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0015 RIPPLE COVE ROAD
I` i �. i h � l tt� INE Town of Barnstable Building Department - 200 Main Street * saxwsras�. Hyannis, MA 02601 MAC. (508) 862-4038 a Certificate of Occupancy Application Number: 200706175 CO Number: 20080328 Parcel ID: 325065 CO Issue Date: 05129/09 Location: 15 RIPPLE COVE ROAD Zoning Classification: RESIDENCE B DISTRICT Proposed Use: SINGLE FAMILY HOME Village: HYANNIS Gen Contractor: DAVID SAURO Permit Type: RC00 CERTIFICATE OF OCCUPANCY"RES Comments: Building Department Signature Date Signed, � 4 Town of Barnstable C 4 Building Department - 200 Main Street Hyannis, MA 02601 MAS&63¢ ' �508) 862-4038 o FO Ahl�d Certificate of occupancy Temporary Application 200706175 CO Number: 20080329 Parcel [D: 325065 CO Issue Date: 05129109 Location: -15 RIPPLE COVE ROAD Zoning Classification: RESIDENCE B DISTRICT Owner: CONSIGLI; OLIVE G Proposed Use: SINGLE FAMILY HOME 46 PURCHASE ST M1LFORD, MA 01757 Village: HYANNIS Gen Contractor: DAVID SAURO Permit Type: RTC RES TEMP CERT OF OCCUPANCY Comments: TEMP CO GOOD FOR THIRTY (30) DAYS - EXPIRE JUNE 29,2009 Building Department Signature Date Signed Expiration Date �t"ETA Town of Barnstable Building Department - 200 M1 m Street : AB Hyannis, MA 0260 Eo19�A,��MASS (508) 862-4038 Certificate of Occupancy Teipporary Application 200706175 CO Number: 200900003 Parcel ID: 325065 _ CO Issue Date: 07107109 Location: 15 RIPPLE COVE ROAD Zoning Classification: RESIDENCE B DISTRICT Owner: CONSIGLI, OLIVE G Proposed Use: SINGLE FAMILY HOME 46 PURCHASE ST MILFORD, MA 01757 Village: HYANNIS Gen Contractor: DAVID SAURO Permit Type: CTC2 2ND COMM TEMPORARY CO Comments: 30 DAY TEMP.C.O. EXPIRES ON 7129109 7 7 Building Department Signature Date Signed Expiration Date �Wr �o� Town of Barnstable +.. Building Department - 200 Main Street BARNSTABLE, * H yann i s, MA 02 601 MASS (508 1639. ) 862-4038 n Certificate of Occupancy Temporary Application ' 200706175 CO Number: 20080329 Parcel ID: 325065 CO Issue Date: 05129/09 Location: 15 RIPPLE COVE ROAD Zoning Classification: RESIDENCE B DISTRICT Owner: CONSIGLI, OLIVE G Proposed Use: SINGLE FAMILY HOME 46 PURCHASE ST MILFORD, MA 01757 Village: HYANNIS Gen Contractor: DAVID SAURO Permit Type: RTCO RES TEMP CERT OF OCCUPANCY Comments: TEMP CO GOOD FOR THIRTY (30) DAYS - EXPIRE JUNE 29,2009 S �� -- Building Department Signature Date Signed• Expiration Date P TOWN OF BARNSTABLE BUildi hg' Application Ref: 200706175 r -,* BARNS TABLE, * Issue Date: 10/22/07 Permit 9 MASS., �AT.i63 A1� Applicant: CONSIGLI,OLIVE G Permit Number: B 20072604 - FD MA Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/20/08 Location 15 RIPPLE COVE ROAD Zoning District RB Permit Type: REBUILD HOUSE AFTER TEARDOWN Map Parcel 325065 Permit Fee$ 1,609.25 Contractor DAVID SAURO ` Village HYANNIS App Fee$ 100.00 `License Num 072866 Est Construction Cost$ 392,500 Remarks . APPROVED PLANS MUST BE RETAINED ON JOB AND j REBUILD 5 BR SINGLE FAMILY HOME,DETACHED GARAGE. THIS CARD MUST BE KEPT POSTED UNTIL FINAL CHANGE OF CONTRACTOR 06/17/2008 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CONSIGLI,OLIVE G BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 46 PURCHASE ST INSPECTION HAS BEEN MADE. MILFORD, MA 01757 Application Entered by: PR Building Permit Issued By: 777177 THIS;PERMIT CONVEYS NO RIGHT TO OCCUPYANY STREET AT I,Y OR SIDEWALK OR AN PART TH EI HER TEMPORARILY OR'PERM ENCROACHEIvIENTS`ON PUBLIC PROPERTY NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE AP 171 .PROVED'BY THE JURISDICTION. STREET OR AL;LY.GRADES ASxWLLGA$DEPTH{AND LOCATION;OF�PUBLIC SEWERS MAY BE OBTAINED"FROM THE DLPARTMENT'0' PUBLIC WORKS THE ISSUANCE OF T'H S PERMIT DOES,NOT RELEASE T,HEsAPPLICANT FROM zTHE CONDITIONS OF ANY APPLICABLE SUBbIUI3IONrRESTRICTIONSc MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. •"`^70R TO COVERING STRUCTURAL MEMBERS(READY TO LATH). SULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Miffn » BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS �. 9— t6 - og .� z g.(o ff S L) © 2-moo n 2 2/�1/ I/r/ A. r u s 27, 3 J- G..C'� 1 Heating Inspection Approvals Engineering Dept f 5:0 by¢ S Fire Dept' 2.����� � �� Board of Health ��� '11``3 0— �'-cj vim• C��� � ., PROJECT NAME: ' ADDRESS: e,4" /,0, PERMITA"?6 CP /7j� PERMIT DATE: �~ S— M/P: LAR GE ROLLED PLA NS ARE IN. BOX SLOT : Data entered in MAPS program on: [ a� BY: �J q/wpfiles/archive IHE TOWN OF BARNSTABLEBuilding' T - °� Application Ref: 200706175 BARNSTABLE, Issue Date: 10/22/07 Permit 9 MASS. $Ar i639� A��� Applicant: CONSIGLI,OLIVE G Permit Number: B 20072604 FD MA'I Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/20/08 Location 15 RIPPLE COVE ROAD Zoning District RB Permit Type: REBUILD HOUSE AFTER TEARDOWN Map Parcel 325065 Permit Fee$ 1,609.25 Contractor DAVID SAURO Village HYANNIS App Fee$ 100.00 License Num 072866 Est Construction Cost$ 392,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND I REBUILD 5 BR SINGLE FAMILY HOME,DETACHED GARAGE. THIS CARD MUST BE KEPT POSTED UNTIL FINAL CHANGE OF CONTRACTOR 06/17/2008 INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner ori'Record: CONSIGLI,OLIVE G BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 46 PURCHASE ST INSPECTION HAS BEEN MADE. MILFORD, MA 01757 Application Entered by: PR Building Permit Issued By: THIS'PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR AW PART TH _ I HER TEMPORARILY OR P.ERMANENTLY: ENCROACHEMENTS ON PUBLIC.PROPERTY,NOT:SPECIFICALLY PERMITTED UNDER THE BUILDING.CODE,MUST.BE APPROVED BY THE`JURISDICTION. STREET OR ALLY GRADES AS WELL AS DEPTH'AND LOCATION OF PUBLIC'SEW ERSMAY.BE.OBTAINED FROM THE DEPARTMENT OF PUBLIC.WORKS. THE ISSUANCE OF THIS PERMIT DOES'NOT RELEASE THE.APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION.RESTRICTIONS: MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5. INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE.THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire-Dept 2 Roard of Health ' IME,� TOWN OF BARNSTABLE , Building Application Ref: 200706175 BARNSTABLE, Issue Date: 10/22/07 Permit 9 MASS �p 1639. ��� Applicant: CONSIGLI,OLIVE G rF01NA�e► Permit Number: B 20072604 Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/20/08 Location 15 RIPPLE COVE ROAD Zoning District RB Permit Type: REBUILD HOUSE AFTER TEARDOWN Map Parcel 325065 Permit Fee$ 1,609.25 Contractor PROPERTY OWNER Village HYANNIS App Fee$ 100.00 License Num Est Construction Cost$ 392,500 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REBUILD 5 BR SINGLE FAMILY HOME,DETACHED GARAGE. THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CONSIGLI,OLIVE G BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 46 PURCHASE ST INSPECTION HAS BEEN MADE. MILFORD, MA 01757 Application Entered by: PR Building Permit Issued By: THIS PERMIT CON-V S,NO RIGHT TO OCCUPY ANY STREET;ALLY OR SIDEWALK OR ANY,PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY: ENCROACHEMENTS ON PUBLIC,PROPERTY,NOT SPECIF,ICALLY,PERMITTED UNDER THE BUILDING CODE,MUST BE.APPROUED BY THE JURISDICTION. STREET OR"ALLY GRADES"AS'WELL AS DEPTH AND`LOCATION OF PUBLICSEWERS MAY BEOBTAINED FROM THE DEPARTMENT;OF PUBLIC'WORKS- THE ISSUANCE OF THIS'PERMIT DOES NOT RELEASETHE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). ,7'N7 �,W11, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2. 