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Home My WebLink About0135 SCUDDER AVENUE i ,� /t�� u c'/c��- 1Q V� u� �� I i � II�'� � I � � CAPE COD , INSULATION Ii8lR Olg55 >t..mi_55 OAM 9YSYlnOlO IN MA BgTTS �a/fl Lxi InSU{iION CIIlIN05 \, 1-800-0-96-6611 \V, Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date: Dear Building Inspector - - - - Please accept this Affidavit as documeination that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the vtcifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Pro ert Owner Property :address Village r Sw o P►vrd' c N l 3 SS Sc,V IS dlAr vA-,P (� ��-YO�Nf✓�S V'�M�'�-•�1 �-2.ot2'1 O s�� Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) l ) ( ) ( ) Walls l��P Se.a.l t��te � ✓S�r�e..,..�' Pre—-t Sincerely He y E Ca sidy r, President Ca e Cod sulation, Inc. I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ Parcel 043 Application # Health Division Date Issued Oct Conservation Division Application Fee tQJ Planning Dept. Permit Fee s c Date Definitive Plan Approved by Planning Board �ilr:p Historic - OKH _ Preservation/Hyannis Project Street Address ,14�-- Village Owner S��z�4�! i/�t/,, Address . 1,' Telephone „ ?2,e Permit Request /E- 2 0 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation o�joD, D Construction Type, //011"/ -/ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .2r"' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes .9'qo On Old King's Highway: ❑Yes-,t3'N-o �T Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other t' Basement Finished Area (sq.ft.) Basement Unfinished Area (sgft Number of Baths: Full: existing new Half: existing `'i-' new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roo 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 Z�4Pe /'�� ,�e/S,>/f9 � / Telephone Number Address 4 License #AD Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE o/,lq�/�� t} FOR OFFICIAL USE ONLY *' APPLICATION# DATE ISSUED MAP/PARCEL NO. 3'ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ,t ASSOCIATION PLAN NO. I = ==(( 10 Park Plaza - Suite' 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Reqistration: 153567 Type: Private Corporation Expiration: 1 211 5/201 2 Tr# 206433 CAPE COD INSULATION, INC HENRY CASSIDY 455 YARMOUTH RD. - --- HYANNIS, MA 02601 ..:.Update Address and return card. Mark reason for change. —I Address _ Renewal I L mployment l Lust Card 5-CAi ii tiON104/04431U1216 l)I'ficc 01 sumo Atrairs /13us'uc: Regulation License or registration valid for individu! use en!; HOMEP �6�%�` fJ` ��NfrAetGi before the expiration date. If found return to: Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration: 12/15/2012 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 OD INSULATION, INC HENRY CASSIDY 455 YARMOUTH R.D. HYANNIS,MA 02601 --� Undersecretary t alid ith t si tune :- alas,:,rlrusetts-J31cpartnrcnt of Public Sall a% Board of Building- Rc�!ulations and Stant1,11-' s' Qonstruction Supervisor License y Licensc; C5 100988 yvy iKu1 . HENRY CASSIDY " 8 SHED ROW WEST YARMOUTH, MA 02673 Expiration: 11/11/2013 ('lluwli.•f,n.•r Tr#: 7620 1 �, Sul [ � : ilrlvi No. 1605 P. 1 t Gllent#:4597 CCINSUL ACORD,,, CERTIFICATE OF UABILITY INSURANCE DATE(MM/DDYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. NQS2 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,THIS CERTIFICATE OF INSURANCE DOES NOT CONSTI'tuTE A CONTRACT BETWEEN THE ISSUING INSURER(5),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPQRTANT:If the cerllflciii-holder is an At)DITIDNAL iNSUREW the policy(ies)must be endorsed.If SUBROGATION 13 WAIVED,subloct to the terms and conditions of the policy,certain policies IT%reyulra an endorsement.A Btalemeht on this certificate does not confer riglTts to the Certificate holder in Iie41 of such endorsemen((s). PRODUCER Rogers&Gray his. -So.Dennis NAME Mar aret Youn PHONE 434 Route 134 AIC No Exl:508-760-4602 a Na.617-81G-2156 E-MAIL South Dennis, MA 02660-1601 sob 398-7980 _INOURER(6)AFFORDING COVERAGE NAIC H INSNRERA!Peerless Insurance _ 18333 INSURED' - Cape Cod Insulation[no INSURERB:Evanston Insurance Company ` 455 Yarmouth Road INSURERC:Atlantic Charter Insurance _ Hyannis, MA 02601 INJURERD-Commerce Insurance Company 34754 INSURER E: ___ IN60RER F I COVEria cEs CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT' THE POLICIES OF INSURANCE l-ISTIM IJCLOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NDICATED. 