Per accident)1$ HIRED I NpN-OyyNEp PROPERTY DAMAGE — AUTOS ONLY --I AUTOS ONLY I (Per accident) :$ $ .. / _I UMBRELLA UAB' _J OCCUR I � i EACH OCCURRENCE EXCESS LIAB 1 CLAIMS-MADEI 1 Ii AGGREGATE DED i RETENTION$ j B !WORKERS COMPENSATION j ! 1 SERT - HI !AND EMPLOYERS LIABILITY UTE E YIN 500,006IANY PROPRIETOR/PARTNER/EXECUTIVE I5B659382 I E.L.EACH ACCIDENT FaFnCERM 'N/AI MdatoryE 500,000n NE) EA EMPLOYEE E.L.DISEASE If yes,describe undert 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I I i i s DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) i CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE KENDAL&WELCH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM16�6'11YYY) 02/11/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A[•lC) CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOY AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSLIpaANCE DOES NOT CONSTITUTE ilk CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be-endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endollsement. A statement on this certificate does not confer righty to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT - NAME: Suzanne Harrington MURRAY& MACDONALI�'- INSURANCE SERVICES INC PHC(NI? FAX 0 o t (508 289-4170 A/C No: nDORliss; sharrington@mmisi.com 550 MACARTHUR BLVD INSURER S AFFORDING COVERAGE NAIC/I INSURED BOURNE — MA 02532 w$tiRERA: AIM MUTUAL INS CO 33758 � -�- INSt1RER B:_ ,LEE ANDERSEN ['// IN$tiRERc: INSURER D; PO BOX 993 INSLIRLR E; FORESTDALE _ MA 02644 INS LiRERF: COVERAGES _ CERTIFICATE NUMBER: 367031 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICIi THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BUN REDUCED BY PAID CLAIMS. TN SR — ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE mqn_WVD POLICY NUMBER _ MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE CLAIMS-MADE OCCUR DAMAGE TORE TED $ PREMISES Ea occurrence $ MED EXP(Any oneperson) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ ,� POLICY❑PRO-JECT I LOC OTHER: PRODUCTS-COMP/OP AGG $ _ _AUTOMOBILE LIABILITY $ COMBINEDSINGLELIMIT $ Ea accident ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $ ' AUTOS AUTOS N/A U OS BODILY INJURY(Per accident) $ HIRED AUTOS NON-UVJNED. AUTOS PROPERTY DAMAGE $ ., Per accident) UMBRELLA LIAB OCCUR EXCESS LIAB EACH OCCURRENCE $ CLAIMS-MADE N/A AGGREGATE $ • DED RETENTION$ _ WORKERS COMPENSATION _ - $ AND EMPLOYERS'LIABILITY Y/N X STATUTE ER ANYICER/M MBERPARTNER/EXECUTIVE E.L.EACHACCIDENT $ 100,000 A (Mandatory In NIA N/A N/A VWC1001i0228112019A 01/03/2019 01/03/2020 (Mandatory In NH) If Yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A PSCRIPTIONW OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may tie attached If more space is required) orkers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employee's outside of Massachusetts. This certificate of insurance shows,the policy in force on the date that this certificate was issued!(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govllwd/workers-compensation/investigations/. Sole proprietor has not elected coverage. — CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kendall & Welch A060RDANCE WITH THE POLICY PROVISIONS, Po Box 490 AUTHORIZED REPRESENTATIVE " Osterville MA 02655 3 o THE Town of Barnstable' Building Department Services aasrrarnsrE Brian Florence,.CBO n�nss sb39.��' Building Commissioner FD MA'1 100 Main;Street,Hyannis,_. 0260`1 www.iownaarnstable.ma.us; t Office: 5087862-4038 Fax 5.08 9.0=6230' t Property Owner Must ' Complete and Sign This Section? If Using A Builder 1 u I, 4 - as 0 merr-of the subject property hereby.a uhonze 6l Pdlll/ f �i�liw. to.act on my.behalf,. � ` m all-matters.reladVe to.work authorized by this buildikg.pesrnit app scat on for:" (Address.of Jobj 4 * i`Pool fences and,alarms are the responsibility,of,the:applic`ant. Pools are not to'be'filled or utilized before fence 19,ir stalled'and all'.final inspections are performed'And accepted. afore:of'Owrier Signature:of Applicant' r Print Name Pant Name. ` Date , 1 4 Q:FORMS'OWNE"ERMISSIONPID IS Rev;08/1611.7 r Town of BarnstableBuilding A Post This Card So That it is Visible From the Street-Approved,Plans`M'ust be*Retained on Jpb_and this Card=Must be Kept 'Ll� sted Until Final Inspection Has Been Made.. r � here a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made rermit . Permit NO. B-19-1089 Applicant.Name: KENDALL&WELCH CONSTRUCTION Approvals Date Issued: 05/03/2019 Current Use: Structure Permit Type: Building-Demolition Expiration Date: 11/03/2019 Foundation: Location: 65 OCEAN AVENUE, HYANNIS Ma /Lot: 287-120 Zoning District: RF-1 Sheathing: Owner on Record: WHELAN,JAMES F&SUSAN H Contractor Name' KENDALL&WELCH Framing: 1 CONSTRUCTION Address: 86 CENTRE STREET Y 2 DOVER,MA 02030 Contractor License`. 128405 ,tt Chimney: Description: Demo existing house s '� Est. Project Cost: $0.00 Permit Fee: $-125.00 Insulation: Project Review Req: tFee Paid: S 125.00 Final: Date:' 5/3/2019 y Plumbing/Gas Rough Plumbing:. { Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after.issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the,approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. ` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building,and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing _... 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6 Insulation Low Voltage Final: Final Inspection before Occupancy Health here applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 4Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �I The Commonwealth of Massachusetts Department of IndtistrialAccidents .Office of Investigations - 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information _ I Please Print Leuibly Name(Business/Organization/Individual): k tom I ( a/6* 4W7 O I Clot/ Address c tOw'KelpM City/State/Zip: 02-9f Phone#: ;�Or�/ �-/Z d''` L11900 Are you an employer?Check the appropriate box: Type of project(required): 1, I am a employer with 4. I am a general contractor and I — 6. New construction. employees(full and/or part-time).* have hired the sub-contractors, 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling - ship and have no employees These sub-contractors have g, X Demolition working for me in an aci employees and have workers' Y capacity.ty. $ 9. ❑Building addition [No workers' comp.insurance comp,insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 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' 13.❑Other ' comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their worker,'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy and job site information. - Insurance Company Name: -64 F,P`f/Ji rl-&�.S cf� e� ' Policy#or Self ins.Lic.#: � ( n 1, 5� �� ✓t Expiration Date: 0,44) be 2a� Job Site Address: 6Y t✓ri��i/1 !41/e City/State/Zip: t/,Qitrlr r Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby nder the pains and penalties of p 'ury that the information provided abbove is true and correct: Si ature- j Date: Lf Phone#• Official use only. Do not write in this area;to be completed by city or town oj)`iciai City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r , Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or 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,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number- Me Commonwealth of Massachusetts Department of Industrial Accidents O►ffice of I,uvestigatiow 600 Washington Street Boston,MA 021.11 Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia i 1, Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, 49-'E husetts 02118 Home Im prove m-ent_Cgntractor Registration Type: Partnership KENDALL&WELCH CONSTRUCTION y Registration: 128405 P.O.BOX 490 w Expiration: 04/05/2021 OSTERVILLE, MA 02655 a • w x Update Address and Return Card.' SCA 1 0 20M•05/17 ,� �rnireaivaerc�l�a�✓l��c��ac�iu�ed/� Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE.;\Partnership before the expiration date. If found return to: RRe istration Expiration Office of Consumer Affairs and Business Regulation }18405 ==1l 04/05/2021 JT' 1000 Washington Street -Suite 710 r�l-t KENDALL&W��CH_CONSIKiUCTION Boston,MA 02118 >1 DAMON L.KEND" 54 KOMPASS DR. FALMOUTH,MA 02536 Undersecretary Not valid without signature Commonwealth of.Massachusetts Division of Professional Licensure lug Board•of Building Regulations and Standards ConstrO01''l�,ri`%bpg(visor P CS-070086 I r E' ires: 11/21/2020 DAMON L KENNDALLf 48 KOMPASS"*RIVE EAST FALMOUCL TFi MA•07536 �}, �' Commissioner ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM'QD `' 1 02/11/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE REPRESENTATIVE OR PRODUCER,AITHE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject t the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to th certificate holder in lieu of such endorsement(s). PRODUCER CONT NAMEA.. Suzanne Harrington MURRAY& MACDONALD INSURANCE SERVICES INC P"CN o t. 508)289-4170 FAX No, E-MAIL ADDRESS: Sharrington@mmisi.Com 550 MACARTHUR BLVD INSURERS AFFORDING COVERAGE NAIC# BOURNE MA 02532 INSURERA: HARTFORD UNDERWRITERS INS CO 30104 INSURED INSURER B: KENDALL &WELCH CONSTRUCTION INC INSURERC: INSURER D: PO BOX 490 INSURER E: OSTERVILLE MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER: 367024 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL UE SR POLICY EFF POLICY EXP POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE1-1 OCCUR DA AGE ED PREMISES Eaoccurrenca $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D PRO- [—� JECT _J LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ a Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIREDAUTOS AUTOS NED A PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION �/ OT AND EMPLOYERS'LIABILITY YIN /� STATUTE EERH ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBER EXCLUDED? NIA NIA NIA 6S60UB5033P43519 02/06/2019 02/06/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional(Remarks Schedule,may be attached if more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored.daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED I. Town Of BarrlStabl(5 ACCORDANCE WITH THE POLICY PROVISIONS. 367 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 I Daniel M.CrA)ev,CPCU.Vice President—Residual Market—WCRIRMA i DPFUCCI-01 RAULIE• TA CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD •12/18/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THI CERTIFICATE DOES NOT AFFIRMATI, LY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE:HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorse' If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy,certain policies may require an endorsement. A statement o this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER iCAO ME:NTACT N Almeida&Carlson Insurance Agency,Inc PHONE FAX PO Box 554 (A/C,No,EXt):(508)540-6161 (AIC,No):(508)457-7660 Falmouth,MA 02541 A RE : INSURERS AFFORDING COVERAGE NAIC# INSURER1.ARBELLA PROTECTION INS CO 41360 INSURED 1 INSURER B:Hartford Underwriters Insurance Co D P Fuccillo Const Inc INSURER C 548 Thomas Landers Rd INSURER D E Falmouth,MA 02536 'INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE fSD N DL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY I 1,000, 00 I EACH OCCURRENCE CLAIMS-MADE L J OCCUR i 8500045171, 10/20/2018 10/20/2019 DAMAGE SO RENTEcur�nce) S 300i 00 X BLANKET ADD'L INSURE i 5; 00 MED EXP(Any oneperson) is PERSONAL&ADV INJURY Is 1,000i 00 GEN'L AGGREGATE LIMIT APPLIES PER: I i I I { 'GENERAL AGGREGATE 2,00016 PCO PRODUCTS-COMP/OP AGG $IJ LPOLICY LOC 2,000., 100jOTHER: j I ! COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident) !ANY AUTO i ; BODILY INJURY Perperson) $ —�OWNED SCHEDULED AUTOS ONLY I AUTOS i i I BODILY INJURY Per accident $ HIRED j NON-OWN Ep PROPERTY AMAGE AUTOS ONLY AUTOS ONLY ( I Per accident $ is UMBRELLA LIAB I OCCUR I EACH OCCURRENCE is EXCESS LIAB CLAIMS-MADE i AGGREGATE is DED RETENTION$ g B WORKERS COMPENSATION I I STATUTE ERH AND EMPLOYERS'LIABILITY YIN I56659382 11012312018 10/23/2019 500I 00 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ _ FFICER/MEMBER EXCLUDED? I��NIA Mandatory In NH) i i I E.L.DISEASE•EA EMPLOYEE $ 500; 00 If yes,describe under I DESCRIPTION OF OPERATIONS