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health r David Sauro Inc. Construction Management Residential / Commercial LETTER OF TRANSMITTAL DATE: 5 12 -C) JOB NO: 163 Tern Lane Office &Fax: 508-778-0897 Centerville, MA 02632 Cell: 774-487-2206 ATTENTION: GL davidsauro@comcast.net RE: Mohan TO: OW c)ryl a 1 S I e Cove - G<< Y) ins��, M►� 02 � WE ARE SENDING YOU ;(Attached ❑Under separate cover via the Following items: ❑ Shop drawings ©Prints ❑Plans ❑ Samples ❑ Specifications ❑Copy of letter ❑Change order COPIES DATE NO. DESCRIPTION 5 0 � THESE ARE TRANSMITTED as checked below: ❑ For approval ❑ Approved as submitted ❑Resubmit copies for approval For your use ❑Approved as noted ❑Submit copies for distribution ❑ As requested ❑Returned of corrections ❑Return corrected prints ❑ For review and comment ❑ ❑ FOR BIDS DUE ❑PRINTS RETURNED AFTER LOAN TO US REMARKS: - - --- . COPY TO: SIGNED: If enclosures are not as noted,kindly note us at once. 13600 X 209 - 2720 S.F. lv 107 HOUSE COVERAGE - 2425 S. F. GARAGE COVERAGE - 288 S. F. 0° TOTAL COVERAGE - 2713 S. F. A � s CONC ` O l06 OAR FON p' 00• F LOT 104 000 13.600 ' S.F. CONCRETE 00. FOUNDATION iv ti e(: k' E ,� ♦° T.O.F. 11.9 t.kt q�t��C.v w`trr 6 ° ' tt J.`.. 4`53�,nN .�� .._.4 x i... r: t � a° F� c.+ a AYYYi�...• 3 4'+1•�C. ,`a...,.. •.�., 1.v',] i.t r�.:. "r.-., v ,.�'! °Ot�h1 �O 1�%lS -a 60 ZONE RB SETBACKS A6 v FRONT - 20' 6 SIDE - 10' REAR - l 0' LOT COVERAGE - 20tt. I HEREBY CERTIFY THAT THE DWELLING DEPICTED ON THIS PLAN WAS LOCATED ON THE GROUND %'A OF A4q PLOT PLAN BY SURVEY ON APR. 16. 2008 ��`` �y }°` IN AND EXISTS AS SHOWN AS OF THE FRmc BARNSTABLE. MA DATE OF LOCATION. MG SCALE: I '-JO" APR. 24. 2008. THIS PLAN /S FOR PLOT PLAN '�F�SiE .. F REVISED: MAY - 7.12008 PURPOSES ONLY AND NOT FOR 0, /*���� •,EAGLE SURVEY I.NG ,� ''1INC RECORDING. DEED DESCRIPTIONS °923 Route SA OR ESTABLISHING PROPERTY LINES... ♦ �, / Yormouthpoit, AAA, 02573 "f • "• _ ,� (508) 362-8132 ♦ (508) 432-6333 ' a THIS PLAN /S VOID IF NOT STAMPED AND SIGNED /N RED. 0 15 30 60 PROJECT NO. 05-028 i 1V o° o° A cow GAR FON Off' 00 LOT 104 7� y � O� CONCRETE 00 ti FOUNDAT/ON P.O.F.- ft.9 o A o ZONE RL SETBACKS A FRONT - 20' (; SIDE /0' 1� REAR - l 0' I HEREBY CERTIFY THAT Of THE DWELLING DEPICTED ON THIS PLAN WAS LOCATED ON THE GROUNDFRW �, PL 0 T PLAN SURVEY ON APR. 16. 2008 a WHffM IN AND EXISTS AS SHOWN AS OF THE e Q DATE OF LOCATION. �� a �' BARNSTABLE, MA _ .� :, SCALE: I " APR. 24. 2008 THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND NOT FOR 'E EAGLE SURVEYING , INC RECORDING. DEED DESCRIPTIONS 923 Routs 8A OR ESTABLISHING PROPERTY LINES. Yormouthport. MA. 02675 � (508) 382-8132 (508) 432-6333 THIS PLAN IS VOID IF NOT STAMPED AND SIGNED IN RED. 0 15 30 60 PROJECT NO. 05-028 David Sauro Inc. Construction Management 163 Tern Lane Centerville, MA 02632 Office & Fax: 508-778-0897 Cell: 774-487-2206 davidsauro@com cast.net November 13, 2007 Town Of Barnstable Building Division Mr. Paul Roma Hyannis, MA 02601 Re: 15 Ripple Cove Road, Hyannis Building Permit B 20072604 Dear Mr. Roma, As a follow-up to building permit for 15 Ripple Cove Road, Hyannis, enclosed you will find the following: "As Built Floor Area Calc"by HPD Design dated November 6, 2008. The plan indicates that the Floor Area total is 3,949 square feet and the maximum FAR allowed is 4,080 square feet. In addition, we will be submitting to you a"Flood Elevation'Certificate."The preliminary work has been completed and we are just waiting on the placement of mechanicals at the outside of the building. Respectfully submitted on behalf of the building owner Marilyn Mohan, David Sauro o `i t t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION- Mai Parcel Application# Health Division Date Issued Conservation Division � � Application ? Tax Collector Permit Fee lea Treasurer � - Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address /Jr 0.J2 C_ Village 9110aws Owner Address Telephone J�0 Re-boy // n Per Request 1 Z) /C�CJU/lLf AD/7)e— a,3 IF tQoJl l�,►� 5 !� Square feet: 1 st floor:existing proposed��'aS 2nd floor:existing holc proposed IYU Total new 3f!i Zoninq District Flood Plain Groundwater Overlay b"57s0v Proct Valuation 1AW&D Construction Type 00od jc�A)Wcl Lot Size/ 14906 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure lq�,l Historic House: ❑Yes /Z No On Old King's Highway: ❑Yes I% Basement Type: ❑ Full ACrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) A cL— Number of Baths: Full:existing 1 new Half:existing / new Number of Bedrooms: existing new Total Room Count(not including baths):existing (o new_ First Floor Room Count Heat Type and Fuel: A Gas ❑Oil ❑Electric ❑Other �?f Central Air: Yes ❑No Fireplaces: Existing 1 Newer_ Existing wood/coal stove:Z0 Yes': ❑No 6- _ Detached garage:❑existing Jd new sizeP&V Pool:❑existing ❑new size Barn:❑ xisting FD newx=size Attached garage:Qd existing ❑new size Shed:d existing ❑new size/Z 1�, Other: G' . Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name !1 Telephone Number_ Z3 Address License# 0 ?A4 _ 02722 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Gig, DATE .r FOR OFFICIAL USE ONLY APPLICATION# a. 'DATE ISSUED MAP/PARCEL N0. .y ADDRESS VILLAGE , OWNER r DATE OF INSPECTION: (c .FOUNDATION I S ,O FRAME INSULATION ti. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ?? GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. r � i Town of Barnstable . Regulatory Services ff > SS '. Thomas F. Geiler,Director V Y �p ab79. �1e� a i � V (� rEo►�„ Building Division 0" Thomas Perry, CBO,Buflding Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 F": 508-790-6230 PLAN REVIEW Owner: Map/Parcel: _ � Project Address R f PpQF C61/2�;Builder: -Y) We The following items were noted on reviewing: C 4 C--C-U LA-'T r 6 Z- 0 1 c © V E"6—G7 76 Z74 IS oFf=rCL 1 aR 7-0 1sS019"C L-P N 5 s-7-71-wl ICE� R Y 5 7- k UC7-UgP4. Reviewed by: Date: i � � I - C77 Q:Forms:Plnrvw The Commonwealth of Massachusetts Department oflndustrial Accidents - Office of Investigations 600 Washington Street r Boston,MA 02111 <.j t www.mass.gov/dia Workers" Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 40 U/'C&se S� City/State,/Zip:&d-ed & L✓ Phone.#: SDk'y79 elkR 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 . 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. employees and have workers' 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 ahomeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MG!, 12. Roof repairs c. 152 §1(4) and we have no P insurance required.] t 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. xContractors that check this box must attached ari 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 providb their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below isthe policy and job site information. Insurance Company Name: Policy##or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),... Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby certify:ender the pains-and penalties of perjury that the information provided ab ove is true and correct: Sienature: Date: T Q _ Phone#: 6 Official use only. Do not write in this area,'tb 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: x i a-� / (V .4 eta i y 1 1 � i E e . �OFTHE,p� Town of Barnstable Regulatory Services r • BARNSTABLE. t Thomas F. Geiler,Director tAss. �pT i630. A.�� Building Division FD frtA't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 UOMEOWNER'LICENSE EXEMPTION. CDATE' k. T +� JOL+�OC B ATION; war,._. �5- /11Pj9J,G COV — P4, /yel,4121)1_5 number street village "HOMEOWNER,!: 11 /W0/7name D/ home phone# work phone# C,URRENT,MAEUNG ADURESSs �� f T L�/�,r�G 4Se, 75 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 reqkiirements. �Sgnature;of Home wner� -�""' „� - 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 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. ® r 1.1 08 11 : 12a Louis J. Rntico 5.613959460 p. 1 - C� David Sauro Inc. Conshwedon Momenwnt 163 Tern Lane Ce Mrville,MA 02632 Ofce do Fay 508-77""7 Ce1L 774-497-2206 & MSaww&vnwastnet To: R. Data �3/i�c�S' Total number of pages: .. Subject: �. , /p,c� c �a vC- Fax Number; �L LG!,!J' �� � if VO �//�,-hiss •��v'>sj G� w L0 u�y - Mar 11 08 11 : 12a Louis J. Rntico. 5613959460 p. 2 1 0 C (e V LOT 104 �-• = f .. I3.600+ S_F.- p fl � N ✓l - +e 4 0_./ EVIS74AW one AAA AF us iFMW Sl FE, / 0-4 � +9.6 _ }, N P.a - 7_7 O / n « Y w Mar 11 08' 11 : 13a Louis J. Rntico 5613959460 p. 3 IYIQf: II• LUDO II •Ulnlvl ITU. Ii7I !• owl WNW e a I17=.AMN eA� 1 n ( SIf!!!S•A mEu 0 I A I 1 RIMIWe 't; e•'cs�F14 ,W. U'`; I 1a1 Y n � e It i II n a; N c li 0 - II B a. I II 1 a� Y R n •P'� A a q U u n a .:IC•• aaeor I q SPACE n n n e 10 I — I Q _ A 1111 II IA Al II 9t law n _ / Y ..I 1 n I p I d>BIs191�1�R1I A•— � 1 I t p_ II IL A twsm u48_ all,��I � 1 e IIAll33dlll e L I�' 1NOR W SWFUMWAL - 1 / 1111/9YI�nAF' A 1 p n I l U 1 tll I N � U p ldNllA1111111C ii n 7-61 �ph"I P.E. 0 FA a el Ar 1 I n _ n I� A R�DRC M�911MI�MAII a Y I IT1 pI n 111p11f1 II�f AiD® 1 i j IT1 p p 0 Er II 17 9i' II aD10R.FDf!P 11.. LO. — II e one: tl n �'II- q IfRe161GxNUC _ a IPY� A tl li 9YW� nY n .r U yE a a�l®wr•ulm e e 71^XWAIR® _ e JI _ ' N II e n miko lar I R Alm I .A .. q - Ie16RkYA�1AE � n I i�lelEA.lS1� � a 1 .. - `IfelR�bi - q 1.. N A II•---- A a 9 pj 1 tl -- q +ENi6i9Yle�loA 7�INI11611�� �.YYeEh® 1�AIti - - wir FOUMAIION PLAN A /( p Daniel E. Brandn,`P.E `'- �. �, ��y p► 1 1��/ 189 Harbor Point PA c-� Cummaquid MA 02637-0361 tp p_c.E �ov 220 o L"tat -aco SAS h Ca�-C�F �. t7 Fob 2c�® SQ� � E�Z �t..cv c�,fl l O.: `3- zoo XZ ;�..�6C1F3 G,•�,p.,D Via. t o E. S UCr r PIE Permit# ` Permit Date REScheck Software Version 3.7.3 Compliance Certificate Project Title: Mohan Residence Report Date:09/26/07 Data filename:G:\2005\20512D-1\MASSCH-1\20050320.rck Energy Code: Massachusetts Energy Code Location: Hyannis,Massachusetts Construction Type: 1 or 2 Family,Detached Heating Type: Other(Non-Electric Resistance) Glazing Area Percentage: 170/a Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 15 Ripple Cove Road Mohan HPA Design Inc. Hyannis,MA Assembly - . �.• Flay Ceiling:Flat Ceiling or Scissor Truss: 729 30.0 0.0 26 Sloped Ceiling:Cathedral Ceiling yno attic): 1386 30.0 0.0 47 Wall:Wood Frame,16"o.c.: 4205 13.0 0.0 282 Double Hung:Vinyl Frame:Double Pane with Low-E: 456 0.350 160 Awning:Vinyl Frame:Double Pane with Low-E: 24 0.340 8 Fixed:Vinyl Frame:Double Pane with Low-E: 7 0.320 2 French Slider/Hinged:Glass: 242 0.350 85 Solid:Solid: 32 0.540 17 Floor:All-Wood Joist/TrusS:Over Unconditioned Space: 1835 30.0 0.0 61 Air Conditioner 1:Electric Central Air:13 SEER Furnace 1:Forced Hot Air:86 AFUE Compliance Statement:The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the Massachusetts Energy Code requirements in REScheck Version 3.7.3 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code.The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Company Name Date Mohan Residence Page 1 of 4 I "\VfREScheck Software Version 3.7.3 Inspection Checklist Date:09/26/07 Ceilings: ❑ Flay Ceiling:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: ❑ Sloped Ceiling:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall:Wood Frame,16"o.c.,R-13.0 cavity insulation Comments: Windows: ❑ Double Hung:Vinyl Frame:Double Pane with Low-E,U-factor:0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Awning:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Fixed:Vinyl Frame:Double Pane with Low-E,U-factor:0.320 For windows without labeled U-factors,describe features: ' #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ French Slider/Hinged:Glass,U4actor:0.350 Comments: ❑ Solid:Solid,U-factor:0.540 Comments: Floors: ❑ Floor:All-Wood Joist/fruss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Air Conditioner 1:Electric Central Air:13 SEER or higher Make and Model Number: ❑ Furnace 1:Forced Hot Air:86 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. ❑ When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2• Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 Us)air movement from the the conditioned space to the ceiling cavity.The lighting fixture shall have been tested at 75 PA or 1.57 Ibs/ft2 pressure difference Mohan Residence Page 2 of 4 and shall be labeled. Vapor Retarder: ❑ Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment must be identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: ❑ Ducts shall be insulated per Table J4.4.7.1. Duct Construction: ❑ All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions.Mesh tape may be omitted where gaps are less than 1/8 inch.Duct tape is not permitted. ❑ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ❑ Thermostats are required for each separate HVAC system.A manual or automatic means to partially restrict or shut off the, heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: ❑ Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: ❑ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: ❑ All heated swimming pools must have an on/off heater switch and require a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps require a time clock. Heating and Cooling Piping Insulation: ❑ HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. Mohan Residence Page 3 of 4 Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water - Temperature(°F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2.Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(°F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 11.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Mohan Residence Page 4 of 4 Permit No.: TOWN OF BARNSTABLE DEPARTMENT OF PUBLIC WORKS SEWER PERMIT Connection: Modification: Disconnect: Repair: Assessors Map No. WATER SUPPLIER: N(J Wig �`• Assessors Parcel No SEWER ACCOUNT NO.: i Street: S l e a l SEWER ACCOUNT NO.: �^ 40 Village: y�h��� PERMIT FEE: $ JU G < < a6�O?� Septic Abandonment Permit (1)Resldentlal Bldg=$420.00 (each addt'l.bldg.on same service=$200.00) Obtained From Health Department: (1)Commrc'I.Bldg.