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 hY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOwN MAY HAVE BEEN RLDUCED BY PAID CLAIMS. ti ADDL SUB POLICY EFF POLICY t>< TYPE OF IRBURANC) POLICY NUMBER MMIDDNYYY MM10DA^eYY LIMITS q ckNERALuaBILITY COP8263063 4101/2012 04/01/201 EACH OCCURRENCE $1 UUU 000 X COMMERCIAL GENERAL LIABILITY FEST ,uNccu,rcnac 11 UU 00U CLAIMS-MADE OCCUR MEO EXP(Any one pomon) %5 000 PFR8ONA!,&AOV INJURY $1 000 000 OENERALA00REGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLI68P&R: PRODUCTS.CDMPlOPAGG $2000000 CT POLICY PRO- LOC (] AUTOMDBILEuA61LlT'Y 12MMbCKVMK � 4/O1/20I2 04/01/201 c°,BINED SINGLE LIMIT 1 UUOODU AIJY AUTO BODILY INJURY(P..peron) 5 ALL OWNED SCHEDULCD T AUTOS X AUTOS - BODILY INJURY(Par accident) S .. X HIRED AUTOS )( NON-OWNED PROPERTY AM f"k AUTOS $ S X UMBRkLLAL1AB OCCUR XONJ453512 4/01/2012 04/01/201 EACH OCCURRENCE $1 000 000 EI(CI;56 LIA9 GLAIMS•MAOE— .. AGGREGATE $1 000 U00 DED X RETENTION 10000 . C AND EMPLOYER LIAILIT WGA00525902 6130/2012 O6/3OI201 X tlGSTATU. I —�OTI* AND EMPLOY COMPENSATION ION ,� 0FRC6R/M�Mr 011Up�I��ECVTIVEa N!A E,L,EACH ACCIDENT" 1 ODO OUO I y6d,dadry in Under E.L.DISEASE-EA EMPLOYEE $1 OOQ 000 ' It yoa,AeBCnDa under �� - DESCRIPTION OF OPERATIONS helaw r _ E.L.DISEASE,POLICY LIMIT $1 00U 000 DESCRIPTION OF OPERATIONS!LOCATIONS 1 VEHICLES(Allaah ACORb 101,Addillonal R.m,ks Spheaui%1(more apace to required) "Workers Comp Infori-nation Included Officers or Proprietors Cerlfticate Holder is included as an additional insured under General Limlity when required by written contract or agreement. CERTIFICATE HOLDER CANCELLATION Cape Cod Ills ulation,InO '` SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OF CANCFLLGp 13EFORO THE EXPIRATION DATE .THEREOF, NOTICE WILL BE, DELIVERED IN ACCORDANCE WITH THE POLICY PROVIsIoNs. - AUTHORIZED REPRLSENTATIVE ®180 -2010 ACORD CORPORATION,All rights merved. ACORD 25(2010/05)' 1 .of 1, The ACORD name and logo aro rogistored marks of ACORD #S83849/M83848 MAY rf� Ta The Cornmorlll',dih of Massachusetts DeStlrtrnent u/ Industrial Accidents " Dfflce (.)/ Investigations 600 VI/oShington Street Bosvoo, IIiA 02111 �... =— WWll .(,r;isS.gov/dia Worker's compensation Lisuratice AI'titd�,A: Builders/Con tractors/L,lectricitu1s/�l'lurnbers MI)plicmlt Information Please Print L.,ebibly Naut� (Liltsiuc,ss/Orgru)),"L.�ltlprl/a.nclividual): � (� t ......... t'It}ltil:ltt%/ip:_. -- Pholaok-,,6 > . Z Z 6 L/. /� Are you all employer? Cheek the rippropriate box: Type of project(retluir'c.d): f. � l tun t eutployer' with 4. (� _ ❑ I am a n i,d ontraetor and I have 6. L__I New Canso IC6011 . r.utpluycrs (full and/tat part-time).* hired thw.,uh-,:onn'actors listed on 7. Reniotle.ling the art tch.:�l shoat.$ Ca I lull a suit:proprietor or partnership These tiuh-, uuractors have 8. Demolition uua have uo elrtployees working;For employe aid have workers' comp. 9. Building adilifiun nlr many capacity. [No workers' insulau .:j WHIP insurance required.] 5. We ue i k:;ul oration and its 10, � Electrical rcpairs.ur additions I office)S II:at rsercised their right of 11. Plumbing repairs ur additions taut a ilomeowuer doing all work exemptioi., pet MGL c. 152§ (4),and 12. Roof repairs mysc;li INct workers' comp. we have iill('tttployees. [No workers' suratnce ai r ed. l3. Other ret I 'I . comp. iu�ur;ui�c required.] 