below - I E.L.DISEASE-POLICY LIMIT $ 500; 00 � I , i I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOR KENDAL&WELCH THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED I ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �,4 / Am :.1 f v ACORD Client#: DATE TM CERTIFICATE OF LIABILITY INSURANCE 03/07/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 'HIS CERTIFICATE OF INSURANCE DOES NOT COfITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Guilherme Camossato DISCOVERY INSURANCE AGENCY LLC PHONE (978)726 9830 668 Main Street EMAIL guicdiswvery@gmail.com ADDRESS: HYANNIS,MA 02601 Phone:(508)771.4600 Raphaeldiscovery@gmail.com INSURER(S)AFFORDING COVERAGE NAIC INSURED INSURER A:UDW AT LLOYDS LONDON INSURER B:ARBELLA INSURANCE FB CONSTRUCTION INC INSURER C:WESTCHESTER FIRE INSURANCE COMPANY 110 ZENO CROCKER ROAD INSURER DACE AMERICAN INSURANCE CO CENTERVILLE,MA 02632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 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 TALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL AODU SUBR POLICY EFFPO IC TR TYPE OF INSURANCE NSR WVD POLICY NUMBER MM/DD/YYYY MWDD LIMITS A GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES(Ea—ce) $ 100,000.00 CWMS-MADE (X I OCCUR MED EXP(My on.person) $ 5,000.00 ATRIA/1 4349 L 9/17/2018 9/17/2019 PERSONAL S ADV INJURY $ 1,000,000.00 GENERAL AGGREGATE $ 2,000,000.00 ` GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG INCLUDED X POLICY 7 PROJECT 7L.. B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Eas dde l) ANY AUTO BODILY INJURY(Pwpemm) S 20,000.00 AUTOS OWNEDALL AUTOESULED 8HC 737220 -8/8/2018 8/8/2019 BODILY INJURY(Per—M-) $ 50,000.00 NON-OWNED PROPERTY DAMAGE ` HIRED AUTOS AUTOS (Peracc W) $ 250,000.00 C X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000.00 ;-X-T CLAIMSMADE UMBMAF146229621 9/17/2018 9/17/2019 AGGREGATE $ 1,000,000.00 RETENTIONS D WORKERS COMPENSATION YIN WC STATUTORY OTM AN" EMPLOYERS'LIABILITY LIMITS I JER ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? FN E.L.EACH ACCIDENT N/A N/A S62UB1K70192918 11/9/2018 11/9/2019 $ 1,000,000.00 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000.00 If yea,damilm under DESCRIPTION OF OPERATIONS Wbx E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this cerlificatE,was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance).The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/Iwd/workers-compensationfinvestigations/. General Liability for regular and usual jobs. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE KENDALL AND WELCH CONSTRUCTION, INC. EXPIRATION DATE IT IS THE CUSTOMER'S RESPONSABILITY TO INFORME ANY 108 PARKER ROAD/POBOX 490 CHANGES OR CANCELATIONS. �I OSTERVILLE,MA 02655 rfm ueonec r+nnnneonrn I ,3/21/29,19 L I. OL?i'196 Lp�,,�pT uverLiTrvQi 'I ,O��4,g8t4,PA7,,JROM: 5087781218 LU IL Pf ge: 1 Client#:44089 2CAPTAINSCR ACORM CERTIFICATE OF LIABILITY INSURANCE DATE(tAWDD/YYYY) 10/0512018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVE?,'OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE;A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REFRP-$EN7ATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the pollay(fes)must be endorsed,If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may raquire an endorsement,A statarnant on this cert(fiGete doss not conrer rights to the certificate holder in lieu of such endoraernent a . PRODUCER NAME: Dowling&O'Neil Insurance Agy SORE 508 775-1620 612 5087718 973 lyannough Road E-MAY. exI A/c Na; P.0,Box 1990 A INSUrtER S AFFORDING COVERAGE NAICiP Hyannis,MA 02601 14788 INSURER A:HON InwrarKo Gomp.ny INSURED Captain's Crew Painting,Inc. ` INSURERS 20 Chackerberry Street INSURERC: Hyannis,MA 02601.2416 INSURERD: INSURER E: INSUAGR F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CER7IPY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 1SaUE0 TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPI=CT TO WHICH THIS CERTIFICATE MAY RR ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOVIN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UB fNdl00 OUGY� LIMITS LTR D POLICYNUMBER A GENERALLIASILITY MPTIT79F D7111/2018 07111/2010 EAGHOCCURRENCE $1 000r- 000 �E•r � X COMMERCIAt,GENERAL LIABILITY ISES soowEO $500000 CLAW ,MAOE 51 OCCUR MED QP My me rWA) ;1 O 000 X PDDed:250 PERSONAL&ADV INJURY $1000000 OENERALAGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2 000,000 POLICY 7X Wa X LLOC $ AUTOMOBILE LIABILrrY COM IN LIMIT Ea mcdcl6ral ANY AUTO BODILY INJURY(Fla rporsm) $ AVTOS ED SCHEDULED 800ILYNJURY(Per aechem) $ NON•OVVNED PgOPERTYDAMA $ AUTOS HIREDAUT08 AUTOS P ncddenl UMBRELLA LIAB OCCUR EACHOCCURRENCE_H $ EXCESS LIAO CLAiMS•MADE AGGREGATE $ •DED RETENTION S WORKERS COMPENSATION WC8TATU• OTH- A WCT1775P 7/11/2018 01111/2019 X AND RMPLOYERS'LIABILITY D YIN ANY PROPRIE � ECUYVE E.L EACH ACCIDENT $500000 CERMEMBYgq OFFI LUED7 N NIA (MandatorylnNH) E.LDISEASE-EAEMPLOYEE $500000 Hyaa ORTMIOA 11-O DESCRIPTION OwOPERATIONs below E.L.OISEr161~-POLICY LIMIT $500 00D DESCRIPTION DF OPERATION8I LOCATIONS/VENICLES(Allnell ACDRU 101,Add111onal ReMaAf 6ohedele,if nvoreapaeo Is required) Insurance coverage is limited to the terms,Conditions,exclusions,other limitations and endorsements. Nothing contained In the certificate of Insurance shall bei deemed to have altered,waived,or extended the coverage provided by the policy provisions, CERTIFICATE HOLDER CANCELLATION Kendall$Welch Construction SHOULD ANY OF THE ABOVE DESCRIBED POUGIEF,HE CANCELLED 10EFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 108 Parker Road ACCORDANCE MTN THE POLICY PROVIPIONS. 0stetvllle,MA 02655 AUTHDRI=REPRESENTATIVE na 4oaa.aA4n eCnnn rnRPnI*ATEnN_All rinhrn rhmvrvad. I '4 CERTIFICATE"OF LIABILITY INSURANCE F DATE(MM/D AIYM THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TH S18 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF-INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND HE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED previsions or be enjd If SUBROGATION IS WAIVED,subject to the terms and cond'utions of the policy,certain policies may require an endorsement. A statem this certificate does not confer rights to the certificate holden in lieu of such endorsement(s). PRODUCER NAME; JIM HINDMAN Schlegel&Schlegel ins Broker PHONE 508.771-8381 F 34 Main Street o: 608-7 West Yarmouth,MA 02673 / anDREIMM"ss: SCHLEGELINSURANCE GMAIL.COM / INSURER(S)AFFORDING COVERAGE INSURERA: NGM INSURANCE COMPANY INSURED INSURERS: TRAVELERS CAPE COD SPRAY FOAM INSURER C: PROGRESSIVE 49 SISSON ROAD HARWICHPORT,MA 02646 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE OWUL WOK vivo POLICY NUMBER MM D E hAM D EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE a OCCUR R MISES a oc $ 500,00 MED EXP An one person) $ 10,00, A MPK9358X 11M6117 11/16/18 PERSONAL&ADV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,OQ POLICY❑PRO- JECT LOC PRODUCTS-C MP/OPAGG $ 2,ODO,OQ OTHER: $ AUTOMOBILE LIABILITY COMBINED QED INGLE LIMIT $ 1,000,00 ANY AUTO -)- BODILY INJURY(Per person) $ C OWNED SCHEDULED AUTOS ONLY AUTOS 07881343-4 06/0$/18 05/08/19 BODILY INJURY(Per accident) $ X HIRED NON-OWNED PPROaER OA OE $AUTOS ONLY AUTOS ONLY S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE DED RETENTION S AGGREGATE $ WORKERS COMPENSATION $ AND EMPLOYERS,LIABILITY Y I N STAT E R ANY PROPRIETOR/PARTNER/EXECUTIVE B OFFICERMIEMBEREXCLUDED? N/A 6HUB61313036613 07/23/18 07/23/19 E.L.EAC H ACCIDENT $_ 600,00 (Mandatory in and E.L.DISEASE-EA EMPLOYE $ 600001 Iryea,descdto under DESCRtPT10N OF OPERATIONS below E.L.DISEASE.POLICY LIMIT $ 600,06. DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Isemarks Schedule,maybe attached If more space Is required) CORPORATE OFFICERS HAVE ELECTED TO BE COVERED UNDER THEIR CURRENT WORKERS COMP POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN KENDALL AND WELCH CONSTRUCTION ACCORDANCE WITH THE POLICY PROVISIONS, 32 WIANNO AVE SUITE A5 OSTERVILLE MA 02656 AUTHORIZED REPRESENTATIVE bookkeeperkandw@gmai I.com, ' n 1aRR 7n'1Yi rnon rn ATIAAI All.1..Ma.....___._.i I ACORt7® CERTIFICATE DF LIABILITY INSURANCE OATE(MMJDDrvwv) 10/06/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF-INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AN . HE CERTIFICATE(HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy{les)must have ADDITIONAL INSURED provisions or be en orsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: JIM HINDMAN Schlegel&Schlegel Ins Broker PHONE Fxtl- 608.771-8381 pI o; 508-771.0663 34 Main Street West Yarmouth,MA 02673 ADDRESS; SCHLEGELINSURANCE MAIL.COM � INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: NGM INSURANCE COMPANY 14788 INSURED INSURERB; TRAVELERS CAPE COD SPRAY FOAM INSURER C: PROGRESSIVE 49 SISSON ROAD HARWICHPORT,MA 02646 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFYTHATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR TYPE OF INSURANCE p POLII.Y NUMBER M 1 Y E M MfOD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE OCCUR PREMISES Ea ocw $ 500,00 MEDEXP An one arson $ 10,00� A MPK9358X 11/16/17 11/16l18 PERSONAL&ADVINJURY $ 1,00000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,06 POLICY❑JEC PROT L.J• 4 J LOC ` PRODUCTS•COMPIOPAGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED a SI NGLE LIM nll $ 1,000,00 ANY AUTO BODILY INJURY(Per person) $ CO AUTOS ONLY X AUTOSULED 07881343-4 06108/18 05/08/19 (Per accident) $ BODILY INJURY P HIRED NON-OWNED P eOaER DA G g AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER AND EMPLOYERS'LIABILITY YIN TAT U' E ANY PROPRIETOR/PARTNER/EXECUTIVE�N E.L.EACHACCIDENT $ 500,00 B OFFICERIMEMBER EXCLUDED? N/A 6HUB6B13035513 07/23118 07123/19 (Mandatory In NH) If E.L.DISEASE-EA EMPLOYE $ 600,001 Yes,descrlbo undar DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 600,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CORPORATE OFFICERS HAVE ELECTED TO BE COVERED UNDER THEIR CURRENT WORKERS COMP POLICY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN KENDALL AND WELCH CONSTRUCTION ACCORDANCE WITH THE POLICY PROVISIONS. 32 WIANNO AVE SUITE AS OSTERVILLE MA 02666 AUTHORIZED REPRESENTATIVE bookkeeperkandw@gmaii.com, 01988 201$ CORD CO ON. All rights reserved f AC40RID0® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 02/11/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME: Suzanne Harrington MURRAY& MACDONALD INSURANCE SERVICES INC HONE . (508)289-4170 No; ADDRESS: sharrington@mmisi.com 550 MACARTHUR BLVD INSURERS AFFORDING COVERAGE NAIC# BOURNE MA 02532 INSURERA: AIM MUTUAL INS CO 33758 INSURED INSURER B: _ LEE ANDERSEN ' / INSURERC: V INSURER D: PO BOX 993 INSURER E: FORESTDALE MA 02644 INSURER F: COVERAGES CERTIFICATE NUMBER: 367031 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 13ELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP INSD Vivo POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADVINJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY JECT �LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Peraccdent $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE - N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N /� STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBEREXCLUDED7 NIA NIA N/A VWC100602213112019A 01/03/2019 01/03/2020 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Kendall & Welch ACCORDANCE WITH THE POLICY PROVISIONS. Po Box 490 AUTHORIZED REPRESENTATIVE Osterville MA 02655 'Dj Daniel M.Cro y,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD f ACo CERTIFICATE OF LIABILITY INSURANCE °ATE'Nliv "' 9/4/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSIQANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE - REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE:HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject t the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to th certificate holder in lieu of such endorsement(s). PRODUCER NAME: Karen Bernier Eastern Insurance Group. LLC PHONE Xt• 774-213-0873 FAX No:781-586-7704 439 State Rd. E-MAIL ADDRESS:kbernier@Easternlnsurance.com P.O. Box 79398 _ INSURERS AFFORDING COVERAGE K233329 # North Dartmouth MA 02747 INSURER AMerchants Insurance Group INSURED INSURER BMerchants Mutual Insurance Com Rons Excavating Inc. INSURER C: 81 Echo Road, Unit #1 INSURERD: INSURER E: Mashpee MA 02649 1 INSURERF: I COVERAGES CERTIFICATE NUMBER:CL1843005134 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD; INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS; EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL SUBR POLICY EFF POLICY EXP LTR 1 TYPE OF INSURANCE POLICY NUMBER 1 MMIDD/YYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE ($ 1,000,0 0 DAMAGE A I CLAIMS-MADE i X OCCUR i I ! PREMISES(Ea oc u ence) $ 100,6 0 I j GMP9148246 5/1/2018 5/1/2019 MED EXP(Any one person) $ 5,0 0 PERSONAL&ADV INJURY $ 1100010 0 GEN'L AGGREGATE LIMIT APPLIES PER: i j GENERAL AGGREGATE $ 2,000,0, 0 X POLICY I I PRO- j I a u JECT LOC i I I PRODUCTS-COMP/OP AGG $ 2,000,4 0 OTHER: $ o I AUTOMOBILE LIABILITY I I j I COMBINED SINGLE LIMIT $ j Ea accident HA — ANY AUTO I j I I BODILY INJURY(Per person) $ 1,000,01 0 ALL OWNED —I SCHEDULED AUTOS i�AUTOS I MCA7013915 8/16/2017 18/16/2018 BODILY INJURY(Per accident)I$ 1,000,61 0 X"HIRED AUTOS J NON-OWNED j AUTOS PROPERTY DAMAGE I Per accident is 1 000 0. 