=$875.00 (each addt'I.bldg.on same service=$200.00) X Connections requiring installation of a pump,add$300.00 to base charge. Abandonment Permit Not Required: � PROJECT CONTACTS PROPERTY OWNER Mailinq Address S WER INSTA LER Name: J O CAA (! Name: Joe L O a-'A Address: I-Ib (i k4ft J ` Address: Jpq aIO2 S Phone: Phone: PROJECT DESCRIPTION REGULATORY REQUIREMENTS The installation of all sewer connections must be done in accordance with FACILITY&LAND USE DATA the provisions of Article XXXVI,Town of Barnstable,General By-laws and regulations issued by the Department of Public Works. Before excavating NUMBER OF UNITS METER SIZE FIXTURE NO. within a Town Way the sewer installer must also obtain a Road Opening permit and comply with the Construction Standards and Specifications RESIDENTIAL: _ outlined therein. At least 48 hours prior to the installation, the applicant must notify the Department of Public Works, Engineering Division for the COMMERCIAL: purpose of inspecting the installation. The Inspector will complete the Compliance Sketch locating the installed lines and connection. RESTAURANT: By signing the Application, the applicant acknowledges and understands INDUSTRIAL: the regulatory requirements and understands that failure to comply with STANDARD INDUSTRIAL CLASSIFICATION NO.: them shall.be grounds for revocation of the Sewer Connection Permit and the denial of any future application. This sewer connection permit shall be NO.OF BUILDINGS: NO.OF BEDROOMS: valid for 180 calendar days from the date of D.P.W. approval indicated bblow. The required notice must be given and the installation SIZE OF PARCEL: ACRES: commenced before the end of that period. Otherwise, the permit shall become invalid. When that occurs, a new permit must be applied for and ESTIMATED DAILY SEWAGE: GALLONS a new fee paid. PIPING: LENGTH DIAMETER Detailed engineering drawings must be submitted with each commercial permit application and be approved prior to acceptance of this permit. EXPECTED INSTALLATION DATE: I SIGNATURE(INSTALLER): LA. DATE_ 7 SIGNATURE(DPW APPROVAL) O � DATE THIS PERMIT EXPIRES ON: NSTAROne NSTAR Way _ EL EC TR/C Westwood,Massachusetts 02090 ` GAS September 18, 2007 Marilyn J Mohan 46 Purchase St h Milford, Ma 01757 RE: 15 Ripple Cove Rd; Hyannis F Dear Marilyn J Mohan: At NSTAR, we're committed to delivering great service. This letter serves as confirmation that, as of 09/18/07, the electric service to.15 Ripple Cove Rd, Hyannis, has been removed. Based on this information, there is no electric power at this address and you may proceed with the demolition. If you have any questions, please contact me at(888) - 633-3797. . Sincerely, New Customer Connects w I Energy Delivery 127 Whites Path. South Yannouth, MA 02664 September 20, 2007. Marilyn Mohan 46 Purchase Street Milford MA 01757 RE: 15 Ripple cove Rd., Hyannis This is to confirm that the natural gas line to the above address has been cut and capped as requested. .This was done on September 14, 2007. If you have any questions please call me at 508-760-7481. ' Susan McMullin Field Coordinator J�gyspan Delivery Company. i Hyannis Water System Invoice No. 6275-499E P.O. Box 326 Hyannis, Massachusetts 02601-0326 (508) 775-0063 fax (508) 790-1313 INVOICE — Customer Name Marilyn Mohan Date 09/20/2007 Address 46 Purchase Street Acct. No. 602684 City Milford State MA ZIP 01757 Service No. 6275 Phone FOB Qty Description Unit Price TOTAL 15 Ripple Cove Rd 1 Special Charges - Turn off& remove meter 9/14/07 $25.00 $25.00 PLEASE ENCLOSE COPY OF INVOICE WITH YOUR PAYMENT IN ENCLOSED ENVELOPE Non-Taxable Total _ $25.00 SubTotal Non-Taxable Total $25.00 Taxes MA TOTAL $25.00 i 4 IN wt IV ry Q aye b° a Ir - b _ ik Vy -71 Jy CPO a N r 0 r y t � iv- Cm .. -eItov t ' spyfirNW ai s" r 3: 6 t�-fv t� .i ,i, c �s'� {{{��� „"•.;' Vi V �,�►,� `pig. � � y' s ,.,J , 1 � h . s �' � • DoczIP056s467 02-15-2007 9:08 OtF*: 182374 BARNSTABLE LAND COURT REGISTRY COMMONWEALTH OF MASSACHUSETTS �f,��`�R LAND COURT ITHIS DEPARTMENT OF THE TRIAL COURT �CQPY CASE NO. 07-SBQ-07615-01-001 Upon the petition of Marilyn J. Mohan representing that Olive G. Consigli was the surviving registered owner in Certificate of Title No. 52151 issued from the Barnstable Registry District; and representing that said Olive G. Consigli held property as a tenant by the entirety with Henry G. Consigli, who died on April 12, 1983; and further representing the death of said Olive G. Consigli,testate, on August 21,2000, and the allowance of her will by the Probate and Family Court,Worcester Division, in said Commonwealth; and praying for a new certificate of title, after due proceedings, it is ORDERED: that said Certificate of Title No. 52151 be cancelled and a new certificate of title for the land described therein be issued to Marilyn J. Mohan of Milford, in the County of Worcester and said Commonwealth of Massachusetts. By the Court. Attest: Deborah J. Patterson Recorder Dated: January 29;2007 A TN;oury + 8�9': WARM MJM: 46 Purchase Street Worcester, _ o cester, MA 01757 TO BE REGISTERED WITH THIS ORDER: BARNSTABLE COUNTY l. Death Certificate of Henry G. Consigli REGISTRY of DEEDS 2. Affidavit of No Divorce Re: Henry G. Consigli A TRUE COPY,ATTEST SRG/tdp R BARNSTABLE REGISTRY OF DEEDS i r SEWER PERMIT 36d� TOWN OF BARNSTABLE DEPARTMENT OF PUBLIC WORKS CERTIFICATE OF COMPLIANCE THIS IS TO CERTIFY THAT T- 6*: b Lo t��r has installed a sewer connection at the following address Date: S -z�" SZ. SEWER ACCOUNT NO.. STREET NO. /a STREET NA 9t oeh t v- 80 we. P-Z� VILLAGE: /-j ASSESSOR'S: MAP 3 z S PARCEL O6 S The work has been done in conformance with the provisions of Article XXXVI,Town of Barnstable General By-Law and Specifications of the Department's Road Opening Permit Signature- Date: epartm nt of Public Works SEWER INSTALLATION SKETCH �� ,00 36' 06 i a � s 9 - *S L-11 K'To� 3� ° Jo — , I 73 j f SEWER PERMIT 36c�9 TOWN OF BARNSTABLE DEPARTMENT OF PUBLIC WORKS CERTIFICATE OF COMPLIANCE THIS IS TO CERTIFY THAT �o�-t�t5 Lv tf—�r has installed a sewer connection at the following address _ Date: � —Z�S�--- SEWER ACCOUNT NO. STREET NO. I STREET NA J,Oeh/e- i VILLAGE: ASSESSOR'S: MAP 3 z s' PARCEL 06 S G� The work has been done in conformance with the provisions of Article XXXVI, Town of Barnstable General By-Law and Specifications of the Department's Road Opening Permit Signature• Date: b - /,7' -2— epartm nt of Public Works ii:'�:>:'+i%:iiijii.........................:.....................::i:iiii:S:ii'?�J.'•iii:< SEWER INSTALLATION SKETCH Jk s0 .,IS tiz S'O o� I � y3� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parce4o Application # cx,� Healtfl Division - Date Issued Conservation Division Application Fee Planning Dept. _ Permit Fee Date Definitive Plan Approved by Planning Board Historic'- OKH Preservation/ Hyannis , Project Street Address Village5/�/Ltils Owner/�19-e/ZYA— ° ` Address Telephone Permit Request ® pn 02' { Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address G ' 4-19/ e License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE 1 FOR OFFICIAL USE ONLY L APPLICATION#' DATE ISSUED t MAP/PARCEL NO. h ADDRESS VILLAGE OWNER >ti • .y DATE OF INSPECTION: FOUNDATION FRAME Off - V"-_a "i INSULATION 0((-- S o -b Pk— FIREPLACE r ELECTRICAL: ROUGH FINAL > PLUMBING:. ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING Jy DATE CLOSED OUT i ASSOCIATION"PLAN NO. 1 I ` tKE� Town of Barnstable Regulatory Services ' M MAass. Thomas F.Geiler,Director Eo�q'p, ►.,'`�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-8624038 4 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY I, Ul-&Squ eo f ` Z:1t'e' , Construction Supervisor License. # `70 �� ,hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit#o200'66 J?sued to (property address) / on l7 , 200,; The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration(if applicable) Commonwealth of.Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LICENSE HOLDER DATE q/forms/newcontrb INE 1p Town of Barnstable Regulatory Services vMMASM I'Eg Thomas F.Geiler,Director 1639. Do Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 A NOTICE TO THE BUILDING DIVISION OF WITHDRAWAL'OF LICENSED CONSTRUCTION SUPERVISOR FROM PROJECT I; 1AJ 44M hereby certify that I am no longer the Construction Supervisor listed on the application for the project under construction as authorized by building permit # ,issued to (property address) on JUr2 C / , 2001 I also certify that on , 200-�L, I notified the property owner,that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. LIC S OLDER D T 'q/forms/newcontr reference R-5 780 CMR Town of Barnstable Regulatory Services RUMSTAU'E� Thomas F.Geiler, Director �Al�n �a�m Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder I A I.-I �� , as Owner of the subject property hereby authorize 1',Lv j Sauko to act on my behalf, in altmatters relative to work authorized by this building permit application for: ( . dress of Job) Signature of OVPer Date i Print Nam' If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable ��pTHE Tp�� Regulatory Services • sAttxsTears. Thomas F.Geiler,Director Y MASS. Building Division PlfO 1iApya Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Rynv.town.barnstable.ma.us Office: 508-8624038 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 lo9:1.1-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 H7th 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. K` Board of Building Regulations and Standards f i Construction Supervisor License g$ ! Licenser CS 72866 ¢ 441 Expi t n 5/6/2009 Tr# 13670 d Restrr�ctton 00 1 ' DAVID A SAUROt ' 11t 163 TERN LANE w f CENTERVILLE,MA 02632 Commissioner fie i�omvrnovzuleaLlfi a��acjivaet7a Board of Building'Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: �n Board of Building Regulations and Standards Registration', 14fi82p1 g g Expiration=9/13/2009 Tr# 133017 One Ashburton Place Rm 1301 ,JE 1 P� Boston,Nla.02108 DAVID SAURO/CON:STRUCTI,ON;MANAGEMENT .DAVID SAURO - t y �—x 163 TERN LANE CENTERVILLE,MA 02632' Administrator 1 Not valid without signature 1 i t 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers APPUcant Information Please Print Legibly Name(BusinesslOrganization/Individual): / 11/� 2C • Address• �� �'� • City/State/Zip• A;711.oam. 0 an employer? Check the appropriatRol x: Type of coject(required): 1. a employer with 4. am a general contractor and I 6. QJNew construction . employees(full and/or part time).* have hired the stab-contractors 2.El am a sole proprietor or partner- listed on the attached sheet 7. El Remodeling ship and have no employees These sub-contractors have g. (]Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp.•insurance comp•insurance't required..] 5. We are a corporation and its , 10.❑Electrical repairs or additions 3.❑ 1 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 ram]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comb.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'comp Lmfion policy information. " t Homeowners who submit this affidavit indicating they art;doing all work and then hire outside contactors must submit a new affidavit indicating such. ZCaniractors that check this box must attached as additional sheet showing the name of the sub-contractum and state whether or not those entities have employers. If the subcontractors have employees,they must prm°idt;their workers'romp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 1 Insurance Company Name: �,L7C i I Expiration Date: e) 7_v0 Policy#or Self-ins.Lio.#: "1�����3 Z 71 Job Site Address: �S RT[0 Cove City/5tate/Zip: 1'l I 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 . •mirial penalties of a fins tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Off ce of Investigations of the DIA for immn-ance coverage verification. I do hereby c�undfer�vhe -an of perjury that the information provided above is true and correct Si a Date: Phone .�2`Z e 0 L 9 7 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 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 representative's 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-contractors)namc(s),addresses)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 nurnber 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 (Le. 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 t�give us a call The Department's address,tclephone-and fax number. The Commonwealth of Ma=6husdU Lie wltaent Qf ladustdal Accid=ts Office of Investigatim 600 Washington Street - Boston,MA 02111 TO. #617-727-4900 ext 406 or I 77-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.govldia Sub Contractor W-9 and Certificate of Insurance ro �' �'.��;,,., '" Ins,"ured,, ,�,A,,��� Cer'ifieate�ofln'surance��c�uati,'on�Rate;" Po1fc limb®r�.:�.W9 �Em Ace Arborculture General Liability 04/19/08 NPP 1082374 X 04-3194573 Phone: Automobile Liability 10/01/08 07MMMM9021 025-48-7944 Fax: Worker's Compensation 11/18/08 WC 844-99-24 Advantage Electric,Inc General Liability 01/11/09 MP095993 Phone: 508-326-7921 Workers Compensation 01/11/09 WCC5005299012008 Fax: 508-394-9620 All Cape Garage Door Co.,Inc General Liability 06/01/09 168087K26379TIA08 Phone: 508-398-2757 Worker's Compensation 06/01/09 WCC5002586012008 Fax: 508-428-1184 Associated Alarm Systems,Inc General Liability 04/05/09 CLS1489915 Phone: 508-775-3442 Fax:508-790-2330 Associated Elevators Companies,Inc. X 04-309-3454 Phone: 508-760-3875 Fax: 508-760-2809I Baxter,Inc. General Liability 08/01/07 SRSGLMA05092 Phone: 508-775-0375 Worker's Compensation 10/06/06 US3796B81705 Fax: 508-771-7324 Riggers Coverage 03/29/08 QT6607344B865TIL05 Belanger,Susan X, 020-70-7459 Phone: 508-776-9482 Workers Compensation 04/25/09 WC6007213012008 Fax: 508-420-3568 General Liability 04/27/09 3600031197 Belanger,Steven General Liability 06/14/09 BP17034414 020-60-4983 Phone: 508-428-1389 Workers Compensation 02/04/09 VWC6002932012008 Fax: 508-420-3568 Automobile Liability 07/02/08 95375400001 Brennick Building System LLC General Liability 02/25/09 CB4E1820 Phone: 508-775-5111 Automobile Liability 04/01/09 T39797 Fax: 508-896-79971 Umbrella Liability 10/05/08 5J6592 Brian Bolton Worker's Compensation 02/23/08 UB7254864A07 Phone: 508-776-3466 General Liability 02/18/09 MPB90590 Fax: 508-362-4129 X Builder Services Group,Inc.