1G +1n apphcaut that checks box #1 must also till out the section below shoe in,,dwo workers'compensation policy inforniatiott. �. Ft"uucommas who sub,nit this airfictavit indicating they arc doing ail wall ;w,l,lien hire outside contractors must submit a new affidavit indicating such.uactui_ that cl'icck this box must attach an additional sheet showing di,mill:of the sub-contractors and state whether or not those entities I'tave employees.II'- ,lie sot-,�outractora have etnptuyc;cs, they must provide their workers'cony,.pchcp number. - l am an employer that is pro viditig workers'cornpensatioit ilisiiraitce for my employees.Below is trio policy and job site I1ltUYlll!!Q(I n. ' linut,utcr`C'oritpany Name`. Expiration Date: 1uh sur Adilre» City/State/Zip: Attach a copy of file worl�ers'compensation policy declaration pagt (slowing the policy number a»d expiration elate). failure to secure covo,ttgc as required under Section 25A of MGL c. l>_'caul Iced to the imposition of criminal penalties of a finis up to �f,500.00 end/ur emr-year iwpnsunrnent,as welt as civil penalties in the form of a STOP 4Vt WK ORDER and a fine of up to$250.00 a day against the violator. be advised h:u I t'V(1y Of,th"statement nta a forwtrrded to the Office of of the DIA for insurance coverage verification. 1 do here c if urtder the ins and penalties of per�urV that the information provided above is true and correct. "'ihrl�ttw c : Date: official lose only. Do "lot write in this urea,to be completed uP c iry or town!official — - ff1 City ur Tow»: _ Ilerinit/License# Isstiilig rlutbority (circle one): t.flriard oMealth 2. Building Department 3.City/'1'uwn Clerk 4,Electrical Inspector S.I'lumbijig I'tlspector ('untact l'crsoq: Phone#: i 460 %.lest Main Street HOUSING Hvanni s, 1,17-� 02601-3698 ENERGY & HOME REPAIR ASSISTANCE (5a8) 730-7106 F (5a8) 79a- CORPORATION 2425 HOME OWNER WEATHERIZATION WORk PERMIT& FUEL RELEASE: - - PL-EkSE-FI-L--O-HENBi --S�GN�H-{�FC)RRM-A- -*9 Lj RE THEAPPLICANT HOMEOWNER. r li <-7 hereby consent to and agree that weatherization work maybe done by theWeatherization Program of Housing Assistance Corporation (herein after referred as "Agency") on the property located at:: ' The weatherization work done wi11 be based on programmatic priorities and availability of funding and it may includea]I or some of the following measurea Weather-stripping& caulking of windows and doors, insulation of attics, sidewalls& basements, attic and other ventilation measures and possibly replacement of badly deteriorated windows. In consideration of theweatherization work to bedone at my home l agreeto thefollowing 1. 1 give permission to the"Agency" its agents and employeesto travel onto or acrosssaid property with such equipment and materials as may be necessary to perform weatherization work on said property. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basisfor no more than five(5) years after theweatherization work is completed. have read the provisions of his agreement as listed and freely give my consent. H ome Owner: (Signature) Data Agent: (signature) Date. HAC approved Weatherization Company : f' C6CO z,14,111 All Cape Energy, Caliber Building&Remode' f ape Cod Insulation, Cape Save, Cresivell Construction, Frontier Energy Solutions, Lohr&Sons, Peter Smitb, eso ution Energy, Rock Solid Construction . • f� r a / 'own of Barnstable. *permit Expires 6 months from issue date Regulatory Services Fee. - F�+ RA INSTAR7 + - MA9S. n Thomas F. Geiler,Director T�B Building Division (� L{� `Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.town.bamstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �f -� (`� �No,Yalid without Bed X-Press Imprint Map/parcel Number t/ � v w!(/ Property Address Vesidential Value of Work _S 6� Minimum fee of$35.00 for work under$6000.00 5 Owner's Name&Address Au ' e Contractor's Name C J E'_ +(Z Telephone Number t!6 n g Home Improvement Contractor License#(if applicable) i J Construction Supervisor's License#(if applicable) O Z Z.