0 I i Medical payments $ 5,0 0 IX UMBRELLA LIAB X OCCUR B I EXCESS LIAB 1 I EACH OCCURRENCE is 1 000 0. 0 —�—r CLAIMS-MADE] I I j AGGREGATE Is 1,000 o. 0 DED 1 X 1 RETENTION$ 10,000 1 ICUP9147746 5/1/2018 j 5/1/2019 $ WORKERS COMPENSATION I X ST X 'ERH ATUTE IAND EMPLOYERS'LIABILITY YIN j j IANY PROPRIETOR/PARTNER/EXECUTIVE � ( E.L.EACH ACCIDENT $ 1,000,Q(0 B (OFFICER/MEMBER EXCLUDED? i N I N/A - I i (Mandatory in NH) I WCA9094537 5/1/2018 5/1/2019 E.L.DISEASE-EA EMPLOYE $ 11 000 0; 0 If yes,describe under ((( DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ 1 000 0 0 - I I I I i i i I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION catrina@kendallandwelch.co SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Kendall and Welch THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 108 PArker Rd ACCORDANCE WITH THE POLICY PROVISIONS. Osterville, MA AUTHORIZED REPRESENTATIVE ti. •i____-. r._._.__ ___/.+,r. �/)IyIAI�/i�.7 A11IAf l 0� I 4 G 9 fi G G �DJ G G G G fi G Effective Date: April 3rd, 2019 fi 9 G Western Surety Corn fi G LICENSE AND PERMIT BOND G G fi G KNOW ALL PERSONS BY THESE PRESENTS: Bond No. 64589632 G G G fi 9 Thatwe, Kendall and Welch Construction Co, Inc G G fi G of Osterville State of Massachusetts as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do surety business in the State of Massachusetts , as Surety, are held and firmly bound unto the Town of Barnstable State of Massachusetts , as Obligee, in the penal sum of Five Thousand and 00/100 DOLLARS($5,000.00 ) lawful money of the United States, to be paid to the Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives, firmly by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That whereas, the Principal has been licensed Residential Contractor Town of Barnstable by the Obligee. NOW THEREFORE, if the Principal shall faithfully perform the duties and in all things comply with the laws and ordinances, including all amendments thereto, pertaining to the license or permit applied for, then this obligation to be void, otherwise to remain in full force and effect until April 3rd 2020 , unless renewed by Continuation Certificate. This bond may be terminated at any time by the Surety upon sending notice in writing, by First Class U.S. Mail, to the Obligee and to the Principal at the address last known to the Surety, and at the expiration of thirtyxfiv&it 8 %days from the mailing of said notice, this bond shall ipso facto terminate and the Surety shal Ffe eupon b elieved from any liability for any acts or omissions of the Principal subsequent to said dateReof #he number of years this bond shall continue in force, the number of claims made Mtf <� agar s is bon ��-the number of premiums which shall be payable or paid, the Surety's total limit of liar li£y shall not b(I ei ulative from year to year or period to period, and in no event shall the Surety's total ha��biy }p call clai�aki�exceed the amount set forth above. Any revision of the bond amount shall not be cui%u tyve. G gb G Dated phis 3rd day of April 2019 G u fi 9 fi G G 9 Ke and Welch Construction Co Inc l ' P pol G fi G Principal WEST.E SURET COMPANY fi G G � G G G G By Paul T.Br flat,Vice President r Form 532-12-2015 u fi 9 G G r G f ACKNOWLEDGMENT OF SURETY STATE OF SOUTH DAKOTA ss (Corporate Officer) COUNTY OF MINNEHAHA On this 3rd day of April 2019 before me,the undersigned officer, personally appeared Paul T. Bruflat who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY, a corporation, and that he as such officer,being authorized so to do, executed the foregoing instrument for the purposes therein contained, by signing the name of the corporation by himself as such officer. IN WITNESS WHEREOF,I have hereunto set my hand and official seal. thh�whh5yhyy�,�,hhy�,hhhhy��+ M. BENT s sEAS NOTARY PUBLIC(SEAL IS s SOUTH DAKOTA s Notary Public—South Dakota +hhShSyhyhh5hh5hy5y5yyhy+ My Commission Expires March 2, 2020 ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) STATE OF ss COUNTY OF On this day of before me personally appeared known to me to be the individual described in and who executed the foregoing instrument and acknowledged to me that—he— executed the same. My commission expires Notary Public ACKNOWLEDGMENT OF PRINCIPAL STATE OF (Corporate Officer) ss COUNTY OF On this day of before me personally appeared who acknowledged himself/herself to be the of a corporation, and that he/she as such officer being authorized so to do, executed the foregoing instrument for the purposes therein contained by signing the name of the corporation by himself/herself as such officer. My commission expires Notary Public C� E ~ U o w r. >1 z a q w W a� m U) i W Z41 w � v r4 o. o w a d o o � w -o i h } Western Surety Company POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota, and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming, and the United States of America,does hereby make, constitute and appoint Paul T. Bruflat of Sioux Falls State of South Dakota , its regularly elected Vice President as Attorney-in-Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for and on its behalf as Surety and as its act and deed,the following bond: One Residential Contractor Town of Barnstable bond with bond number 64589632 for Kendall and Welch Construction Co, Inc as Principal in the penalty amount not to exceed: $ 5,000.00 Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety Company duly adopted and now in force,to-wit: Section 7. All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys-in-Fact or agents who shall have authority to issue bonds,policies,or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds,policies,undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile. In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its Vice President with the corporate seal affixed this 3rd day of April 2019 ATTEST WESTE N U R E T>�)COMPANY CDT ZtLa.'(� By L.Nelson,Assistant Secretary Paul T Bruflat,Vice President z _ STATE OF SOUTH DAKOTA ss •, COUNTY OF MINNEHAHA s ` p On this 3rd day of April 2019 before me, a Notary Public, personally appeared Paul T. Bruflat and L. Nelson who, being by me duly sworn, acknowledged that they signed the above Power of Attorney as Vice President and Assistant Secretary, respectively, of the said WESTERN SURETY COMPANY, and acknowledged said instrument to be the voluntary act and deed of said Corporation. +yhyh�yyhhyyyyyy5h�,yyhyhh+ s J. MOHR s sa—SE�[ EZ NOTARY PUBLIC s SOUTH DAKOTA Notary Public +yyyyyyyyyyyyyyyyhyyyy.�y+ My Commission Expires June 23, 2021 ry To validate bond authenticity,go to www.enasurety.com >Owner/Obligee Services>Validate Bond Coverage. Form F1975-1-2016 �W TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel . (V - Application # ; Health Division / Date Issued Conservation Division�`� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyar�nis Q Project Street Address G CCNU AU[ Village 10N'tuu s PAT Owner ANOU U Mait( Address Afo Llt? , lu Lax oyq OR Uytjouo 06 Telephone ' 7 9 3?6 3 5_95- ` Permit Request R l'Lulu tZQIT C,i J S'TXL S 3 VU CtAaA C f,:._ -t 5 lJ 60 Square feet: 1st floor: existing 7Sproposed �� 2nd floor: existing Q proposed G Total new r Zoning District , Flood Plain N Groundwater Overlay % Project Valuation Construction Type LJOU0 fIRWIF, l 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 XCrawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(isq.ft) Number of Baths: Full: existing_ new Half:.existing 1 new 0 Number of Bedrooms: C existing new Total Room Count (not including baths): existing new D First Floor Room Count l Heat Type and Fuel: XGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes C No, Fireplaces: Existing-2LNew o Existing wood/coal stove: ❑Yes)(No Detached garage: existing ❑ new size_Pool: ❑ existing '❑ new size Barn: ❑existing ❑ new size garage: 9 g Other: ' Attached ara e: 0 existing ❑ new size UShed: ❑ existin ❑ new size Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes �KNo If yes, site plan review# Current Use RE Scow Tw. Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Uulimi�) F utcar Telephone Number �-O& 361 Address �) l 0�f 5 gmwwwt PA 0)65ULicense # Q/ 0 3 b6 .-u 't M1111T, Home improvement Contractor# 3 7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 5 ) Lio DATE SIGNATURE (,. FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. A ADDRESS VILLAGE , OWNER " DATE OF INSPECTION: Iv FOUNDATION f FRAME " A INSULATION FIREPLACE E. ELECTRICAL: ROUGH FINAL-, { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 4 � FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. --` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel Application # 7 � Health'Division ' Date Issued Conservation Division �1� Application Feed" G�J Planning Dept. Permit Fee Date Definitive Plan Approved-by Planning Board Historic - OKH Preservation /Hyannis , i V - Project Street Address 0 C(NJ U Village WtAluwi PORT 0:) u'j 0 Owner AWL LJ f 1NkoiC Address W Ltd7 . 16 tot Uouo OR Lr(siUoaQ h� Telephone `��l 3)C 9 5- Permit Request R C.171,E cx-' R,m C,IV qt u_ S 'i Pi c_ a t\ (fc 0 Fla Square feet: 1st floor: existing C75--proposed 7 2nd floor: existing O proposed C1 Total new C'a Zoning District r t Flood Plain. NJ U Groundwater Overlay �� A Project Valuation II 40G Construction Type LEE CR60C Lot Size Grandfathered: *;Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family `®� Two Family ❑ Multi-Family(# units) Age of Existing Structure u Historic House: I❑Yes `0°No On Old King's Highway: ❑Yes �XNo Basement Type: ❑ Full ®Crawl 0 Walkout 0 Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0 Number.of Baths: Full: existing `T new Half: existing new Nun/ber of Bedroo/pms:!! "'yt� existing O new V - t�/••`l � 4 ff � rylp�`�Y� q `� Total Room Count (not including baths): existing . t new O First Floor Room Count `( Heat Type and Fuel: ®Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes tp,No Fireplaces: Existing )_ New Q G?t" Existing wood/coal stover ❑Yes D�No Detached garage:`®existing ❑ new size_Pool: ❑ existing ❑ new size 0 Barn: ❑ existing D new size Attached garage: ❑ existing ❑ new size Shed: ❑ existing ❑ new size Q Other: r Zoning Board of Appeals Authorization ❑ Appeal # Recorded❑ }; Commercial ❑Yes XNo If yes, site plan review# ?. Current Use RC S`01,11 TIN Proposed Use 1"�f.S?Da tA-l/*,t-. APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) t 4 Name uu-ut w-1 . P UPt Ut Telephone Number s 361 7 6 K q Address PO 10 ftivMuj 0A U�G5"License# (- 0 f r) 36� Nu� _lftf"ITT Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ",X114kO T(A1010L SIGNATURE // .��'.�/ DATE ��5 A t FOR OFFICIAL USE ONLY k _ APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r' t DATE CLOSED OUT ASSOCIATION PLAN NO. r Ft Town of Barnstable Expires 6 rironths from iss a date °^ Regulatory Services Fee • 1AMSTABLE, i 9� MAss. $s639. Thomas F. Geiler,Director �� 1 AlED MP't s 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 20 Property Address 5 OU&, dv& U ❑Residential Value of Work $� 'a0 Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address s th mg 011Luk a4l& n,nutir n i� Ja Contractor's Name T&"M I'lio Telephone Number1508)• 395-0(&2- Home Improvement Contractor License.