-Cape Cod Closets General Liability 06/30/08 MWZY55525 d/b/a:Quality Insulation&Bldg Prod Worker's Compensation 06/30/08 TRJUB122DO26AO6 Cape Cod Custom Floors,Inc General Liability 12/13/08 6802525C15A Phone: 508-778-1965 Worker's Compensation 05/25/09 OBWECKL1007 Fax: 508-778-5575 Cape Cod Insulation,Inc. Workers Compensation 06/30/08 WC8962496 X 04-271-5757 Phone: 508-775-1214 General Liability 04/01/09 CBP9587416 Fax: 508-778-5735 Automobile Liability 04/01/09 BA9587917 Cape Cod Welding General Liability 09/13/07 TBD Phone: 508428-3843 Worker's Compensation 08/15/07 UB-5520084-1-06 CapeCuts,Ralph Tovar Worker's Compensation 10/06/08 7019907012005 017-72-6980 Phone: 508-7264176 General Liability 06/07/09 SCP0661814 Fax: 508-430-0951 X Christopher N.Yerkes General Liability 09/10/06 MPB72549 231-35-3650 Worker's Compensation 10/15/06 UB3774B94205 X ' Cloney,Kevin Electrical Contractor LLG X 047349-9263 Worker's Compensation 12/17/06 7015775012005' General Liability 12/16/06 QB1U7947811 David O Nordberg General Liability 05/29/07 20OIX0450 X 010-69-8126 Phone: 508-4284443 Fax: 508-428-8109 DeNardo Home Improvement of Cape Cod,Inc. General Liability 09/10/08 680883OA359COF X 030-40-3734 Phone: 508-477-5574 Worker's Compensation 12/20/08 UB 0315B15407 . Fax: 508477-8999 Automobile Liability 01/06/09 PMC7191293 Downey,Wayne B. General Liability 06/06/09 53644633 X 021-44-8836 Phone: 508-760-2091 Workers Compensation 08/19/08 6KUB692K742207 Finnemore,Joseph R. General Liability 08/06/08 MPS30346 X 20-3902628 Phone: Worker's Compensation 01/01/08 UB-1323C97-1-07 Fax: Forest Keepers X 25747-0515 Phone: 508-790-1620 Fuller Electric Company,Inc. General Liability 09/22/08 MP080356 04-228-2361 Phone: 508-775-0030 Worker's Compensation 09/22/08 WC080356 X Fax: 508-775-6977 I I Confidential 06/18/08 Pagel Sub Contractor W-9 and Certificate of Insurance �u is P .: 6r "/ ' A 'tea Y •` '1 x.5' F,w�-.. . insured , 3„„ ;.�,Ce_rbficate of lnsurance� -z trdU_on pafe� ''oltc rmj 0 ,E' to Gardner Concrete Forms Inc. General Liability 04/04/07 1680346CC154 X 861141815 Phone: 508-759-5630 Automobile Liability 04/04/07 92079400002 Fax: 508-759-5091 Worker's Compensation 05/01/06 WC6700475 Govini,Peter X 043250384 Phone: 508-420-9195 General Liability 05/31/06 2001L6220 Fax: 508-420-9195 Workers Compensation 09/20/06 WC006804404 Gray,Ian General Liability 07/24/07 PX7843 X 014488938 Phone: 508-477-7696 Workers Compensation 06/09/07 08WECJN0285 Fax: 607-724-7759 Gregoire,Frank General Liability 04/01/07 BH003 52484287 X 043458812 Harvey Industries,Inc. General Liability 03/01/08 ' 710012316 Phone: 508-775-7788 Workers Compensation 01/01/08 WA71 1 D254242037 Fax: 508-771-3217 Hickey Construction Company,Inc. Workers Compensation 01/17/09 WC8934821 X 042913741 Phone: 508-771-4128 General Liability 04/09/09 1680159513907 Automobile Liability 04/09/09 BA1944B05A Hill,John -General Liability 02/09/07 BP17041543 X 018381622 J.C's Concrete Floors,Inc. General Liability 11/18/08 NC 500372 Phone: 508-775-8371 Workers Compensation 09/20/08 AWC 7019708012005 Fax: 508-534-9050 Jesse Davies dba New Image Flooring General Liability 12/15/06 HJP371 Phone: 508-385-3727 Fax: 508-385-3496 JFM Flooring General Liability 05/01/08 GL3326473 Phone:508-771-1608 Workers Compensation 06/28/08 6ZZUB-7982B18 Joyce Landscaping General Liability 11/15/06 8500029622 Phone:508-4284772 Automobile Liability 03/15/07 BA0837W91606SEL Fax: 508-428-4707 Workers Compensation 04/07/07 WC8954116 Kevin McBride Plumbing&Heating Inc x 20-477-1754 Phone: 508-778-4556 General Liability 12/18/08 R0644392A Fax: 508-778-2549 Workers Compensation 11/19/08 08 WEC KJ6536 L&M Glass General Liability 05/01/09 CCP9721358 Automobile Liability 05/01/09 BA9721858 Workers Compensation 05/01/09 WCC5004479012008 Laferriere,Kevin X 013466674 Phone: 508-737-2454 General Liability 09/29/07 MPP83469 Workers Compensation 05/15/07 WC8945433 Lambros,George General Liability 01/10/09 CB834784 Lawrence Robinson Masonry Inc. General Liability 09/07/08 CB 7E 32 32 Phone: 508-524-1426 Workers Compensation 09/06/08 76 WEG NQ5620 Luiz Romcelli General Liability 10/01/08 GL3594203 Workers Compensation 03/11/09 'WC000167884 Miguel Tatara Neto -General Liability 03/14/09 BP00008250 X 017-90-0816 Phone: 508-360-8365 Workers Compensation 06/24/08 7PJUB7744A71203 - Michael Mongeau General Liability 12/12/07 MPS57527 Phone: 508-778-9797 Workers Compensation 03/04/08 UB480X760907 Fax: 508-778-9797 X 030401009 New England Landscape&Development Corp. General Liability 12/19/07 9946D5128 X 043016608 Phone: 508420-5188 Automobile Liability 01/27/08 BA-2660C60A Workers Compensation 03/01/08 Wcc5001933012007 Northern Sealcoating&Paving Inc. General Liability 10/01/08 CLA019849410 X 042742821 Phone: 508-398-9474 Automobile Liability 10/01/08 MAA019849510 Fax: 508-394-0955 Workers Compensation 04/01/09 NOWC904736 Paul J.Cazeault&Sons Roofing Inc. General Liability 04/30/08 BINDER255115 Phone: 508428-1177 Workers Compensation 08/10/08 UB0095B64A07 Fax: 5084204555 . Fires Construction Corp. General Liability Phone: Workers Compensation 08/24/06 WC6876142 Automobile Liability Residential Development,Inc General Liability 07/25/07 CTR0006825 Phone: Automobile Liability 10/17/07 1628696 Fax: Workers Compensation 01/12/08 WCC5004174012004 Robert B.Our Company .General Liability 12/01/08 CPA13014281 Automobile Liability 12/01/08 MMA130144016 Workers Compensation 01/01/09 WC0008557 Shaw,Jeffrey P. X 018365674 Phone: 508-776-2347 General Liability 01/23/07 BH00652460711 Automobile Liability 01/01/07 ZB142789 Confidential 06/18/08 Page 2 - Sub Contractor W-9 and Certificate of Insurance __ Insured _ , __ Cerificater6f assurancexpirattdn. ate Pa�tcynum er. ';1=mplaye 1©# Shorey manufacturing Co.,Inc General Liability 12/01/07 CPA130142815 Phone: 508-760-1070 Workers Compensation 01/01/08 WC0008556 Fax: 508-760-5716 Automobile Liability 12/01/07 MAA130144015 Tanguay,Martin General Liability 06/19/08 SCP031530224 x 044-42-5987 Workers Compensation 03/04/09 WC8737405 Top to Bottom Chimney Service,Inc. General Liability 07/03/06 PAC6506144 X 043508281 Phone: 508-394-7.986 Workers Compensation 09/29/06 7010131012005 Fax: 508-398-4328 Tuckahoe Turf Farms Inc. General Liability 12/31/08 ZDN4934142 Phone: 401-364-4020 Workers Compensation 12/31/08 MDA0274608 Fax: 401-364-6423 Automobile Liability 12/31/08 ABN4934082 USA Painting-Andre Luiz Costa Lessa General Liability 05/27/06 CPP0708740 X 919724280 UTS of Massachusetts Inc General Liability 05/01/09 C2094820462 Phone: 781-438-7755 Automobile Liability 05/01/09 2094820459 Fax: 781-438-6216 Workers Compensation 02/02/09 3102800710 Winslow Plumbing&Heating Co.,Inc. General Liability 12/01/08 CBP9919974 X 042846193 Phone: 508-394-7778 Automobile Liability 12/01/08 8218494 Fax: 508-394-8256 Workers Compensation 01/01/08 1580A Wright,Richard X 135347631 Phone: 508-246-1452 General Liability 10/14/08 MPB75769 Workers Compensation 10/26/08 7017664012007 ,Confidential 06/18/08 Page 3 .. GRANITE STATE INSURANCE COMPANY 24435-0000 WC 438-13-25 --------------------------------------------- J 013-66-o8O7-00 013-66-o807-00 • . PENNSYLVANIA DAVID SAURO INC 163 TERN LA �� Member Companies of CENTERVI LLE, MA 02632-0000 American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW-YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE WC990610 EASTERN INSURANCE GROUP LLC WORKERS COMPENSATION AND EMPLOYERS` 233 W CENTRAL ST": LIABILITY POLICY INFORMATION PAGE NAT I CK, MA 0176o-3133 INSURED IS PREVIOUS POLICY NUMBER CORPORATION RENEWAL 004399993 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE wc9go6lo ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM o8/25/07 TO o8/25/08 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease, $ . 