&O ❑Workman's Compensation Insurance Check one ❑ I am a sole proprietor ❑ I Ain the Homeowner have Worker's Compensation Insurance Insurance Company Name 5 e q-CI-j Workman's Camp. Policy# Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) Re-roof(stripping g All construction debris will be taken to . in old shingles)-❑R roof(not stripping. Going-over existing layers of roof) Re-side Z` �Q�� #of'doom �_ Replacement Windows/doors/sli -Value ' " (maximum .44)#of windows *Where required: Issuance of this pe i d not exempt compl• cc with other town department regulations,i:e.Historic,Conservation,etc, ***Note: Prope er must sign P erty Owner Letter of Permission. A co f e Home Imp ement Contractors License& Construction Supervisors License is re e IGNATURE: 1WPFUMTORMS1bui7d' g permit fonnslE S.doc >vised 070110 i The Commonwealth of Massachusetts Department of Industrial Accidents C, Office of Investigations d 600 Washington Street A �< &ston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Dame(Business/Organization/Individual):.. Address• '"1 ok _2 . . `� City/State/Zip:MA.0AoP,s OA'Af, 1✓A 666g9_Phone.#:(5() ) q i qq Are you an employer?Check the appropriate box: Type of project(required):. 1. I am a emP Y to er with Z- 4. ❑ I am a general contractor and I , 6. ❑New construction employees(full and/or part-time).* have hired the stab-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: ❑Building addition [No workers' comp.insurance comp.insurance. re 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions q ] ffi ocers have their 11. n airs or additions 3.❑ I am a homeowner doing all work ave exercised ❑Plumbing repairs myself. [No workers' comp. right of exemption per MGL 12.❑ oof 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 or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: SSe e: Policy#or Self-ins Expiration Lic:�#: � �� '2- � f 41 O_ 2f . ' Job Site.Address:]35 5C,)ddeL•Aje City/State/Zip: dun(1n1,5 XA deG � Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage s required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 an or on ear imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a da aga' the violator. Be.advised that a copy of this statement may be forwarded to the Office of Investigations of t IA r insurance coverage verification. I do hereby cer lunthe pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Z Z x 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 an two or more �P P� � rP g tY� Y 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-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 orLLP 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 of citizen is obtaining a license or permit not related fo 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:. 1 The Commonwealth of Massachusetts Departtnent of Industrial A.00idents Office of InvestigatWas ; 600 Washington Street Boston,MA 02111 Tel.##617-727-4900 ext.406 or 1-877-MASSAFE Revised 11-22-06 Fax##61 T-727-774 wwwmass..gov(dia rP �TME Town of Barnstable �. Regulatory Services Thomas F.Geiler,Director 163� 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, �/� CGZCA C►L ,as Owner of the subject property hereby authorize �C to act on my behalf, in all matters relative to work authorized by this building permit r (Address of job) Pool fences and alarms are the responsibility f the applicant. Pools are not to be filled before fence is installed an ools a not to be utilized until all final inspections are perfor d and ccepted. f Signature of Owner /igna� of App cant F Print Name �. Print Name Date 7�lQ:FOkMS:OVINERPERMISSIONPOOLS t IHKE Town of Barnstable Regulatory Services t B"NSTASLE, + Thomas F.Geiler,Director `bp 16g9. .•�A Building Division rfD MA'1 - 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:. 