#(if applicable) 14o45:7 Construction Supervisor's,License#(if applicable) (rs ❑Workman's Compensation Insurance Che one:. [t' I am a sole proprietor 4 FT am the Homeowner JAN 2010 ❑ I have Worker's Compensation Insurance TOWN-OF BARNSTABLE Insurance Company Name - Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. 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) t, Re-sideVveU=�� \ #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: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is r required. SIGNATURE: \ Q:\WPFILES\FORMS\buildi permit forms\EXPRESS.doc Revised 090809 The Commonwealth of Massachusetts Department of Industrial Accidents !'F� Office of Investigations I' 600 Washington Street `-� Boston MA 02111 www.I iass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly_ Name (Bus iness/Organization/Indivi dual): Address: �9 6 �A City/State/Zip: ng Phone #: 508- 395 -6GOZZ Are you an employ r? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I �employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.®-1 am a sole proprietor or partner- listed on the attached sheet. 7. [t1'Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#] must also fill out the section below showing thcir 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy# or Self-ins.Lic.#: Expiration Date: Job Site Address:' City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and'expiration date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against.the violator.Be advised that a copy of this statement may be. forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct: Signature: Date: hveilnm Phone#: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License# Issuing Authority (circle one): 1: Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#: `r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another Linder 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,constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition, an applicant that must submit multiple perrnit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.rnass.gov/dia THE r� Town of Barnstable Regulatory Services SrABLE'8; Thomas F. Geiler,Director 039. 'DIED}+tA1 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barilstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder WL1,41A , as Owner of the subject property hereby authorize to act on my behalf, F in all matters relative to work authorized by this building permit application for. (Addres of Job Signature of Owner ate Wlll � P W?Pu-C Ia( Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERM1SS10N Town of Barnstable 43 Of SHE Tp� o Regulatory Services .. �. ' Thomas F. Geller,Director • BAMNsrwBt.c, M.nsa 039. 14 Building Division TED MAI Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityltown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends.to reside, on which there is,or is intended to o su ch use and/or farm structures. A - e be,a one or two-family dwelling, t attached or detached structures accessory_ person who constructs more than one home in a two-year period shall not be considered a homeowner. Such m "homeowner"shall submit to the Building Official on a for acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. in this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPF.ILES\FORMS\homeexempt.DOC *= Massachusetts- Department of Public Safet% Board of Building Regulations and Standards Construction,Supervisor License License: CS 66658 Pam:, ° Restricted to: 00 JAMES R MEDEIROS ' 696 RT 6A , YARMOUTHPORT, MA 02675 � Expiration: 4/16/2011 ('ummissi4 n e r Tr#: 5104 " ,p� fie "�omvrr�o�zuiea�_o�,�aaaac/zuaetr!a j ;. ; Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration 40157 10 Park Plaza-Suite 5170 Expiration W;9/2_Q11 Tr# 288734 Boston,MA 02116 TypeW-p—A�ivtdual— JAMES R MED1�2�9 ' (ti JAMES MEDEIRQ 696 ROUTE 6A YARMOUTHPORT� IIA`0275f Undersecretary „ Not valid without signature 4 , y •i TOWN OF BARNSTABLE BUILDING PERMIT.APPLICATION,., .o Q� a Map li � ' arcel. - 'Application # TO Health Division •Date Issued 1 Z' f . Conservation Divis' n =;Application F Planning:Dept: Permit Fee Date Definitive.Plan Approved by Planning Board Historic _ OKH Preservation/Hyannis Project Street Address Azle 6G Village Owner Aime, f Doi b-r Address 0,Cm a(4 Telephone Permit Request `(:. - a"'d g-� &1&!;, mew r„� �� e M�• nDi.,,,D[_ )1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater'.Overlay }- Project Valuationt. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .0 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing. new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Wetached garage: ❑ existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use -� APPLICANT INFORMATION --(BUILDER OR HOMEOWNER) Cn rn Name J a,,v., Telephone Number -395-9 6 F Z Address (b A License Home Improvement Contractor# 1g61S_1 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .weJJ A WAa SIGNATURE DATE if-s d L d FOR OFFICIAL USE ONLY r. APPLICATION# DATE ISSUED MAP/PARCEL N0: ADDRESS VILLAGE OWNER DATE OF INSPECTION: _ v FOUNDATION {� FRAME— �— P ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL tr ' GAS: ROUGH FINAL FINAL BUILDING y DATE CLOSED OUT ASSOCIATION PLAN NO. 5 �[y The Commonwealth of Massachusetts Department of Industrial Accidents w W Office of Investigations 600 Washington Street Boston,MA 02111 �� ,�•�' www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers _Applicant Information Please Print Legibly Name(Business/Organization/Individual): P- ylubjAlzo ILA Address: t 9% Jsu;6 (oil City/State/Zip: uyS Phone.#: Sob- 3_1S -848-1 Are.you an employ ? Check the appropriate box: :Type of project(required):, 4. I am a general contractord an I l:❑ I am a employer with 6. ❑New construction . CM0loyees(full and/or part-time).* • have hired the sub-contractors - 2. I am a.'ole proprietor.or partner- listed on the'attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g, []Demolition rorkin for me in an capacity. employees and have workers' g Y P tY 9. []Building addition [No workers' comp,insurance comp, insurance.$• required.] 5. We are a corporation and its. 10.❑Electrical repairs or additions .3.❑ I am a homeowner doing all work . officers have exercised their 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' 13.❑ Other comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site" information. Insurance Company Name: Policy#or Self-ins.Lic•#: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration.date). Failure,to secure coverage as required under Section 25A of MGL c.. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK,ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the /pains•and penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: ' Official use only. Do not write in this area, to be completed by,city or town official City or Town: Permit/License# Issuing Authority(circle one): .1.Board of Health 2.Building Department 3, City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: , 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as `.`...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or. renewal of a license or permit to operate a business.or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." AdditionaIly,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance.. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as areference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only.submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"i.he applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, Please do not hesitate to give us.a'call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or"1-877-MASSAFE Fax#617-7277774 Revised 11-2M6 www.mass.gov/dia ; i EIIERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: Site Address: print Town: Applicant Phone: Applicant Signature: Date of Application: NEW CONSTRUCTION: choose ONE of the following two options) 780 CMR TABLE 6107.1 . PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Option 1: Slab Basement Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-3 8 R-19 R-19 R-10 4 ft. 1987 as amended,minimums or greater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck-Web which can be accessed at http://www.energ_ cy odes.gov/rescheek/ ADDITIONS'OR ALTERATIONS,TO EXISTING BUILDINGS.OVER:5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2.in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b- a) SF 100 x. - _ % of glazing (b) Glazing area equals SF b a .If glazing is<40% use the chart below. If glazing is> 40,% proceed to "SUNROOM"section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter Fenestration - Wall Floor Basement Wall Exposed floors R-Value U-factor R-Value R-value R-Value R-Value and Depth .39 R-37 'a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls,and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) 1� oft"� ti Town of Barnstable ' Regulatory Services • BARvsrABLK • MAas. $, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us . Office: 508-862-4038 Fax: 508-790-6230 . . Property Owner Must Complete and Sign This Section If Using A Builder I, �UlUt1 �J Dal G r , as Owner of the subject property hereby authorize Som.o 62 �{hecQ },,1 to act on my behalf, in all matters relative to work authorized by this building permit application for: 65 � Q,0e �D (Address of J ) ufiS/` Signature of Owne Date Print Name ' If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:0%NERPERM 1SS10N Town of Barnstable SHE r, Regulatory Services BA>:rrsz+tatE Thomas F.Geiler,Director MASS. �PrE1639. A Building Division Tom Perry,Building Commissioner 200 Main-Street, Hyannis,MA 02601 vvww.to wn.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner':'certifies that he/she understands the Town of Barnstable Building Department . minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION, The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly When the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed' Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her n sponnbilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms`homeexempt i 1. _x Board of Building Regulations and Standards License or registration valid for individul`'Use only HOME IMPROVEMENT CONTRACTOR : t before the expiration date. If found return to: / Registration 140157 j( Board of Building Regulations and Standards Expiration g%1 gj2009 Tr# 133523 One Ashburton Place Rm 1301 � Type In4iividual Boston Ma.02198 r it v f JAMES R MEDEI�ROS yl` JAMES MEDEIROS s` v 696 ROUTE 6A � =. �, � y YARMOUTHPORT, MA O2(i75 v Administrator Not valid without signature` -, -- Board of Building Regulations and_Standards I i jConstruetion Supervisor License I.. License: CS . 66658 1 . BrrtfidateF16/1968 (E�xpi tion 4/,16i,2009 Tr# 13355 °l =fir. Restrrcticir JAMES R MEDEIROSt „ a 696 RT-6A YARMOUTHPORT, MA`02675. Commissioner - - r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 7=:� Applicatidn'# ®T'.®6 Health Division '^Date Issued I Zq fxo Conservation Division Applicatiori Fee pm_ Planning Dept: .`Permit Fee' -Date Definitive`Plan Approved by Planning Board ' 6 �,-: Historic =OKH Preservation / Hyannis Project Street Address CS .q 0(16A0 Village (Alum Owner MOPE U , Ur"i 611li Address Af Ph 45 _ L D I..O JLWUO 0 R_ Telephone Permit Request ft1�,1' ba_ • RpT:T caj S 1LS IU CA113AC.L -E A I f A LIJ CO S WE Square feet: 1 st floor: existing roposed 2nd floor: existing 0 proposed Total new Zoning District' Flood Plain Groundvvater Overlay U Project Valuation 1.3 0)J Construction Type Lot Size f Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ._ Two Family ❑ Multi-Family(# units) Age of Existing Structure U 4 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes XtVo Basement Type: ❑ Full Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) ® Basement Unfinished Area(sq.ft) Number of Baths: Full: existing c' new 0 Half: existing 1 new G Number of Bedrooms: existing Onew Total Room Count (not including baths): existing _�new First Floor Room'Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑ Other Z^ c7 � _ Central Air: ❑Yes XNo Fireplaces: EA ng New Existing woodf oal sto2g: ❑,Yes ❑ No C,7e Detached garage: existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn. ❑Lexistin .