500,000 policy limit Bodily Injury by Disease $' 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, If any, listed here: ' SEE ENDORSEMENT - WC2003Q6A - ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration Premium $100 OF Re- ❑X Annual❑3 Year muneration Annual ❑3 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $246. EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $284 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $4,788 If indicated below, interim adjustments of premium shall be made: F" Semi-Annually 11 Quarterly Monthly _ DEPOSIT PREMIUM ENDORS EMENTS(FORM NUMBER) SEE ATTACHED` FORM SCHEDULE -: WC990612 ., ' I J 08/23/07 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Representillve We 00 00 01 39967 in�c� IC�CI"1D �nnv f Jun, 18. 2008 9: 20AM No. 2805. , P. 2 GRANITE STATE ,INSURANCE COMPANY 24435-0000 We 438-1.3-25 13102 ------------------------------------=-------- 013-66-0807-00 J PENNSYLVANIA a DAV I D SAURO INC Member Companies of 1633 TERN LA CENTERV I LLE, MA 02632-0000 American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE -•' WC950610' I.D# EASTERN INSURANCE GROUP LLC WORKERS COMPENSATION AND EMPLOYERS .2.33 W CENTRAL"ST.. LIABILITY POLICY INFORMATION PAGE NATICK, MA 01760-3133 INSURED 15 PREVIOUS POLICY NUMBER CORPORATION RENEWAL 004322293 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - wc9go6lo ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the Insured's mail Ing address FROM 08/25/07 To 08/25/08 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work In each state listed in Item &A. The limits of our Ilablllry under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 5OQ,000 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A I ITEM 4 The,premium for this policy will be determined by our Manuals of Rules, ClasslfIgatlons, Rates and Rating Plans. All Information required below is subject to verification and change.by audit. Estimated Total Rate per Estimated i clesslllcetlone Code Number Remuneretlon E700 OF R . Premium 1�`enJ X Annual 3 Year mune►ation �Annual 9 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $246 EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) 284 MA MINIMUM PREMIUM 00 MA TOTAL ESTIMATED PREMIUA—P1 $4,788, 11 Indlcatad below, Interlm adjustments of premium shall be made: t r El soml-Annually (]uuwrly 11 Monthly DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 08/23/07 ASSIGNED RISK 66 Issue Date . Issuing office Authorized RapresentlAive we 00 00 01 39907 rnl�l,ln�no r•nr�.i T , David Sauro Inca Construction Management 163' Tern Lane Centerville, MA 02632 Office & Fax: 508-778-0897 Cell: 774-487-2206 davidsauro@comcast.net April 27, 2009 - Town Of Barnstable G' Building Division cn Mr. Paul Roma t Hyannis, MA 02601 Re: 15 Ripple Cove Road, Hyannis Building Permit B 20072604 Dear Mr. Roma, As a follow-up to building permit for 15 Ripple Cove Road, Hyannis, enclosed you will find the following: "Elevation Certificate" completed by Frank Whiting of Eagle Surveying,Inc. dated April 10, 2009. Respectfully submitted on behalf of the building owner Marilyn Mohan, David Sauro g1S�S U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency Expires February 28,2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's dame Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Company NAIC Number City State ZIP Code 11-1irf.Vi✓t5 s21s4t 0 2loa/ A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) tT S,0 z.sy7t hYe- A5. Latitude/Longitude:Lat._/V 41038° 43" Long. y✓ 70° /6' Va' Horizontal Datum: NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number-_a_ ' A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) /(.7/ sq ft a) Square footage of attached garage sq It b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade /0 walls within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b Z03Z sq in, c) Total net area of flood openings in A9.b sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Bl.NFIP Community Name&Community Number B2.County Name State 63. llkov B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) ooa� Jal- z, /9fz- A B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile EZFIRM ❑Community Determined ❑Other(Describe) B11. Indicate elevation datum used for BFE in Item B9: Z NGVD 1929 ❑NAVD 1988 ❑Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ® No Designation Date ❑CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction` ® Finished Construction "A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item AT Benchmark Utilized Vertical Datum _ �/iVk. o Conversion/Comments !VOAI Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_/.0 ®feet ❑meters(Puerto Rico only) b) Top of the next higher floor A-3 . 3 ®feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) _❑feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) _❑feet ❑meters.(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building /0 .2®feet ❑meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) _�.s ®feet ❑meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) // , 0 ®feet ❑meters(Puerto Rico only) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. ,. OF �`.'... �I Check here K comments are provided on back of form. t, Certifier's Name License Number Title Company Name 4' j No 2Z3 Zoo/ .4 �i��A"Va) ,9,4r- /Yl�- OZG7� Z l0 23t ��p AddreAs City State ZIP Code 101A0A.�yt�9 J�6-3/2-8132- �er����1. Signature Date Telephone FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number City State ZIP Code Company NAIC Number /Sf iP`scJiV. SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items El-E4, use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is ❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is_. ❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in SectiW Items 8 and/or 9(see We 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _❑feet LJ meters ❑above or LJ below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters ❑above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _❑feet ❑meters ❑above or ❑belowthe HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8.and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: ❑ New Construction ❑Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O.Route and Box No. Policy Number city State • ZIP Code Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View"and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page„ following. i mw lip r • r rowf Building g p Photo ra hs Continuation Page For Insurance Company Use: Building Street Address(including Apt., Unit, Suite,and/or Bldg. No.)or P.O. Route and Box No. Policy Number. City State ZIP Code Company NAIC Number c�2G o/ If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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N V n �'� 2:2%10 P.T_ftUSfl 04 P.T. codactelipadealplcom Provide solid blocking at all horizontal plywood joints nailed at 4"on center(staggered). o PMT - Connect 4x4 post at either end of shear wall to the posts below with.a Simpson PHD2-SDS3 - m �115Z 4%4PTholdown. Provide(10)Simpson SDS'A"x3"screws into the side of the 4x4 and anchor into the Pr o 'a LN 1N I 4xa P.T. 22x6 I �''T POsrwwwNPAdeatgncomconcrete with a 518"diameter Hilti adhesive anchor(or equal)R"minimum embedment ALE $ P05T P.T.SILL AeovE Shear Wall"B" — — - Y I I 3 4X4 T. I —_ o 04 P.T. o s I 14 Second floor to plate height-shear wall width is 8'•0" d S (Same as shear wall A) - OB3k:l- 'xll-36•LVL FLUSH BEAM i axa P.T. . ' o ---� POST Shear Wall"C" I a a Ps. I - PoSTFROM I axa P.r. DWD ENGINEERING, INC. T P05T FRal 4x4 P.T. ABOVE P05T 5 MICHAEL ROAD, 7 BRIDG-9602 WATER S+ ABOVE I 9~9 TeL (508) 378-9602 Second Door to plate height-shear wall width is 10'-0" 414 P.T. P05T \� I R Fax. (508) 378-2922 (Same as shear wall A) T (IBZ2:1�'X11-V LVL R15H BEAM - '�' 4 4 P.T. 4X4 P.T. - m IL I T8 051 P057 I �l Shear Wall"D" P05T FROM 4 4 P.T. ABOVE Foundation to Plate height-shear wall width is 4'-0" P31 T 6 (Same as shear wall A) _ 52J . 