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 responsibilities,many communities require,as part of the permit application, I 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:fonns:homeexempt I HOBM1E IMPROVEMENT CONTRACTOR Type. Region: -162938 Expiration:-�}(2ZM013 DBA 'MR R BROTRE[t5COF1STR1JG170N MICHAEL MEAGHEF�IR 97 EMERALD LN MARSTONSMILL,MA - UnderseaersrY LlCense or registration volid fOp individul use only before the egpiration date. iffound return tu:- ptfice of Consumer Affairs and Bns�s Regulation 10 Park Phm-S 70 I- BpSWD MA 0211 Not d out signature. Massachusetts-Department or Public Safer Board of Buildir-, Red-zulations and Standards Construction Supervisor License License: CS 102260 Restricted to-- 00 MICHAEL MEAGHER JR 97 EMERALD LANE MARSTONS MILLS,MA 0260 Expiration: 1115/2012 .. (oultuicc�q�cP Tr#: 10225D r• Ri.ij,"'AI=ax 02-2 1V?C/2.011 6:51:31 kM PAGE 2/002 Fax Serve Af;ORD. CERTIFICATE OF LIABILITY THIS CEM.r.W. AATf 1S•%!E17 AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 1HE CERTIFICATE HOLDER THIS )� CE"F'—A b01r6 NGT AFFTWATIVELY OR NEGATIVELY AMEND,EMND OR ALTER THE COVERAGE 4(7:);. FO RT?1:f.i t'._QES ZEIAW, T 'S CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT SEIWEENTHE ISSUING INSURMM,a UTN*.tP!?ED RSoRFSE14T.4?IVE OR PRODUCER,AIJD THE CERTIFICATE HOLDER IMPORTANT:R the eerti&oate holder is an AODITIO NAL INSURED,tha paboV(esl must beera brsad.4 SUSROGATION 18 WAIVED,suMftttotha tame Arid o4ro iwta 0 the"Icy,ceddn Policies mt;Y iagWi*mW wdersenerd.A statamant on this cwbflcMe does not oorlter rightstc dw to:)T�9t9 hcid-r in k.•oe suchardorsarDMKO. F +;UdCo; CONTACT NAME: PHONE FAX GI DE i;AfT C IDD I IS AWN (AiC,No,Ett?: FAx (AVC,No): ;.9X WI.NTER STREET F4AML ADDRESS: . PRODUCER WYAN N IS.MA W2160I CUSTOMER to 0. 236RC INSURER(S)AFFORDING COVERAGE NAIC P INSURED INSURER A: TRAI'ELiRS INDIJ12411TY COMPANY INSURER B: ?&A MR NUCHAEL DBA MEAGEER CONSTRUCT?ON INSURER C: INSURER D: 97 EJAERALD MZF.ET INSURER E: ,%"kYfUNS]A1L_A-.S. C0ERAGES CERTIFICATE NUMBER: REP.StON HUrABER- ..A!7A V4(Mr nPY THAT THE POUOTS OF IFSURANCE L•STED BELOW HAVE BEEN ISSUEDTOTHE NRUREO NAMED ABOVE FORTHE PCUCY PE 000INDICATED- bMT%VW. AbuINOAHY REWRLRAENT.TERMOR CONDITION OF ANYCON'RACTORMER OOCUMW.`MT:?. CERTIRCATERAV BF'mED OR MAY PERTAM.THEINSURANCEAF?ORDED EY THE POLICIES DESCFEBEO HEREIN G SUBJECT TO ALLTHETE'RNK EXCLUSIONS AND CONDMONSOF MX34 POLICIES. UMITS SHOWN MAY HAVE SEEN FEDUCED 9Y PAID CLAN$.. Wen AOL'LS'JBR -OUCVEFFDAT'E POUCYEXPDATE TYRE OF INSURANCE POUCV NUMBER (MUADDA'tYYYI (ARADM"YYi UNUTS GENERALLAII&M EACH OCCURRENCE ? ;:1iuHaFilClAi G:r:FR^l.;01�INKY DMAAGE TO RENTED 3 PREMISES(Ea Ottutrwice)' mtU tAr rpny ens vmn) $ PERSONA &H AOV HQURY S r• .na"gym•?%.SEUiVrf?i'%"t'-^,F?R: GENERALAGGREOATE 3 rOLY:Y PRi+.)EC1' Lt7C PRODUCTS•001AKOP AOG AUTOMOBILELIABILYI'Y COMBINED SINGLE 3 ANY AUTO LIMIT IEaacdderli) ALLOVINEOAt1TOS BOOILYINJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Pat wddeail NCN•OWNEDAUTOS PROPERTY DAMAGE S (Per eccidmo UMORELLALIAO GCC R EACHOCCURRENCE 3 EXCESS LU.B CLAIRIS^MADE AGGREGATE 3 DEDUCTIBLE S RETENTION 3 S V/C STATUTORYLUJITS OTFFA WORKERS COMPENSA71ON AND EMPLOYER'S LIABILITY YIN U9 4639?4dA-1 I I/04?2011 :109/2012 E.L EACH ACCIDENT S 10.,000 YPRCFEFTTcPMARTNER'E,".E+:UTIVE N E.L.DISEASE-EA EMPLOYEES IOO,C01 A'd (YF{i�R'U.EMJEREYC LOEO% (Mandator/InNFp E.L.DISEASE^FOLICYLWI T 5 500,000 06S"PTICN OF OPERATIONS Dew. DESCtART10!cCFOPERATIONSILOCATI09e'x.NiNICLESIRES€:cTIONSISPECIALITEMS THIS RMACES ANY FRIOR CPRTLPICATEISSUED TC M COZTE ICATE I40L7ER AFFFXTLNO WORW..S COMP COVERAGE. NIGHER A(JCHAFL S COVERED WC THEWORKFR,C rONS EJ!Qm1 r`w Orr r.y HOLDER Ck17CELLATION 'I'rj*&OF BARNSTABIE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 2EfOP.E7HE EXPIRATION f 1-..THEREOF,NOTICE WILL BE)F'!Y.4CRED',N 13?3C�L'Si3 STRFE';', c.CCORDANCF.6rTTriTr:E�OUCY r L-SIOU` AUTHORIZED REPRESENTATIVE ' t�,rm'IS,MA 02601 Charles J Clark ACORO 25(20 M9(. IOM2008 ACORD CORPORATION. Ali Agiris reserved. Al�' CERTIFICATE CF LIABILITY INSURANCE DA 11129111 WI 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 CONSMTUTE A CONTRACT BETWEEN THE ISSUING !NSURER(Sj AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER () IMPORTANT: if the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must to 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 508-771-33001 NAtdE CT --_— Olds tape Cod insurance i PHONE Martha Findlay 508-TT5 3821 c.Ya.E=r. ---- --- I+ac.Hol: .