�0 new size_ 9 ZZ Attached garage: ❑ existing ❑ new size QShed: ❑ existing ❑ new size _ Other: I C� ca Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes XNo If yes, site plan review# f Current Use Proposed Use ` APPLICANT INFORMATION r_ (BUILDER OR HOMEOWNER) Name kk J� a��(Z c� �f Telephone Number l 3 6 3 Address Uf 9�1 Iu L610CWoUm OR. LaFM464D License # -�dnl�l cwIU' Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO %JaW rl t SIGNATURE DATE I �� f� j FOR OFFICIAL USE ONLY F `i APPLICATION# } 1 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE k 'OWNER r DATE OF INSPECTION: FOUNDATION FRAME INSULATION a FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ,l i 'r f The Commonwealth of Massachusetts r' Department'oflndustrialAccidents a Office of Investigations a 600 Washington Street �< Boston,MA 02111' ww'mmass.gov/dia Workers'"Compensation Iusurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information q ..Please Print /L+eairbly Name(Business/Organization/Individual): /�� ?. l�ill. ' Address: �S ( ® �U �G'P�o�� DtL UElSfo 00 City/State/Zip: P�;' Phone.#: Areyou an employer? Check the appropriate box: :Type of project(required):, 1.❑ I am a employer with . 4. [] I am a general contractor and I 6. ❑New construction employees (full and/or part-time).* have hired the sub-contractors 2. I am a'sole proprietor or partner- listed on the'attached sheet. 7. Remodeling . ship and have no employees These sub-contractors have g, []Demolition workingfor me in an capacity. employees and have workers' y p tY. 9. 0 Building addition comp, insurance,$ [No workers comp.insurance p' 5. We are a co oration and it required.] s 10.❑Electrical repairs or additions � � 3.(] I required.] 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' 13, Other CIZ��liri n�t'Aj 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 anew 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. lam an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site* information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration.date). Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of.a STOP WORM ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy-of this statement maybe forwarded to the Office of Investigations of the c o rage vuiflcationA I do hereby certify n enalties f erju1AAVA ation provided aboves tr a and correct. Si atureDate: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit[License# Issuing Authority(circle one): _-1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6. Other Contact Person: • •Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute, an employee is defined as"...every person in.the service of another under any contract of hire, . express or implied,oral or written. An employer is defined as"an individual.,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced_acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),_address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted.to the Department of Industrial 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 question_s regarding the law or_if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly..The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year;need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" Lhe applicant sshould write."all locations in _(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where_a home owner or citizen'is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Ac01dents Office of Investigation 600 Washington Street Boston, MA 02.111 x Tel.#617-727-4900 ext 406 or 1-$77-MASSAFE ; Fax# 617-727-774 Revised 11-22-06 L www.mass.gov/dia - A PVC Guide to Pl/ood Construction iii High Wind flreas: 110 itiph 611il-ld Zone Massachusetts Checklist for Conap3liance (780 CNIR 5301:2.1.1)' Check Compliance 1.1 SCOPE WindSpeed (3-sec. gust).................................................................. ................................................ 110 mph WindExposure Category.................................................................. ..................:..........................................B Wind Exposure Category................Engineering Required For Entire Project ........................................C 1.2 APPLICABILITY Number of Stories (a roof which exceeds 8 in 12 slope shall be considered a story) stories, 5 2 stories RoofPitch ....................:.........:............................................(Fig 2) ........................................... 'i s 12:12 MeanRoof Height .....................................................:........(Fig 2)................................ ............... ft :5 33, BuildingWidth, W ...............................................................(Fig 3)................................................ ft 5 80, BuildingLength, L ..............................................................(Fig 3).................................................�ft s 80, Building Aspect Ratio(L/W) ...............................................(Fig 4)................................................. I5 3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4)................................................�—�6,8" 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2).......................................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete....................................................................:.....................:.................................. Concrete Masonry ..................................................................... ...........................................,................... :. 2.2 ANCHORAGE TO FOUNDATION 1'3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative.in concrete only Bolt Spacing= eneral �� in. P. 9 9 .........................:..............:.(Table 4)............:....:............................. < Bolt Spacing from end/joint of plate .............................(Fig 5)..................:................. in. 6"—12", Bolt Embedment—concrete.........................................(Fig 5)......................................:........... in. >7" Bolt Embedment 7 masonry.................. ......................(Fig 5)............ .,............................. in. > 15„ PlateWasher................................................................(Fig 5)..............................................>3"x 3"x'/4" 3.1 FLOORS Floor-framing member spans checked .::.............................(per 780 CMR Chapter 55)..................�V®N :... Maximum Floor Opening Dimension...................................(Fig 6)..................................................._ft 15 12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig.7)...................................................._ft 5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)...................................................I._ft 5 d Floor.Bracing at Endwalls..............:.....................................(Fig 9)................................................................... Floor Sheathing Type ................ ...........(per 780 CMR Chapter 55).....I........ Floor Sheathing Thickness ..................................................(per 780 CMR Chapter 55)..:...........I......... in. Floor Sheathing Fastening.............:....................................(Table 2).._d nails at in edge/.-in field i 4.1 WALLS j Wall Height Q as Loadbearing walls........................................................(Fig 10 and Table 5)...........................q aft _< 10, Non-Loadbearing walls..................:.............................(Fig 10 and Table 5)....... .......... ft s 20' Wall Stud Spacing .........................................................(Fig 10 and Table 5)...................11 in. s 24".o.c. ' Wall Story Offsets ................................:.......................(Figs 7&8).................. ................ ft <_d 4.2 EXTERIOR WALLS' Wood Studs ' Loadbearing Walls........... ............................................(Table 5)...............................2x 1 -_I ft 3_in. Non-Loadbearing walls.......�� ...�60�.....................(Table 5)....10.4A��?...............2x_ _ft_in. Gable End Wall Bracing } Full Height Endwall Studs..........:........ .....................(Fig 10)....::................,..................................:....... WSP Attic Floor Length.::......:......:....� 11113Q.............(Fig 11)............................................. ft 20/3 Gypsum Ceiling Length if WSP not used .....(Fig 11 ft_!0.9W and 2.x 4 Continuous Lateral.Brace.@.6 ft. o.c. .. (Fig 11)........................................................ or 1 x 3 ceiling.furring strips @ 16"spacing min. with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate Splice Length :.......:......................................(Fig 13 and Table 6)':":: ...:. ft Splice Connection (no. of 16d common nails)..............(Table 6)........................................................: AT-VC Grtide to ff%od Corrstraiction in HiAtrh Hlind itt•eas: 110 ittph Wirtd Zone ` N/lassadinsetts .Check.list fog- C0111PK',111Ce (790 CmrZ 53U1.2.1.1)t Loadbearing Wall Connections Lateral(no. of 16d common nails)................................(Tables 7)..:...............:.................................. Non-Loadbearing Wall Connections Lateral(no. of 16d common nails)................................(Table 8)..........................1............................ Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans ....................................:...............(Table 9)..................................'R ft ® in. 51 1' Sill Plate Spans ........................................................(Table 9)................ ..._ft_in. s 1'1 Full Height Studs (no. of studs)....................................(Table 9).......................................I....... .... Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9)' Header Spans.............. ................................(Table 9)......... .................. .... ft in. 5 12' ............... .. . _ Sill Plate Spans.... .......................................................(Table 9).................................. ft_in. 5 12" Full Height Studs (no.of studs)....................................(Table 9)....................................................... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension, W a Nominal Height of Tallest OpeningZ 6'1 6-8" Sheathing Type...........:..................................(note 4)..................................................... 3 W. TttG Edge Nail Spacing.........................................(Table 10 or note 4 if less)........................ 3 in. Field Nail Spacing.............................:............(Table 10)............................. .................. _,in. Shear Connection (no.of 16d common nails)(Table 10)....................I..�5..�.1�.....................V(�U Percent Full-Height Sheathing...................:...(Table 10).......,............................................ 104% 5%Additional Sheathing for Wall with Opening > 6'8"(Design Concepts).................... Maximum Building Dimension, L Nominal Height of Tallest Opening2.........................................................................1(-,6'8 SheathingType..............................................(note 4)..................................................... oum, Guoufl— Edge Nail-Spacing.........................................(Table 11 or note 4 if less)........................_'In. Field Nail Spacing.......................................:..(Table 11)....................:............... --a in. .. . . Shear Connection (no. of 16d common nails)(Table 11)............................ ....... ... ........ fijp � Percent Full-Height Sheathing........................(Table 11).....I....... ...:....... If 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... Wall Cladding Rated for Wind Speed?.......:.................................... 5.1 ROOFS Roof framing member spans checked?......fle�n,...........(For Rafters use AWC SpadLTool, see BBRS Website) " Roof Overhang ......(Figure 19) Loft 5 smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary.Connectors Uplift................................................