4 4 P.T. 1 5Z I POST FROM 4X4— T . lei Shear Wall"E^ 4X4 .T. I 4% P.T. 4 4 F.T. 7 T T Second floor to plate heieht-shear wall width is 8'-0" — - (Same as shear wall A) Pf o 1,'06 IEAPJ 6 KAJ L Hn IN i PLE 2:2x6 P.T.SILL i I Shear Wall POV — _ P05T FROM I 04 P.T. Second floor to plate height-shear wall width is 5'-8" I P05T l)1 (Same as shear wall A) A P.T.ALL Shear Wall"G" Q f !? f I Posr FROM I axa P.T. Second floor to plate heieht-shear wall width is 8'-0" *' - .n (Same as shear wall A) 4 4 (1 a S ti P� "'I POST FRat I 'T �GJ ABOVE .t) . 116-T.1 20 eRIE I-JOI T5 el-OL. _ _�.,r' f — �" — .'i'� .—.—.—. 2:2%IO P.T.HJSH BEAM (� `l (e)��' �G,�y�4( LU X TTl I{1�-4.1.T.P05 4XPOST �TV P.T.JOI5T5OI6�10L. �o AP CL 1ST FLOOR FRAMING � n IONteC m a. �locotbrt Re,b 1/4" er n P�a I�n'�raae"a>nse un rmRten pwmbstn of IPA Dosg�.Oxo7. SHEET:,`,}\\\ JOB NO. 20050520. DATE: SEPTEMBER T,200E DRAWN BY: RWB ff wntactahpade5lgn. m J CHECKED BY: HPA/DD PATH: .. MOHAW - - - - 20050320_GD5 �. . - SCALE: SEE DRAWING REVISIONS: . ! DATE DESC. G B A 0 9/26/07 155.FOR PE3RMT - 4 2X0 J01515 oiV O.L. ZZt Z,bB 2: 2: B WADER WADERVEADER 4 4 P.T.04 T. 4%4 P.T. O OST P05 POST - 2:2X0 �� HPA D99V% Inc. 52. 4% DF. 911E aP ISFi 4%4 F. o ' n r w X. n r x ALL EXTERIOR PORCH ri _- . _ -- _ __-- _ _ - - -- _ _ -' _ -'_ -_- N MP;aiSPasrc s, 20O SlimamO Bt4 SWLe 6 -- -- -- ---- ( A 1rFIGAL 4xa pF. 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(508) 378-2922 SIF1PSON ECG :V Yp^I f� +Y d p vr��\r* - Fosr FROM OPEN TO - Posr uw QI;r. ` IJit U h-aN ABOVE .4 S A a JI seu o OL. axavFTn sm'SoN I - _ ..$., "t .;r$1,v -•y -�''G tl,�Tk 3ffrAli- IxA j g MSIbS CAM HH5 �A14 I 51H \ `—�l 4 T. I`Rlr�.•/�/ �r JF`O�'y,[, 4X4 OF. — — — RzAGPI�D T I' S'5-owP05T G� ; \ �•'Z CY'• TF h jtfG )`�tS;. - HALL F 4X4 POST MOM :2%4— — — UI1OE-IALKNG I �IT AS YE P057 FROM P05T T WALL PROVE YL h C,/J%•. V n 9 ABOVE ti I TJT Ji v.YIS js $' ry 2:2X4 51FffEON FOSi ID2: , 2�2� 2: 2i2%TAPE x LVLm"A3 BEAM FE , 2:2%TAPERED JO I v; 4, j HAWAR I I P05T 2:2X TAPERED JO Eh:H"XW'FLISH — SJ' I Z +Sd�x 50LI-fXD ING WALL Z ueRr eo1H I W W Q —' Z _— • 04 P.T. 4X4 P.T. 4X4 P.T. — (213012x10 DROPPED 4X4 P.T.4%4 P.T. POST POST POST BEAM ppST POSr I POST , O O J01515 9 VOL.(240 TAPERED TO 1-1/4') 2XB J21515 BIS'OL. I, ALL E%IERIOR HAVE ,1 Z 15 I Yg7 2 IMPSO FO HAVE !� lL YYQQ SIMP.L)N POST cPPS, B I n PICAL Q 2.2.0 WAVER 2:2X4 (ELI")1J i 2:7X4 O �� O POST POST O I+-I Z Lu t IL (3 D- Q DAD- A 2ND FLOOR FRAMING . Qmuwa w w d4eaNraa Ioe�m Rwrne r.proezum�W Q�yymernm,n.hol. �, w Nen�Pxmb6s'm of wA—kr.020or SHEET: PZ JOB NO. 20050320 DATE; 5EPTE HER-T,2oo1 . DRAWN BY: Rye . ! - Lontoctohpodeslgnsom CHECKED BY. HPA/DD . - PATH: MOHAW . 20050320_CD5, SCALE SEE DRAWING REVISIONS: • - - 0 .DATE - DESQ ' - G B A - O 9r16/Ol 155.FOR PERMIT II II II • 2X6 J065016'OL. HPA Dea Inc.. I `AID-9.Of.KRl6 m KALL UlDH2 BEARRIS 7k0 IN 1 7��, 7X4 4X4J215T5 IN TNIS fhb T n2 P05T 2:2xB II AREA HEADER II I 2W SWnewell BNd•Mille 5 _ POST PROM 51 I .. Wrentham MA 02093. . ABO•/E O BEAM B —_-- - — — — — — --- soe ea393em 4X4 r X4 DF. 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I I I A I I 1 FLAT ROOF In . - PECK BHAW it z I Z ____ _ _II < - Fs l 4M IrZT____ _ __ -________ ____________.__ __ __ ____. _ __ _ ____ y� _II _ O U LL 2)E RAFTERS olb'OL.(o POR(+I RWCS BELOW y Z L� ROOF RAFTER5 Q 13 ALL ROOF FAFTER5 ARE 2AO® 16' .G.(UNLE55 Q Z ______ _____________________JI OTHE 1115ENOTED) - II- Lu IL CL 4 IL a L a ROOF FRAMING ��� � 1�ted b w tlanlMted lacalen Retiiae . - e�od:ctbn bbyy oy method,b Mole � �, - .. e pst,b proh6oad without the . wr8ton pormbelon oP WA oeegu02av7 SHEET: JOB NO. 20050320 ---- DATE: sEPTErBER,,boo, DRAWN BC RP0 - . .. t BEAT-T .. contact®hpade6lgn.com CHECKED BY: HPA/DD PATH: BEARING WALL - MOHAN/ , TO UNDERSIDE 20050320_GD51 _ OF 05�D RAFTERS PLYWOOD FLOOR DECK ' .. 7X NAILER B/4'LO RYHDOD SCALE SEE DRAWING cJ1g.pLOOR 514 tG PLYWOOD - NAILED 6 6LUED NAI 5UBOGR e GLUED REVI810N8: 1212 — - - --- 0 DATE DESC. .. FLOOR JOISTS FLOOR J01575 O 9/26/Or 155.FOR PERMIT \ FLOOR JOISTS I, GEILING JOISTS J015T HANGER ROCK,p15T5 J015T HANGER - BEAM(SEE FRAMING PLAN) 66 STRAPPING (SEE FRAMING) - - - I12 rYYPSUM 5TEE-BEAM BEAM(SEE FRAMI N6 PLAN) ARD 'FINISH'IN Ia 1 WOOD (SEE FRAMNG) STRAPPING®I b"O.G. - �T 'FINISH'ON IX3 WOOD _ .(SEE PLANS FOR FIN15HE5) STRAPPING a ib"O.G.- - RqA (5EE PLANS FOR FINI5HE5) - �9 � r HPA Design% Inc. LVL RID6E n BEAM DETAIL 9 BEAM DETAIL BEAM DETAIL a BEAM DETAIL - - FRW-AMAMiNGPLAtll '-1� - 1�'I F-1/a'•°'-0' �''• ta/e•-r-0• � L-FK•a•-o' - 200 SMiumll BN4-SN[e 5 . ✓� - Wrentham MA 02093 - < 508.384ASM M �l 'J•�,'`�f. <� �p�.. 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WALL DETAII. �7CONTROL JOINT Z /:) L-1�'a - IV 1•d�— RSA. „ Lu z IL 0 day W- o p haraori.Rbllcatia ad ely e limRed m w�t��,��Ie penntslm of WA Deslgi.02 0 oT ap JOB NO.! 20050320L' AREA CALCULATIONS : GENERAL NOTES : PROPOSED HOUSE AND PORCH - 2429f S.F. - 17.9% 1. THIS PLAN IS FOR PERMITTING PURPOSES ONLY. PROPOSED GARAGE - 2801 S.F. - 2. Ix TOTAL BUILDING COVERAGE - 2709t S.F. - 20.Ox 2. VERTICAL DATUM /S NGVD. FOR BENCH MARKS N (13.600 S.F. x 20% - 2720 S.F. ALLOWED) SET, SEE SITE PLAN. 3. BEFORE CONS TRUCT I ON CALL 'DIG-SAFE 1-888-DIG-SAFE AND THE LOCAL WATER DEPT. FOR LOCATION OF UNDERGROUND UTILITIES. 4. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEED RESTRICTIONS OR ZONING REGUL A T I ONS. IT SHALL REMAIN THE CL/ENTS RESPONSIBILITY TO OBTAIN ALL PERMITS. SPECIAL pp \ PERMITS. VARIANCES ETC. FOR THIS PROJECT. 'PA b � A� ri ri J 5. IT SHALL REMAIN THE CLIENT'S RESPONSIBILITY TO HAVE THE PROPOSED BUILDING FOUNDATION L O T 104 0 DESIGNED TO ACCOUNT FOR THE EXISTING GRADE AND SOIL CONDITIONS AT THE L OCA T/ON OF THE I J, 600+ S. F. q PROPOSED BUILDING. 7� Of 6. THIS LOT FALLS WITHIN FLOOD ZONE A9(EL IO) PER 0 qv. v s, FLOOD INSURANCE RATE MAP 250001 0006 D DATED JULY 12. 1992 O A aOo, 7. THIS LOT IS SERVICED BY BOTH TOWN SEWER AND \\F TOWN WA TER. 8 ALL SEWER PIPE SHALL BE SCHEDULE 40 OR APPROVED EOUAL. \ EXISTING DMEi1 1NG TO BE s� \ �7c-MOL 15NED AND R£At9VED CROM SITE. � o � oQp�SF� o��F� \ ✓..`e�A i.�. .jc .0 `�(/ Q��F I4 v� /P FNO �j{ Of %. 0 J�p F UP 9914 / 4 1 STIEPHEN w. ® O AS CAOL No.35461 E S A O o o Fo c' 40'op P S / TE /E:' L AN O L A /VO 78 0 / 5 R / PPL E COVE ROAD . MAP 325 . PARCEL 65 SA R /VS TA SL E . < HY-A /V/V / S > "A , L PRE-PARED FOR a st ( MA R / L Y/V " O BHA /V k o�tµ\gt is 46 PL1RC1--1A SE S TREE T . M I L FORO . 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