-----_.__ 296 Winter Street EMAIL � LADRESS: -- -- _—_---_ ---- Hyannis,MA02W1 i ADDRESS: MICHA-3 Martha J Findlay _---- ______ INSuREMS)AFFORDING COVERAGE --_—_ NkC wsurED Michael Poteagher i— J !NSURERA:Essex insurance Gempany _ ___�39020 - -—---- 97 Emerald Lane IjSURERB-_...._....- Marstons Mills,MA 02648 N _ --- --i— — IlSUR'eR C WSURERD: - - INSURER E:--- -- ---T---- 94SUREER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY TeAT THE FCIICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREC NAMED ABOVE FOR THE P0:1CY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CON'lTION OF ANY CONTRACT OR OTHER DOCUMENT W,T:•i RESPECT TO WHICH TF:S 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.!U111TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. — INSR —__ -- !AT— _TR TYPE OF INSURANCE IN R;�o POLICY NUMBER M61FJDlYYYY I RiM�'Jf'YYv.' --- LlrAlr< GENERAL!La8:l1T:' t Er.-:H r- FFFC;CE S 1,00D700 A ;rnn4EP._tAL cEnEI? L i I3DD2B87 1 03124111 1012M12:.k: rY J:!s ac^ren:el 'g ! _1.000 SEED E/? - -'-- — ---i � I:t�a•Nus",c='•_r..e_�'r i t,DaM1A00 11,00D.000 1 " • --• ^^ --. '•TAGF• "4-• i _ _ _r-,;;QP1:Yi•jFrJ= 1 1,000.00 , I _ I .. AL70M_8!Le GJA61NTl" I ! —:t=_•r4f IP:E.r%S N?LE L9PT g =D10 !d FP?';D WNEC UMBRELLA MS i ` i - r .•..c —�=---- EKCESSLIAB _.F.. TF x WORKERS CON.PENSAM14 � '•,,- 'j_ i r Ur:'r!Intl i I .4!D EI!PLO'fERS'LIABILITY y/N ------ :'rr=R+JFRIET,grrART!�E�=r CUDlE �E L.ECH-C CIDE'9T $ !•NIA (NeneatveyhNM) - .—I , _ �� i I` I is r y 1-I �EL CITE>SE-niUC,L, 14 OESCRJPTIDN Or OPERATtOI r3.'LOCATIONS"?EMC_ES(AGach ACORD rot,Atla0wia:P.-:narks Schedule,•t Icore epace's 1,Kutrec) Insured has workers compensation policy.effective 11191114119A2 with Travelers.!have ordered a certificate from the company and it wl!I be sent to you directly. R CERTIFICATE HOLDER CANCELLATION TOWN-01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barr-stableACCORDANCE WITH S.THE POLICY PROVISION Building Department AurHON92EDREPRESENTATIYE 230 South Street Hyannis,MA 02601 ✓S��an�Sta,.� �. Ca71968-2009 ACORO CORPORATION. All rights reserved. ACORD 26(2009109; The ACORD name and logo are registered marks of ACORD Assessor's map and lot number ... / r ,/ ,r THE Sewage Permit number « 6 €.a ' .... ✓ Z BJHBSTADLE, i House number vo MAM ........................................................................ O i639• 9� 'ATE p MAY M1� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO i. t?e?. Z.`'�A . -? ! . ......!..... .. TYPEOF CONSTRUCTION .:: >t; a.` .....�f" ` .:...... ............................................................................... ........:.. .............. ........19. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora ermit according to the following information: Location ... ..t?..!r......... ......... e' U jl. .... 't .......... /h/` ? . �... .��/�:.5....... ........................ Proposed Use ...... ...... ...................... Zoning District .��. ` 4) .�t4) .Fire District . .: ? .............................................. g .................. l f� Name of Owner/ LJ'S � /,�'zr.. : ... -`'..� '......Address i.... �.� ........................................' ` '.... Name of Builder )f!...!..... .. ...........Address !i?/J- ....:: ...../..... Nameof Architect .....,.,..,.........:.......... ..........................Address ?....•.,. .........�.. ................ Number of Rooms ................................................................Foundation -?'�........:�Y / Exterior `r -�fi),Pq/-/— Roofin Floors �° r./��t �� j.