(Table 12)......:.....................................U=30 pff Lateral..............................................(Table 12).............................................L=-Q"plf Shear.................................................(Table.12)............................................S=A—(L plf Ridge Strap Connections,if collar ties not used per page 21... (Table 13)..JP?AV'4! %JT. 4....T= pff Gable Rake Outlooker.............I I.............................(Figure 20) ............... ft 5 smaller of.2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Nbi)c Proprietary Connectors Uplift .........................(Table 14)............................................U= lb. Lateral(no. of 16d common nails)...(Table 14)........:..............................1# — lb. Roof Sheathing Type.....................................................(per 780 CMR Chapters 5Q and 59) .� �.... Roof Sheathing Thickness.......................................................................................... in. _>7/16"WSP Roof Sheathing Fastening............................................(Table 2).....................:..................................IV 1.4 0 Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of i 780 CMR-5301:2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing -'requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade.. i Town of Barnstable Regulatory Services t ST.,BM : Thomas F.Geiler,Director Huss � 1639. .•� Building Division pTfD p Tom Pe Building Commissioner n3'+ g 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /v� JOB LOCATION: G.F .06CAIJ 61i t- El> l 'UkAsV0it number street -p village 6A"HOMEOWNER": wturi, 1��s�r o f I&I �?6 J-15- name home phone# j work phone# �CURRENT MAILINGADDRHSSAre L ( lb . LOt,16tAou 7 PR 1�U,WWO V�U Cl city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER ' Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on_a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies.that he/she understands the Town of Barnstable Building Department procedures and requirements and.that he/she will comply with said procedures and re emen ► � r Signature of Homeown Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, . Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. µ To ensure that the homeowner is fully aware ofhis/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt oFzrgti Town of Barnstable Regulatory Services • a t f ygisBARPMt's$, Thomas F.Geiler,Director_ `b ie3g6 iOrEn�16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder LI)R C(A , as Owner of the subject property hereby authorize ( to act on my behalf, in all matters relative to work tidby this building permit application for:&UV ky&' j�s poku (Ad s of Job) UrSignature of er lati NL Print ame If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FO RM S:O WNERP ERM IS S ION -0 as TA All oo n -coo r 'nt ,r 'e-4 i Engineering Dept.(3rd,floor) Map _ Parcel 12-0 Permit#� House#, (a Date Issued Board of Health(3rd floor)(8:15 -`'9:30[1:00-4:30) 1;r7-706 �Jz rFee, �c kl Conservation Office(4th floor)(8:30-9:30/1:00-2:00) �Iv C Planning Dept.(1st floor/School Admin. Bldg.) ' + �a n tOAC'Jl T BE Definitive Plan A roved b Planning Board r .. 19 INSTAL PP Y g RLIANCE TOWN OF BARNSTABLE�ENVi P �E ANC ` . t0� l REGULATIONS Building Permit Application Project Street Address 65- 0C4y /I-l/f Village /91 4,4. r Owner to TN r:7 &0A14-Iff Address �►'1��' - Telephone Permit Request 6,41.p 4--f RAC,(sT/tLr 13-e0"041 C001f o cn r L2W-1 7V First Floor .square feet Second Floor square feet -Construction Type GJ 00.0 F-/ -F - Estimated Project Cost $ 04 4 Zoning District Flood Plain Water Protection Lot Size Z b o 4cwc Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ' Historic House ❑Yes ONo On Old King's Highway ❑Yes ONo Basement Type: 4 Full ❑Crawl ❑Walkout ❑Other Al-ec+) Witc C2f Fyel Basement Finished Area(sq.ft.) A/.4 Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing )V C New H.,C Half: Existing New E� No. of Bedrooms: Existing A/( . New N-[ Total Room Count(not including baths): Existing New O.0 First Floor Room Count ( Heat Type and Fuel: 19 Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes yf No Fireplaces: Existing New Existing wood/coal stove ❑Yes 14No Garage:`0 Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑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 . 010alll-S Telephone Number 7 `� S ` &9%E 7 Address 1195- :�'J' License# P f3 5—/ 14(YAA l-5/11 -•- / hD Home Improvement Contractor# /(� 02®/ _r_ Worker's Compensation# AM Cr MOO 00.-?4 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 TO2¢�S SIGNATURE 441�1 PATE ILDING PERMIT DE ED' R THE FOLLOWING REASON(S) r �p i� a FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS +VILLAGE t .OWNER' DATE OF INSPECTION: FOUNDATION •, a ,. , •/i j 1 � ' '. 4 j •_ ' t i , -• FRAME ,f /►� �p J G}� 'INSULATION FIREPLACE— ELECTRICAL:' ROUGH FINAL - PLUMBING: ROUGH FINAL. 1 GAS: c ROUGH FINAL F , FINAL BUILDING DATE CLOSED OUT 0 -ASSOCIATION PLAN`NO. € The co/111110111reff/th of 4fassachusetts •� •'• ' Departmellt of Industrial Accidents rA t ;Y =) OffICPD�IdY�S1�9�lIOdS 1• on Street � . y;; � ,.••��% Bustutr.Afu= 02111 �--" Workers' Compensation InsuranceAtTidavit rill, ❑ 1 am a homeowner.performing all work myself. i ❑ 1 am a soft proprietor and have no one working in any capacity 1 am an employer providing workers' compensation for my employees working on this Job. ERNEST B. NORRIS & SON, INC. .� 385 SEA STREET HYANNIS 508-775-045.7 nhnne#• EASTERN CASUALTY INSURANCE CCMPANY neli[�, WCG 1000897 A. In�ttrinc rn r - "' : eowner(circle one)and have hued the contractors listed below wht ❑ I am a sole proprietor.general contractor,or hom the following workers' compensation polices: �• . % Address: phone nolier 0 ... Surnnce rn r � ,-. - - .. ..• _-- rcn ans.,sc�+�-�+'►'t'—�"T^R"�F' . ""�•rf,�JC7°�°'r''-z —a+:• CO �... .m .,�m."na i•n nhonell• InUrince Co. • '' nolicr_il • •• .. ;Attach additionsi•she et�f nt[[SJa 't R "��•'�r"� ~� r �� Failarr iosccnrr corerape as required underp of�1CL 1SZ net lad to the imposition of criminal peadtla of tine np to S1SOO.UO s one}•vets-imprisonment a ��ell as cis ii penalties is the forth of a STOP 1�•ORK ORDER and a line ofS100.00 a day spinst mr- I understand t COPY of this statement mad•be forwarded to the OMec of Inresticatiotu of the DU for toterazt verification. 1 do herehr cenify under the pains and p gibes of periurr that the information prmYded above is true and comet: Signature ate Print name CRAIG N. ASHWORTH ifione 508-775-0457 7, iate do not n•rite in this area to be completed by city or town oftidal permi0cense 0 r1goiiding Department C311eensiag Hoard 05dectmen's Office e response is required �t;esith Department phonetlt i e` j CO rn ME CS3 CO cc I � t!> h-d C") r T t rl.,) C $ 00 =r 3 Cn m _--.-.•__._�_—_ter-_._—_._.___.._.---_...--- -------- -., 1 4 14 3— rn �. r.rcp r• rn �• CCD cm - I W . . 1 cC- 3 CA Z rca 'p f 3 CJ) a C 70'c'* C ' o CA 1 c rn I C-0 O . .a oM. z. I i � I I� j • f I i i S j t ;OR"S MAP 287 � - SCALE IN =�oo � ........ IN FEET G 1 _.•y.. ; . - - r 117 267 288 306 .__._.....». .1._..... i'�� ---..... �1(„ ----- -O]►x: i p •b i 0/71 '. tp 2 1r 1 2651286 6 287 305 _._.:.. 1 �w j .......-.. , ' )) iJ 1 Y i i 1 p w V,o 03SU - t 123 . 1 + 107-2 7 ____ - / f _..-... sou �. r ,•' r �� i W-:____---_�-+-..�--+ Iro ill � l 212J26 .T-TT i..__....... t N x � s ' , , , i 7 • _ LZIK 3 IK 112 19 N1++-rt 1 1 1 oulf 113-1 7 i k r50 e 69 K i 1 - >> ' a , 13 2 �� 1 r r+,r" 11 'ems'• .� � � / > � i t113- 'YVAY 114 ..:3 y i `. , .x , x ,r.. 130 /RI I a 1 a � �; its Osx j. 118 LJ ................ 7 1 . f :: a 4 ASSESSOR'S MAP 287 IN SCALE Yu , 117 _ F 267 __ 1 ,, //d // ' � 1' 265286 e2x2 266287 3 5 �'•��•�,i Q B5- , f _ ` - f s t .. 10 123 eoas ) 70rzow px . 121 tf° Tjp i ,. Ya —' •{ i . . .,, INK \ 1 I �bx `, is ,x ies 20 I I YN"�r.l ., q 12 112 79 , 103 I 102 , LV,,l— _ _ , ONK 113 7 r pi se — — :WS' oYa, onx ti3Yga` ` r 114 �.fit " 7�' ` 'tY" i .. Q130 _.......... t , ... 178 iI' .j r� , y3 r sirs f So 0 s — y "Nit ! 92 an ! ♦I f 3 t x J jE: �e � 6 k Ow s .I,x a f r Y y I q I 4F Ik 1ir xls ��•''`/,, .. tie !/ .. k�� " jx a. • nue `'81 s 8 s =i - s E gVEN \ \r }, t M CMR Appadia Table J&Llb(continued) Prescriptive Packages for Oae and Two-Family Residential Buildings Heated witb Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Arm'(%) U-value= R value' R value' R value' Wall perimeter Egwpment Efficiency' 1pad(age R value° R value' 5701 to 6500 Heating Degree Days' fizille 12% 0.40 38 13 19 10 6 Normal 12V. 0.52 30 19 19 10 6 Normal 12% 0.50 38 13 19 10 6 85 AFUE 5% 036 38 13 23 N/A N/A Normal 5% 0.46 38 19 19 10 6 Normal 5% 0.44 38 13 23 N/A N/A 85 AFUE S% 0.52 30 19 19 10 6 85 AFUE 9% 032 38 13 ZS� ___.NIA -_.N/A— Normal 8% 0.42 38 19 25 NIA N/A Normal 0.42— 38 13 19 10 6 90Af(JE S 9 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: �� 4. %GLAZING AREA(#3 DIVIDED BY#2): 1/! 5. SELECT PACKAGE(Q--AA-see chart above): g NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix J - Footnotes to Table,I5.2.1b: Glazing 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 area, 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 ftZ of glazing area. Z 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 crawlspaces, 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-value 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. If 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 efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 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 and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. 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,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with 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- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 � Q b 10 Z_ � 3 aC v � Co Lii uj �L OL � i O n Z w 1 � u tu Ud Ell, �1 ui - - { LA I I. i1.tGL b00 ' d ;) N ( H ; '1v WO ,:) 53 �] 6n� Ci3d .O-Z 16 it Ia1 W za �u o Ln 1 •T >> 3=)YdS MINA W in ,. — i I m I o � i I I >� I 1350l7 0 'JNIA-MHS WI lvns :n ,\ c'li LU \FLU W In= Imo! i / mQ \ ! W O II X>- I 1------- --------------1 wr II nI? Q o U pe 1- a UJUJO ------- --------------- ------------ ❑ ❑ ❑ HOSOd 300 ' d N I H H W0 ,) S3 NC) J m o . 0 TYPICAL ROOF ASSEMBLY -RUBBER MEMBRANE ROOF/FLASHING -TAPERED FOAM INSULATION -6/8' COX PLYWOOD ROOF SHEATHING -BATT INSULATION (R-30) SLOPE ROOF PROVIDE 2x12 -II 1/8" E.LJ. IV O.C, —1 x 3 STRAPPING 0 IV O.C. AND HANG E. —PLASTER CEILING , , DECORATIVE RAILING E PIRSi FLOOR COILING eL•°'-)Vr YAIDOW RAD iC WT TYPICAL EXTERIOR WALL ASSEMBLY EL-7-!' vmT -2 x I STUDS 0 14' O.C, -BATT INSULATION IR19) -5/8" COX WALL SHEATHING ;y -AIR BARRIER -EXTERIOR SIDING TO MATCH EXISTING m haw" eau WINWI7 K ■r•°yr VER y NEW ADDITION (2) 2 x L P.T. SILL 2 x 12 LEDGER TOP OP MIN FLOOR L-------------- TYPICAL FLOOR ASSEMBLY / EXISTING FOUNDATION -5/4' TOG PLYWOOD GLUED AND NAILED -BATT INSULATION (R-14) / z -11 1/8' E.I.J. 0 IV O.C. BASEMENT NEW 8' CONCRETE WALL --' ---- r- FROST WALL BEYOND. ' CONCRETE SLAG i OF FOOTING 40' BELOi -� TOP Or BLAB / EL --r-O °rr �= TOP OF POOTOIG —————— EL ■-r-4 PVC DRAIN AT BULKHEAD WELL. PIPE TO DRYWELL NEW CONCRETE FOOTING 2 a � `` am 1$OT� vM�n•171Y Lill PC nvaw _Q 1 d tu IL o 0 . a Y a Q V W �n i 600 ' d 0 A FRC,M RESCGIA ARGH . I Nc F . 004 fit El � 0 a ❑ a 6'-0e CA140 0FWrA rl • II I CAS. ~ HALL KITCHEN ROLL-IN SHOVE Jk a , � �, BATH ■lJ e'-�' . �T I GA5 H W _ U BEDROOM � r _ U �oc . a a z ❑ oca PROPOSED FLOOR FLAN SCALE; 3/I1'= 1'-0' EXISTING ATTIC =LOOR TYPICAL ROOF ASSEMBLY -RUBBER MEMBRANE ROOF/FLASHING -TAPERED FOAM INSULATION ; -6/9' CDX PLYWOOD ROOF 61,(EATHING / -BATT INSULATION IR-W SLOPE BOOR -11 1/0, E.F.J. 4 N" O.C. r f -1 K 3 STRAPPING v li' O.C. -PLASTER CEILING DECORATIVE RAILING I i I i i; SEE DETAIL EXISTING SECOND FLOOR gal FLOM Cam '.�''. r: !