�-'�J�.....!.. .. `. � ..Interior -(1� /....................................�...t.....�f.�`...... Heating .... ....r' !>�fq,.... ..... ...`.......... .f.. / Plumbing. ... r/ ( 1 �l................... .......... Fireplace ....p er' ...............................................................Approximate Cosh......... ........................................... Definitive Plan Approved by Planning Board _______________ n __143_ . Area . � Diagram of Lot and Building with Dimensions Fee f ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH � Qlt�4!�2- 00 �zt, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstabler regard i(ng-the above construction. Name .. 0"04"5'6- `/< T BAYSIDE BUILDING CO. , INC. A=289-93-2 No .................4643 Permit for ..,One,.Story,......... Single Family. DwelliAg,,,,,..,, Location ,Lot.. t.—r......135 SQ..1AddP-r..Ave. .....................annis....................... Owner ...BaXs ide Bu JjXjg„GA.........Inc. f Type of Construction ......Er.aMe....................... ................................................................................ Plot ............................ .Lot ................................ � Permit Granted ,,, December 15 19 82 Date of Inspection ....................................19 Date Completed. ......................................19 , S3 a V I 00 .4 ! -Q, i DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH OF 1010 COMMONWEALTH AVE. a, u`MASSACHUSETTS i BOSTON,MA 02215 LICENSE CAUTION EXPIRATION DATE C O N S T R•. S U P E R.V I S O R j" FOR PROTECTION AGAINST qq nn,, 94 EFFECTIVE DATE LIC-NO. THEFT„P;U.TiIGHT THUMB ES�R�CTI� ;y PBiN'T1N°`APPROPRIATE 1 G 6 09/30/1992 046234 BOX ON LICENSE. 1 9 2 FAMILY HOME TIMOTHY .GR"A.Y� p Ion�: tUL'AS71N OPETiATORS S S ## 03 2—5 2—5 2 78 `Y _ MUST INCLUDE PHOTO. • . ...�S / fir' S� � � J PHOTO(BLASTING OPR ONLY) FEE: 1 O O O O NOS T VAUUNTGNEUBY LICENSEE AND OFFICIALLY : l STAMPED.OR-SIGNATURE OF THE COMMISSIONER HEIGHT: DOB: I 1 /30/1 9 5 9 i SIGN TORE LINE _ 4 + I « S NAME IN FULL ABOVE SIGNATURE`e�-_+.• _ !- � - �� / THIS DOCUMENT MUST BE� 1 � TURE OF LICENSEE ` ,. - - CARRIEDONTHEPERSON OFN. 1 , ; i OTHERS-R THUMBPRINT GAGEDINTHISOCCUPATIO` THE HOLDER WHEN EN- J COMMISSIONER j� - .....-1.cL• �..�.ter_ _ _. ..,+ ..- .- -:w.,..r+Y� -► -�-ram _�".. -� ...d •�ii s�oonsar�owrcea�9�✓ua°°aa4.arelQ _\ NONE INPROVENENT CONTRACTOR • Registration 102634 -Type - INDIVIDUAL Expiration 07/02/94 Tivothy Gray Building &.Resod 1inothy Gray i 15 Tobisset St ADMwISTRATOR Nashpee MA 02649 n � o ' r N yl i i j. Assessor's office(1st Floor): fO4 Assessor's map and lot number • `TNIt �o r0` Conservation ' 7 Board of Health(3rd loor): 1i ssaMMci Sewage Permit number — 4 SEPTIC SYSTEM MUST BE . out Engineering Department(3rd floor): INSTALLED IN COMPLIANCE oO�O 39 House number WITH TITLE 5 Definitive Plan Approved by Planning Board SN3A 5 NTAL CODE AND APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN REGULATIONS TOWN OF BARNSTABLE BUILDING • INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION W,1, d 1 �/'CS-r��'e ��a✓�� 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: S S G �j�`1 Location Zj �/Proposed Use �' �` �! X 2 O Zoning District '� / Fire District Name of Owner _1 1 f-'e Address "43'v Name of Builder_�Y 4r r'q Address ° ��Se7 s�• 1�i1 //1��...d Name of Architect i"�i� Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Oy d Area 77 d s0 Diagram of Lot and Building with Dimensions Fee l0q / Zor Decft Deily t11 2Kl 7 hg �� f q 9�' c� 43_7 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License AUGUSTINE, JUNE No 36025 Permit For BUILD DECK. 14. y Single Family Dwelling Location 135 Scudder Avenue Hyannis Owner -June Augustine - 1 Type of,Construction Frame y f, Plot '} Lot ' Permit Granted July 15 , _ 19 .93 Date of Inspection 19• Date Complete da `^ �9� ` 19,. � { I ' 9 Assessor's map and lot number i ...pS/. ....... - Sewage Permit number - 2• r• ; '� � �� . �� , > r_ �` w�10�FCOap``,e� Z BAUSTADLE, i House number ..../.. ...!Y11. A yr�V� � p� t�°�6rr_ � NAM 00°j TOWN ; OFBALE Uv im gy'�!�j c�c .�. , =a TOW q MEW BUILDING.' INSPECTOR' INSPECTOR' APPLICATION FOR PERMIT TO 1rC�j�� i:! .4—..r �cJ13. C.... ^ I .. :.}.... . .: U,J 1 ' TYPE OF CONSTRUCTION .........C��.`� ...................................................................................... i......... " .......19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....CO.T..........Z........'S� U 004:X..AL Or.............. .//>"e,,&Wu...... ��5................................:.. -Proposed Use ............... ......... ........ ........ ...... ................................................................................ Zoning District /='.. 1 f.. .. ..... .....................Fire District ... ... Name of Owner R :.. ....Address .Sd .. ... ... , ... .� 3 Name of Builder ...... . ....:...............Address .,��.�M-°1..�............... f��Name of Architec : .��b'^///:.:!. ..............Address ... ....?�.�.. :...�..✓..... �..� i - Number of Rooms .,....... Foundation Exterior ........., � .......... Roofin Floors ,�� I terior ..,'`(.1...,. .... .... .... .. Al.�.. Heafing. ...... .. .... . ...........Plumbing .. . :F .. :......... :' :.:...:.....' Fireplace ....X ..............................................................Approximate Cost ..... .. I.)................ ...... Definitive Plan Approved by Planning Board` ________________ 19 6-3 . Area ...\`��...... .............. Diagram of Lot and Building with Dimensions Fee .... SUBJECT TO APPROVAL OF BOARD OF HEALTH 'O'd a_ �1 3 � I - J OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the wn of Barnstabl ardin a ove construction. Of— Name ........... .... ........`......ttt.... ................. Ti BAYSIDE BUILDING CO. , INC. 24643 One Story ............. Permit for .................................... Single Family Dwelling ............................................................................... Location .. Lot #2, 135 Scudder Ave. fi.............................................................. ell, Hyannis . ......................................................... ...................... 9a*yside Building Co. , Inc. e^ Owner ..... ........................... Frame Type-of Cons truction .......................................... L ................................................................................ Plot1............................. Lot ................................ December 15, 19 82 Permit,Granted Date of In eon* **.*.**.*... I. - I I I Date �Completecl ......................................19 IJ , do r rye rbI Ib J, C,/* TOWN OF BARNSTABLE � Permit No. _ 3_._______._._ ��y r Building Inspector �snssr i � Cash ---------------------------- ""'" OCCUPANCY PERMIT Bond �'____-__-��a Issued to Baysi.de Building Co. Address s Lot #2,,w 135_Scudder Avenue, Hyannis g ! r Inspection date Wiring Inspector Plumbing Insp ctor - Inspection date "Gas Inspector t _ f� Inspection date . l.�-�, �. _ _^', <' ^" X Engineering Department y ` Inspection date Board of Health ,lr�fr l/ Inspection date f A r THIS PERMIT WILL NOT BELVALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Building Inspector c Lot 3 r Y t s b.wt r 1 t f } i 4 30 9 s S � u a (4CTo t oo' w 1 IL oh CERTIFIED PLOT PLAN t , L 7 2 SCuDUr?4. vE N Ul: �yAl�IIVIS �y H o cONSTRu_CTION oPILy ° 6.29874�q IN ,0f: FOUNDAT10N IS�.J::.2„ ZEET �c��r �Jr �.'�r MASS* `A,BOVC-'I VV POINT OF ADJACENT sua�� , R1t gCALE9 1 = 3o DATE i3"' '82 tJ1V BAvs►vt " I' CERTIFY THAT THE Foc,nciclfo� ,E ING G . GLi;ENT . �-- BNQIfIN ON THIS PLAN IS LOCATED fi<E8ISTERBD F, z�9t -s D AS INDICATED AND p(y THE GROUN A �►A� NO• COORMS TO THE ZONING LAWS , LAND EPI®INEER BUft11EY0 DR �y; R,. Oh' BA.RN$TAB E , MASS. Z•,.M p'IN STREET ars° � NY N.Rls, M1 SS-,. F `;: ;. BH I 'f".,, OR';!. DA E . RM' LAND SURVEYOR