• ..r. :cr., .r, .h:•.rti.:•.A .n ,i. � u-r-1 yr - r11DOtl WAG von Fen, TYPICAL EXTERIOR WALL ASSEMBLY Von" -1 e I STUDS a u, O.C. -BATT INSULATION (Rl9) -6/0' CDX WALL SHEATHING -AFR BARRIER ' -EXTERIOR SIDING TO MATCH EXISTING N i WON 4"ww"T n-r-ev4• i yp" NEW ADDITION cF Fseo►I FLOM 11) 1 1 P.T. SILL 1 a 11 LEDGER EXIST NO FIRST FLOOR a-I TYPICAL FLOOR ASHMBLY EXISTING FOUNDATION WALL -3/4' TIG PLYWOOD GLUED AND NAILED 4'-0� -BATT INSULATION IR-19) ; -11 1/r E.I.J. a U' O.C. BASEMENT NEW 9' CONCRETE WALL T ---- FROST WALL BEYOND. BOTTOM 4' CONCRETE SLAB �� OF FOOTING 19' BELOV GRADE ro►a aorlw �• a•-v-�air �J PVC DRAIN AT BULKHEAD WEL-, PIPE TO DRYWELL NEW CONCRETE FOOTING PROPOSED CROSS SECTION SCALE: 3lV = P-0' ,1 k 4M/2019 1150 J J y.4 a QD 11 -a .i•.�-k. \ RENOWN, \:•ma a - ------------------------- az D is aim.W—ua 6 r s� D 6 II$ + I a Z P4• P Y? SY __ a , I� \\ L ________ OM WCJ°GF 100 fiR.l°b />I_\ O b'OL. b'OL 1\klll! i � a€EYF ---------- -- $ Rill 2'1 $ � eURI 10, ERN 5 lit 9 -fl rao rtn. ,is zco nx.glse �� 3�'�, 3Ju B 00--APSfi � fi $ b'4 r :•row� �� D OL. 7_ ara p P € T4 W-0'_ 5- N , a s 5& : i r G p6N� __________ � ❑❑ ao Z I ------ a O -n 6 At D ' r ___ k sl 3 F --------- �ae:� � a-III• s-0Q Ar D vi•x : z 4 ba.ue ju CD O IY{'xY VD•lvt�YRr lK - ° b•OL. •b'OL oD a �a ' T4 W-0' 9'4 Pt•M C r D zco rs%r:ram wownera b•oc. o. i' Q(D j a®®zag 40nx zN ^w z-t Zql NO3 Oi 5 � a> z 2 6 Z� fit �� OAAAA rn O O O 59 =�R Vim . �qrn �r NNr p� ?D DD u NS �F AO b� rnrn �� ri � �O NOI�i 130 Dq Zq N to N m € Ac fi�l� 'S�m �mn Orn � zv� fil r z 9NqD `T 0pz�� 11 "' t-OZZ �b� %m z-�o =rD- O q L d��F jbj Nrnul; >� Q -0 N fil ITI i,P N-il (i D lrf, U N q p B+ La" Y.($V s ; ° 'F D nrn Ar AMD rnr_ A z �rnm 3 DO_ D S 4 8 O O O U, 9 g y N r0p ZN Ci rn o A X 'P t�t Ol -N c o `q rn tfi O z Cabana at the �Txh A«0.I-WAy D Whelan Residence °�°"° "i � 9 .. • g @ 65 Ocean Avenue XIM A$C S I —T B C H s�no�i ;tr�t a soe Aso sus �o. u khA..& ro° °" ASS 0 C I AT E S.�annis Port Massachusetts T �I� .�� p eeel°,.MI°olArry � cotuik ®� a .cam 8 ".a.eh°A Itanlinn of Archi-T Auae, Floor Plans and Framing Plans o � ,�°�,. residential design archi whmociabes.com I F m D � r I 1656 A. 8 � n / --- ------- i. 1 m � m D i� 0 _ A z z ..... :. 'war'�e` Whelan:Residence x 65 Ocean Avenue an A CHI T B;:C H I 6 t weer"tickmb t s:4:5m4 i b �s4: �. nnis Po Nla�sach IM� A S S 0'C I AT E S. �,�� . Etevsfi=,;Sedon& m r e s i d e n t a.f design an itE 9�1 �3 ace Avenue �n -( /- -Ped,Side Wolk - J `• ASSESSORS REF: L .� c• `a Map 287,Parcel 120 r _ ,220.14` �„- \ \ Stone Ww OVERLAY DISTRICT: x , AP-Aquifer Protection District 50'Reserve Wooded Area 507 Reserve , 3 FLOOD ZONE: \n'i Zones VE EL.14, VE EL.15' LJ"O '•y'g ( � K.rw,ry° ' ro P _ _ _ . - - AE EL 11 ZONE X. \ Community Panel No. be / s"ys "` .✓'^\ , \ #250001 0568 J �y��r ''�•��`' i. Re ove \ ', ' July 7, 2014 r \ j HYA�N9.5 IV Proposed Future Gorestoga withGu Rooms Ab BM SPIKE DIRECTIONS: LOCATION MAP: ELEV. 20.55 Scale: t"= 2000't Hyvnnis-Fellow Main Street to I \:) Oc Odve an Street and take a left.Keep right onto Old Gweny Road and Right onto Casnold Sheet Tum Leff-to Sea Street ZONE. and right O 1 t f PROPo ght to Ocean Ave.Property is PROPOSED on i' / DMVE O I D-BOX �^ N the left 1/65. RF-1 PROPOSED w ; Area(min.)87.120(RPOD) Frontage(min)20' _`r _r P Width(min) 125' CLEAN OUT i Setbacks: .` m,.�v y r I I n _' Front 30' 1`. I ' Side 15' Reor 15 (, 1-Frn sh Grad 10.0 - 3 Maz. Existing 9"Min Compacted F711 .�.;rrliaysc�.a \ ;l n;�O 1 j jJ` w/I Dweflmg Filter } V y " Fabric m 2 ' - i /B.-1/2. Pea Stone ,�(•.- 1 1/Z- Doub o j, j- PRpP W/F i LEACHING Double Washad stone b m a --- Z '.I // '\ ��.,,�. _r�1'/_- r-r..._ I `fn8 0�✓ �o� �� '\ f 12•- 10- •� 20 CROSS SECTION OF CHAMBER NOT TO SCALE Pow PERC TEST:15,400 1 a` m Per tie Cmd / 02 0VT� P�1E®Hr:t9A1089mWLAW{PB to De Removed y_pPp_- 1 -E-. ( 61NlrAMIDIRiAf�ALisC@�tILT1AO.RG -22� f /' P1-3fO CUR 15// - TREES TO BE RAIObED �' /' 0 9 I worms®Er.uw"rn•uw AW,RA.tde - QffiMAeA$,tH-7QWRaYBAexsrAms PROHOE OKYI4f115 �•� "' - .C�Pa E � i j ,< ! � JI S1TBP�SSD FOR RUN OFF AND % /P""{N" PIXY DRAW DOWN(TW.) / �� 0�ot>iP' sue, t1 � ,.�•�' \ s HAZARDWS' §' ii / / \ TO(REA Ei 1} '' �'� G PpE T AOLg 1 -lII.2Aa 78ST 110L8 2 ID.2M �' N6U'YM26YkNd_ _ O.k'L(Y�18Yd32 Y6BY)SNtg®`AYE4FYlYfffWR-= Y> Y-DefrYCstv-0�>�QWN 1REESTO BE / �pg.� �1C�� 15'•� I i, Brian J&Mlrlom P 0•Nedl / Lot Area_ -- -RE710VED ; S�PPF /''11A.."� °� - - ` }` aY®O f YIOlDWI&IBROWN / i 1/ I l`1\ M LOAMY6AND (8L1 l93 /.MY S4NV(9C�®tAYS) / 89,244sf - n � � o / / I Of Upland `1 - CIUYI=t 10Ya 7/a36- -i3 3f[W.=w ff �`r;l, \ YIUOW tz I.a�ABRt<fJA4ft !\ I _ /` ✓ -//' - ' - :Y• rN tnAase=Acm aaA a 1'PBCIrA1m<29OmIN -a � E-Nosh Qurmllera7A Qurm lt7a 7/a _ / / //-/� .51� __^ ' -`,i••`A cq Zo �4L VWYPA8mrowx avow MIDn/118A1m U_ 71' O¢9a1�lfA11m faAVl$. 1 \ _ \ff'9��F w�oramrAT��maft� Qur�tt R753 / / -/ ��e'.� / P/ �• �j0 �/,/ \I00.b. IFC4 Frf'p VPRYPALRB=ORM .�71 / /, `I , \ v 1 e�DArsAND izD l' /C / '.,Y l0le r„• \._-.1 L�,na WrdOfA,V ENCOEWESW •0 T6STHOLfi-3 EL xo TEST ROLE 4 m atA \ % � �(` w ',Yy{�/�, •, / I �`^ \\ �.\ oeTwrBaadr><ia= _ aAUYatmave ire. •5E'Pp� / -oS l/>d'M ''�/ 4``M° \ ` YQRruANYt$A124R�owN VlYrtextreAArJ�moww VED 1 \ \, 1 __ 1•MM _D2 t iD BE REMO /FOR NEW CORRIDOR r®1OW64BBROWN VWlOWtNF r11YOWN '`\ // i e �11ri \\\\\ toAMvwm(swmaaAv al LO0NrSAND(9QE!GRAV1IL) �� QUYIaIo�a]nt 500' �1� r__, \_\\ \\ yatm 25QALOWM<l$M1X lH7 D d Jr.R- vw \ .T _ ._. l -��__...... - --.. 47 -- - - �tt..vvr+r -\" '-'CWH�fiAM! OBA -f�Caw]E<]AtngM TAe- /` //.✓ /l'/and Resforationi Pianhng I I'\ t i.\\\\\` QLA784 f0YR]O CI UYJm 10Ya 7A1 VMYPALEBa04M YBUM �\ _/_3��IaF' 1.. '�L /% //' / / j 4Ii/ .�v •.• 1' tI ys'// /\ \ I1i}. �\ \\\\ 1 wmmmemQmaAtwflmaawro.um,® OARvQBasutM_14- C "PrAB rH�eeD(lvMNA rm 1 7 fMW -3 DA-15019 \ \\ f MIDBVMSAND I HAYARDOUS TREE / \ FG Vista Pruning 1-r TO BE REMOVED i /' y \ VV�� Ste, J %1x Y i `• / I //�.•'� / `� SEMCNOTES cQpar aBy _ i / ! // I / -`\ 1.14=bmofU09mShm m 1TMPL4AmAM=M Lad 72K= °n ` PAX to AsyE mvmlm For 726 P1*0 the 1mlree4aSw Adli m t / / �/\\ \ ft RawYntiftfilkabu s,Dig S.6(14 U4-7M)asdcoma -0 �mY>m>1o�e � rm(wse�s vas} y I ` / /\ \ / .�• C\ 27be Cawavw1xRaq hvdto 9ameAppmpslabPwWtsFWm lbws �\ 3.W � o�mtew�sym t]amt3oOLinmS6e/ �y1?o I� yc�i / r /\ \ \ J , Be CSnm=medof®Ir81sOPasemePfpema�aR De WefmTadedb e4 e o -- : C m➢ ® A9wde WAWWhmtaa.fa Gmaal,W9wU=ShaRbe C=mbueledia ow J '\ ' •\ s }` \ /✓f•,•y aotadm WOHymdr Waag mdSWbe&Aoamdproe W102QCMR1.00-7.Og8310CMR15.K CJT4-Atff9'ofCbrerisReq�edfQARCLmpmafte. 1 60-1-03 \ �� - d !' SA9SavutamBta&dn=FcdwMme &AJM 100• AZ49DOUSIREf I / `1�'�!t`%11„6 %/�IlD taVehkdw 7La5to be"70af.fib dwEnSiaeaY TO o)ED \ / (�ti e ' ^� f°� RasmmmdeOEm that&,7DAfrt'ns be ll9ed 4^�'� t t 4 6.htabRW.WWK- amdCa 10 Wi0om6-ofHiWWQide 11a __ /- \`o\ "\s0• � \ / .�� - ., �•p 0e Srytl47=kftM=d0df4D6AWdCkWLmt;ft -4 MUftotwwfbraepWWktDhea =r8' LEGEND: '2�°�1oD 76e T &ARPlpfftaDba&k40FM ?�Oj� - Holly Tree 9D4fm She 1k-Gh f=>ade llama®4f12:amd.Admiam , -;,. ry sep(de 7lmk�eR 6e a2,%0 Cd1m7 wOha CmBa®em Poe ombt / / / / / � ..- Pine Tree 11.7heSepmtlmDhtlmeeBa4em tbaStpda 7lmkfokbaltd '%a /. ice zlt.` Qr&a�eDhsNOLae Poem OeL dlkplh/=la 7'as�e0®taad Deciduous Tree Ph -[1--d.gh0h.R-h..Wu7bx-Rl4•lr<t�elleFa,wr�n,d�nBrefT®A.aedwaf•.�R.M.adRe Cedar Tree Hazardous Tree / I.b R" i // / /-" / ..�� % to be Removed Trees in View Corridor to Hyannis Harbor be Removed and Replaced Ra`µr F.F.El. 25.00 t^3 See Note 6(typ.) i$ DESIGN DATA F.G. EL. 237•- 'Final Foundation Cradina, To Be F.G. EL 22.6 Max. F.G. EL 22.29 MO.,. 20`Alin Min. 31ngbF1®TyCoordinated With Landscape Plan -IOBaaho®�/1017PD 3.75' Complies With I4= G� Flow Equilizers -ti Breakout Tba1DWityFl-1,IWGPD EL 22.0 ``, Al- As Required 1,10022W%=2,Z000=11om Installer To Elk a2,5W(Is mSqft Thole Confirm Prior EL.1q.70/ - 2500 Gallon To Any Work Septic Tank E 1.45 Top EL. 1929 LEACLWG AMA (See Note 5) 18.90i D-Box EL. 18.74 1J06GM/074(CTAR)-1,486SFRsg dad &&w.H-2(12,V+93.0)t'-4233 SF Leochrg B=mmA--(12M'29LP)-1193.2ST ToemItalled On Chamber ,lap _ 0 Bedding,`T"s• LEACHIIJGCHAMBERDESIGN Inspection Part, .AD � b6e SPB=dole QQ U. & (iet 8alfels :`Ali uasutaplz„@qs;W`;titri_5,__Gtf::? `D ]0-500 leedmg�m ivs93.0a12&T' as Per Title 5 :; •. ys..Jhe Ou}u.Pefiinelgr:ot_„7he_.S__jem_ .- Dbo6te 111-WS(smArldm ave.Sh - EL. 12.5 No Groundwater Per Test Hale 1 Permitting Only DEVELOPED PROFILE OF SYSTEM EL. 5 Not for Construction Groundwater NOT TO SCALE Per T.O.B. Standard Revision:I Add septic structures and details to site plan 1 811512017 TITLE: PREPARED BY.: PREPARED FOR: � NOTES: Site Plan 1.) The property line information shown was compiled from Engineering& available record information. Proposed Improvements _ P James F. & Susan H Whelan 2.) The topographic information and structure location was At SU11 1 VUII Consulting Inc. 86 Centre Street obtained using conventional survey sing a y e 3. Ills datum used is NAVD B8, using a msf with an 65 Ocean Avenue (5M 4M3T44•P.O.Rwt 6"•7 r=r)mr Rind,astern[,MA 42655 Dover MA 02030 odjtfstment of 0.87'. etxi�sullivmaengin.mrtl wr stdlmmerl)ynx= 4)Structures on this property were located using conventional V Barnstable (Hyannis Port) Mass. survey method. O y Draft: JOD Field: MDH�WHL/Afu- zD 0 10 20 - 40 80 r DATE' July 24, 2017 SCALE Jn _ 20' Review: PS Comp./Review: MDH/RRL Project: 30029 Project: C284.5 Edo$ : 1 P 282 P 368 11-1 —2131 5 1 tar f IL 207961 BAR STAB. E LAND COURT REG I S1 OU_ITC_LA_M DEED BNY Mellon, N.A., Personal Representative of the Estate of Anne W. Wright, holder of a power to sell and under a direction to sell set forth in the will of Anne W. Wright, for consideration paid and in full consideration of Three Million Six Hundred Eighty Seven Thousand Five Hundred and 00/100 ($3,687,500.00) Dollars, grants to James F. Whelan and Susan H. Whelan, husband and wife, as tenants by the entirety, of 86 Centre Street, Dover, MA 02030 with QUITCLAIM COVENANTS, the land, together with the buildings thereon, located in Barnstable, Barnstable County, Massachusetts, bounded and described as follows: LAND Land Court Plan 203.15-A Said premisesyare conveyed subject-to and togetherwith f t-the�bene of any-and all=easements, restrictions, reservations, agreements and rights of way of record insofar as the same are now in force and applicable. The Grantor hereby certifies under the pains and penalties of perjury that the decedent, Anne W. Wright did not have a spouse who was entitled to an estate of homestead and that no person has or is entitled to .claim a homestead in the premises. i For title reference see Court Order recorded herewith as Certificate of Title No. o?D 7(a 0 Property Address: 65 Ocean Avenue, Hyannis Port, MA R ' e s WITNESS my hand .and SEAL this day of , 2015 Y f N f• F S' BNY Mellon, N.A. Personal Representative of the Estate of Anne W. Wright as the aforesaid and not individually, by William S. Kau I, Jr Vice COMMONWEALTH OF MASSACHUSETTS o. ss -- __ounty_w -ere executed)- - w On this K dayof 0 vLer 2015 before m t e ue h ndersigned notary public, personally appeared the above-named BNY Mellon, N.A. by William S. Kaull, Jr., and proved. to me through satisfactory evidence of identification, which was o wo-111A , to be the person whose name is signed on the pr eding do ument, and acknowledged to me that he signed it voluntarily, for its stated purpose as Personal Representative of the Estate of Anne W. Wright. NotaryPublic: My commission expires: APPROVED FOR. REGISTRATION loses BY THE COU RT Cr�-�t Ij,,7 MATTHEW GINTY I� kEV TITLE EXAMINER fiI7pP NOTARY PUBLIC CORONF i MOF ssAr,"us rrs UY Comm. q 249 2021 4-0 I'lr � Page 3 of.3 �� —_ . Avenue �——P xad s,d.Walk . , ASSESSORS REF• *'At`�.'�k"ry �.�•.� r � ti O / Mop TB),Parcel 120 ory;'t ` \ �."«� OVERLAYDISTRICT '� \ AP-ARulfer Prot«fiar O!t,1 �}� I B C • �, li `'} / I `50%Reasr.v i-v \ •eu°ae xne\ ` \ / �.J y �,. � 1• FLOOD ZONE: 5 ` n Zanm if ELIN.X ELfs �'•5) } fa9t' _ \ \( AE EL.t1'•ZONE X - 1be/�T \ \ \\ Communlry Panty No. •✓^ +.+r"•�.. \`\v }L' } r--..•A — , - Re ova p 't �,SmID°Di 2oHv {`�1 '� { {�.L}ty'NIA•v_N'�l.Sy� `'! ! I ", �' .vv,, . ._ ,V, drag..ifn'! \ � °l^a,.m•�-...". is 1" Ali'. 5 ! V•h \p aiaat Roorm LOCATION MAP: a0.$9 2 DIRE�CmTIONS: ooD: / �r• / ~ _� \ O—,,'IrM and a leks Kam 1101 / i L? .was\ i co:,amm°seer rRumaoOi°reea�m s.`"a sfr«l ZONE: .�' /r O o-m .� 9 mM 1 mlo Oeeon Aug FWo!ty b m P.F-V (mx. f1J 1'0(RPOD) + P, aPEVN our $eF 4 30' Rear]S' l RNh Woae 1 .. 1 Ulea.9 Lan«f«.al Fala - \ £rAUn..a .. • /0: 506W2 sqfl A fr LEACHIh'C 'fir—raioaxefxvona CHAMBERI Se>m 4..�,' ' - s CROSS SECTION OF CHAMBER Lot Coverage _„_. _� . r -: "� h Na+ ' � NOT TO SCALE Total upland 89224 lu ate F u. ° o laHAC 7E$7`.IS`4(p e t� e 1 lvlm®en�Aus,o.urml• t3 *a ro ec mamfTn emMKmlmlmVta9m CaYRID4IIC ruA, - �avACRAau 4mne • ��cri A�Nn � ra''Total Available lot coverage 20% 17848.8 F��.�mtF- _ _ �� ° `\� pA�BD Y Total proposes lot coverage 8091 sq ft or 9% _ __'Lot Area* - � K9a R _ �m°•� Pa ;� f'+ Ba 2 a._ •r _ .^w+n.Y aeA ._.u.r..um 13 ra.. Gross Floor area available 30% 29767.2 ,- °'°p Total proposed gross floor area r, /- ma > am - I� �f�� f,/lf a,N,o •�. r.../ - �\ } 1 \\\\\ ru�ana aoirAo:� u le Qr .o mruamrx rq er Anwmv ��=%/j it( / �. + I'• v_..�;i ./ SEMCN01W . � ,�.. / „mrm.w,�rlmn.ffiFpaammmmarD.ab ..- � p �, / I �� /\� � eeeraameexae.asmtWampan.waJan�emmn ' A - -/\\ �� JN amp..aeuoa�anmrw°°°..r'ee•�m - 'I \ /✓ Lbm@eYm ilml�lWW4md�eabmAoeodas �g. \ / n ■nwo�aw•74De»oaa um - � � � �._ �..\ �` �` � J a.�.�,e N..` ; �"'----` anermman'er«.rII.•m.aa..wm•amm _ . � ./.__, \( � 04 1 n� r..\. �y sAIIaa•msIIudeamleersammsargme / +i � \'/ eE I �/ JL�J�+`� ! mWlbl•lmttmmbli.Miaelb{IImmel)namm\ - Id3 _j' `.+cA� / �� 1 / f °�'� — /� amfmavmwaemaw..mweera•ar+am�eaae. _. .. '�j r I'W '- ! _\-��--� fie°•... \ L_ // �..\\ _ I� � .ma°.��omr�Po.°°mm'°`a°a..noem°mf a`�nmoo°m eoL., mromem+or•rme..mmmm°r!. / / ( /% / Ld` xLaplmlyemmterrm.em•mmbr.wrouoaauo9a e LEGEND. wanfao-Ja9lsmanmmodbMeteea.b �vt,� � 1 �r: \\ \ asa`,e �j/ `t 11 1 c0�eL U /. /� n �J V 1 / .� 1 i/'f / i f- r Lai Neur r anama%a..ie�®msnmmmalrsa.emetim SS J L t / -wee. /O ( i'' -- 1.�/r/ l f / f .l /a BlpleTNA•%Eo.Lt•a00oes0Y.b�rmboahs -- 't u.aneam•mm•IIrml..aa.sam.+mm,%ae�mM•ae �''/ /�/ .m®oiirre.rro. o�m.r�rm�n�u• ,,� //, � % �/ /f �� / '�, •� /r � Dear4aaa,Tr« Rxm...PdTr ee.m.Rk.R.,om,aw•.n.ro>d / 3 2.V r1, Jr//—)� % / / / '// / f // Cedar Tree - Y v .. - -- f f�/ .iY�/ /f/ // ///,�� /' °�0ee kerr'wwr°wua r.« / 1._ - d rry °a R—m and Repl—d � Hyannis Harbor . r•._- _d map DWONDATA I ' FA a.23.7•-•Fxal Fovndatxn GaQx fo F.a FL=6 Max. Sss Nats B(IIP.) ` 9 Mx. Skpionss-* IuDW a naacaos Ian ].�� pl Wofavo'm•• Floc EpaaGers Ir'Bn iovf - WOmiBeWm 0;lmt<r T. r Aa Raiuded VYe3=m Bww7 C —Prior 2900 0.1m To AnY IYerA' Septic Tank 1BAC��AR� (5«Note 3) D-Box a 1fa0 W ya1%(LTAN)�IAMIDRe.dA _ Fyp%•fpyp'elJOI1'•6AlID Ifl2s.1' } L«china Ail BNb�(11tl'aaAa)�IlallR ro Be In faced On f 1 }S$?. ChamC , 7wrfenu•.fmadonwarml fps"•�i�"�,kt,' �<'+" '€'�:�fa$` -5't�.T�,�aa�aa-eP« f4TcTv." n D I8AC�0CHAMeHIt OHSICA! xarm vsp ,l siraehm aRaara w o�.uRmmeene�m.a fr a sonar. Air rhalptdde SW >�%k4��' - ��B�.fur m P✓RBe 5 �sates Pxenemr s me s Ij /� No 4vwnProter C (� (,} (� C/ v S P��ng OnlY DEVELOPED PROFILE OF SYSTEM l ✓ / Not forConstructlon04, a°( ^°•°f°r/ NOT TO SCALE Per .*a stan°n° 1 ea r.e; as Rom: A PREAARFD BM PREPARm FOR: NOTES Site Plan p he P ap r Ixe xs matm ra.n.a, aampaaa cam Proposed Improvements a anal.re a d x,amaBe. p Engineering& James F. &Susan H Whetan 2)me laves op x amoem a a,ln cmre I«ar;m At Who c in 7,, 86 Centre Street oemxed a,x9 cnnvenitaml,uneymefh I . SUil��4l� UDnsuiLtllg�Llri. a)Tha.clam ace°h NAw nA aaxg 65Ocean Avenue teae)42sewa.RamBea•rRmw a°.aw it mAmaee Dover MA 02030 adpaeme t or D.er. Bamstable,(Nyannii P«f) MasS. OroAx rnY mefnoa Q JOD Field: NON/tSHG/MLL as m j DATE: July 24,2017 S�Alc 7�c 20 AeNer. PS CbmP./ReNana MDH/RRL Pro h 30029 Pro ct:' C1Bs.3 , J Avenue Oceqn - - - - ASSESSORS REF: A Pave Side Walk / 0 / Map 287, Parcel 120 F -21- -_ S63` 19' 50"E OVERLAY DISTRICT: gX �20--4 --- \ \ \ Stone Wall �3 -- - AP - Aquifer Protection District I e Wooded Area \ 0% Reserve 12.8' FLOOD ZONE: `{ JJr5 � r - \ D' i Zones VE EL.14', VE EL.15' A EL.11 , ZONE X. Community Panel No. `R #250001 0568 J 22-'--'-- •` �- _ e OVe � � July 7, 2014 \ \ I i 4 • C Pkoposed Future 0 arage with LOCATION MAP:'CT Gst Rooms \ Brush `�A, Abovecoto ELEV.PIKE DIRECTIONS:. scale: 1" = 2000'f Gravel , From Hyannis - Follow Main Street to 1 Drive `��' \ Ocean Street and take a left. Keep right onto Old Colony Road and Right onto / �a 23 0' Gosnold Street. Turn Left onto Sea Street ZONE. l PROPOSED PROPOSD and right onto Ocean Ave. Property is on RF-1 DRIVE D-BOX the left #65. Area (min.) 87,120 (RPOD) PROPOS o Frontage (min) 20' - ` TAN w Width (min) 125' PROPOSED o i Setbacks: IGravel CLEAN OUT a Fron t 30' L Drive / _ Side 15' 1 Rear 15' Finish Grade ' Law-rh ; 0 3' Max. r \ OPO 10.0' Existing 9" Min Compacted Fill Filter PR�eW w/f 0ne;lin9 Fabric Existing 2 Sty. /r And�Or 9 Dwellin/ w f f T l " 1/8 - 112„ c i � i t � � 2 �1 a� #65 f Pea Stone I 3 3 4" - 1 1 2" m `` POSE LEACHING Double Washed _ P ,� w/F 3 .0' �' o RST CHAMBER stone ao y L L' d LO pWE a k' �t °Cons �� 4' - 10„ NI s 100, e ZN ✓urisd 'ervation 12' - 10„ {ter \ - - __� - �PEv�3� PRE S oO �. O,CN4 4 OSEO �� 37 CROSS SECTION OF CHAMBER Concrete all NOT TO SCALE W ---,.. -�-- -- / P00� R� 20.15�5 �. = l - 0, R�� Pool PERC TEST. 15,400 Ex' g System Low ion E 0�S A�-� \ l O � L as per tie Card OZ O�0 f 19 PERFORMED BY:CHARLESROWLAND,PE I to be moved PPP TREES TO BE REMOVED SULLIVANENGD1EERRVG&CONSULTING,INC. pe, 310 CMR 15 / / "' SOIL EVALUATOR NO 13586 22T / /' / 20" D �9 / R7T NESSED BY:DONALD DESA ARMS,R.S.-TOWN OF BARNSTABLE PROVIDE DRYWELLS � 0P pEN tan Bak 1� 41 JUNE29,2017 FOR RUN OFF AND GAR aape,� Sto f{e �/ '' \ <( SITE PASSED POOL DRAW DOWN (TYP.) / e lord% 50 ~- - �-- -16- 5 -21--� /' ` �Se/ HAZARqQUS 0 / �(L ANING) `' of r� _ -C TEST HOLE- 1 EL.23.0 TEST HOLE-2 EL 23.4 • �' O �E` �K'�� ~ = ---- ...- ... ......n f . P0 n J & Miriam P DNeill " .............................................. . 22.2 TREES� BE O 15 na Bw LAYER 10YR 5/6 Bw LAYBR I 5/6 Lot Area MOVED , OOE�PE / 'oaf{e , YELLOWISHBROWN YELLOWISHBROWN ----14 100 B I 44 LOAMYSAND(SOME GRAVEL) 19.3 LOAMY SAND(SOME GRAVEL) I 89,24 s STROCTION / �'' C1 LAYER 10YR 7/6 36" PERC TEST 20. Of (land CON / i / _--•13. ,y \ YEI,LpW 25 GALLONS IN<15 MIX, ✓ / w 12"" /N F 68 COARSE SAND SOME GRAVEL 17.3 42 PERC RATE<2 lblTA MV(LTAR=0.74) 19.5 �9 / OOD-�2C2 LAYER 1OYR 7/3 C1 LAYER 10YR 7/6 I .mil -� / '� J-- .74� Zon �� VERY PALE BROWN YELLOW / / / 11 r _.._ \E�EV 11• 132" MEDIUM SAND 12.0 72" COARSE SAND S011�GRAVEL 17.0 /� ' F NO GROUNDWATER ENCOUNTERED C2 LAYER 10YR 7/3 1 / J / �0. AFL VERYPALE BROWN J/ / 132" MEDIUM SAND 12.0 f! �' ea / t0 }�,��'8� F Cij� NO GROUNDWATER ENCOUNTERED TEST HOLE-•3••••••••••••••••••EL.24.0 TEST HOLE-4 EL.24.4 •:_:•::•::•::•t71�a[=F��R•:iliY1�:•3/2•.::............. .. ... P f GP t� L . : s:;:;:;:;:::; :::::::::::::::........... \ 10 ::::::::::::::•::::::::::::_: ::•:::::::::::::::::::•:::::•:::;: 23.2 8 ...................--............--................................................. 23.3 p / � � F VIEW C� RIDORD _ I \ \ \� \ BwLAYER]OYRS/6 Bw LAYER 10YR5/6 \ I I YELLOWNHBROWN YELLOWISHBROWN 44 LOAMY SAND(SOME GRAVEL) 20.3 " ( ) // LOAMY SAND SOME GRAVEL -1SJ �� /r / 9"ee SE3-53 7 �� \\ \\\\ CI LAYER 10YR 7/6 32 PERC TEST 21.3 / F In vasive Removal, ` y0 50.0' YELLOW 25 GALLONS IN<1511SIAT seased Tree Oemoval 80 COARSE SAND SOME GRAVEL 17.3 38 PERC RATE<2 MWAN(LTAR=0.74) 20•8 nd Restoration IPlanting I t \\ \ \ C2LAYER 10YR 713 Cl LAYER 10YR 7/6 1 VERYPALE BROWN YELLOW / / \ 132" MEDIUM SAND 13.0 76" COARSE SAND SOME GRAVEL 17.7 NO GROUNDWATER ENCOUNTERED V 2 LAYER 10YR 7)3 E BROWN FS _ -13 -' �/ \ / \ NO GROUNDWATER\ \\ \\\ 132" MEDIUM SAND 13.0 HA DOUS TREE / r Viet Pruning \ I \ I (� p ENCOUNTERED /T0 BEE(LEANING) p /� / � � � / / � (451 .�/\ Sto .`� SEPTIC NOTES Co Deft / / / 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hour ost n d ��- / \ Prior to Any Excavation For This Project the Contractor Shall Make / // I V" \ the Required Notifications to Dig Safe(1-888-344-7233)and contact Sullivan Engineering&Consulting Inc. (508-428-3344). Z The Contractor is Required to Secure Appropriate Permits From Town Agencies For Construction Defined by This Plan.° a) o X / C I f 3. Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shal \ o _ Be Constructed ofClass 150 Pressure Pipe and Shall ter Tested to c o I \ \. / Assure Watertightness. In General, Water Lines Shall be Constructed in D; _---- .._-•-- / J Coordination With Hyannis Water,and Shall be in Accordance /g \ \ \ / With 248 CAM 1.00- 7.00&310 C 1R 15.00. L`o 4.A Minimum of 9"of Cover is Required for All Components. ` '``� - _ 8a• \ \ ` ° �� E� �,o�' ` \ �� S.All Structures Buried Three Feet or More or Subject �o I xx- 100 \� \ HAZARDOUS TREE` I �/ �� 5 / / to Vehicular Traffic to be H-20 Loading.It is the Engineer's et \ (L NING) \ F •. .� Recommendation that H-20 Alwaysbe Used. TO BE�?EMOVED l GE�,� �� r_ r- /� n 6.Install Watertight Risers and Covers to Within 6 ofFmished Grade j/ Over Septic Tank Inlet and Outlet;D-Box,and One Leaching Chamber. 3\ � \ 50' All covers are to be maximum 20"for concrete or 24"Cast Iron. a a.. \ \ �'- '� // e �\ (� Middle cover for septic tank to be a min nm of 8". 1 / P (� 7. Septic System to be Installed in Accordance With 310 CAM 15.00& / I t G e o {or / / / / / ''- ____ e� LEGEND: 248 CAM 1.00.7.00 Latest Revision and the Town ofBarnstable r f �' tai� Bea f / J t ' � Board ofHealth Regulations. S0 05 o Z r,, 8.All Piping to be Sch.40 PVC. e aof* / / f` '- j f �O j/ ;y Holly Tree 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimun 1 Sump of 6 . 10.Septic Tank Shall be a 2,500 Gallons with a Gas Baffle on the Outlet: Pine Tree 11. The Separation Distance Between the Septic Tank Inlets and / Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend a Minimum of 10"Below the Flow Line. Outlet Tees Shall Extend 14" 5re / J / / t� / =s D2C/d000S Tree Aelow the Flnw Tine and Shall hp Frnnnncxi With a C.ac RAfl7B Cedar Tree / Aj;, /// oG� /' / j/ Dead & Hazardous Tree to be Removed A // Trees in View Corridor to ` be Removed and Replaced a Hyannis Harbor fee e �,.--.• '' F.F. El. 25.00 �� 15 See Note 6 (typ.) * _ * .G. EL. 22.29 Max. 20' Min Min. DESIGNDATA F.G. EL. 23.7 Final Foundation Grading To Be F.G.F.G. EL. 22.6 Max. Single Family Coordinated With Landscape Plan - 10 Bedroom @ I10 GPD � Complies No Garbage Grinder FI o w Equ it izers 1 Breakout Total Daily Flow=1,100 GPD EL. 22.00 As Required 1,100x200•0=2,200Gallons Installer To Use a 2,500 Gallon Septic Tank Con firm Prior EL. 19.70 2500 Gallon To Any Work Septic Tank EL. ,9.45 Top EL. 19.29 18.90 LEA CBWG AREA (See Note 5) El EL. 18.74 1,100 GPD/0.74(LTAR)=1,486 SF Required Sidewall=202.83' +93.0'52'=423.3 SF 18.29 Leaching Bottom Area=(12.83'x 93.09=1193.2 SF To Be Installed On Chamber Total Provided=1616.5SF(11962GPD) Stable Compac e ose _ Bot. EL. 23.00 Bedding,"T"s, Inspection Port, ff: rrcciirnI:e cl: Etem.Jo-ire. & :.Rep1aE LEACHING CHAMBER DESIGN -.-•-•••••-:••-•••• :: All Pipes to be Schedule 40. Use -{ �f & Baffe/s :......::Eris i;rit�P l2: dots....fiFif�iii:.::�'::......:.: o AS as Per Title 5 e 0ufier:;Wer m- er-:o:f: a S f rri 10-500 Gal.Leaching Chambers in a 93.0'x 12.83' '` s9 . 00 Double Washed Stone Field as Shown. z n C JOHN C. ti� :: :: :: ::::: : ® ' r o O'DE. ::::. ::. ::...........:::::::::::::::: ® � EL. 12.5 -n No Groundwater c0 0 � � F�/8��'Y� Permittin Per Test Hole 1 o �ruloc g Onl Y DEVELOPED PROFILE OF SYSTEM EL. 5 Not for Construction Groundwater - NOT TO SCALE Per T.O.B. Standard Revision: Add septic structures and details to site plan 1 8 15 2017 TI TLE PREPARED BY. PREPARED FOR: NOTES. Site Plan • 1.) The property line information shown was compiled from Proposed Improvements Engineering & available record information. _ p p James F. & Susan H Whelan 2.) The topographic information and structure location was 86 Centre Street obtained using conventional survey method y AtUlVall Consulting, Inc. 3.) The datum used is NAVD '88, using a msl with an 65 Ocean Avenue ( ) MA02655 Dover MA 02030 adjustment of 0.87'. 508 428-3344 P.O. Box 659 7 Parker Road, Osterville, 4) Structures on this property were located using conventional Barnstable Mass. secit�sullivanengin.com • ,nrM,N►.sullivanengin.com survey method. (Hyannis Port) Draft: JOD Field: MDH/WHL/MLL 20 0 10 20 40 80 V DATE: July 24, 2017 SCALE. 1 » = 20' Review: PS Comp./Review: MDH/RRL Project: 30029 Project: C284.5