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0163 SEVENTH AVENUE (HYANNIS)
;y + TOWN OF BARNSTABLE BUILDING PERMIT.yAPPLICATION,.• !t GG Map Parcel Application # Health Division - 2a l ` Date Issued (o:`3 _ , a lob Conservation Division `; Apprication Fee _. Planning]Dept : ;,'.Permit Fee' HMO-, Date Definitive,Plan Approved by Planning Board Historic OKH —Preservation/Hyannis Project Street Address _1 L ;� Village Owner -T* Address Telephone 4 ) s e Permit Request �5 � . � ��1,...` ctw•�c� v.� �..���. .�- �;��kc '- tnwJ✓� �r'v�:�- �..�-c��:t.c� ' Square feet: 1 st floor: existing/wU proposed 2nd floor: existing proposed Total new '- Zoning District Flood Plain Groundwater Overlay Project Valuation 02dGv Construction Type Lot Size t t. u y Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family try Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: UFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2 new Half: existing i 4-f- ew�L Number of Bedrooms: 3 existing -new Total Room Count (not including baths): existing —new - First Floor Room Count S Heat Type and Fuel: O Gas ❑ Oil ❑ Electric ❑ Other fi F Central Air: Wr es ❑ No Fireplaces: Existing - New Existing wood/d?al stove 0 Yes a-No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑eRi',ting 0-newi�'size_ Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ o , w Commercial ❑Yes ❑ No If yes, site plan review# Current Use _Proposed Use,_ -- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name L WIO", Telephone Number 15'c)Pj 1-7-7e. 2CY70 Address c 9 F) v�a�c �,.nt �� License# Q G C2 7 i C,e_V14V_%A1t C)aC32_1 Home Improvement Contractor# /007 L Worker's Compensation # C z 7-y 3 9S'7 It A-LI-0-06- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L V//M.11 wI w (JC/.gym:7 SIGNATURE DATE '4 FOR OFFICIAL USE ONLY y APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE S OWNER DATE OF INSPECTION: y FOUNDATION FRAME R� INSULATION z 'FIREPLACE ELECTRICAL: ROUGH .FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL # FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. `t the Commonwealth of Mass achusetts `- ,Department Of industrial Accidents Office of Lnvesfigati ns 600 Washington Street Boston, MA OZXXX www.mass.gov/dia Workers' Compensation fusurauce Affidavit: Buiiders/Contractors/EIectricians/ lumbers Applicant Infoxmatioxt Please Print Legibly Name (Businrss/Organizatidn/Individual): •� �— Address: t, City/Sta-tr/Zip: c,;..�-.ryvk phone.#: 50k 774- 2-010 F you an employer? Check the appropriate box. Type of project(required): ama employer with 4• am a general contractor and I6_ ❑Ncw construction employees (full and/or part_ldmc). bavc hired the stf�contractors I am a sole proprietor or partner- listui on the attached sheet. 7. ❑ Remodeling ship and have no employees These svb contractors have g. Demolition employees and have workczs' working for zfac in any capacity. employees []Building addition • . [No workers' cump.•inn rancc �mP incurance.t S. [� We arc a corporation and its 10_0 Electrical repairs or additions z u�j offit:crs have --xcrciscd their Il.❑Plumbing repairs or additions 3.ElI am a homeowner doing all work rnysclf. [No workers' comp- -6gbt of exemption per MGL 12.[]Roofrepairs incrrrance rCquu-ed_I t .p. 152, §1(4), and we haws no 13.❑ Other employees. [No workers' comp.insurance rr-gi. ell] *!wy applicant that ehccla box#1)rural also fill out the section below showing their workers'cortrgarsat.on pofiey infunT atiorr. t Homeovma-s v rho subroit this sJ5 avit indicating they arc doing ali work and then hire outside contractors must subnrit anrw affidavit indicaf mg cueh. XCcrnbaetnts duY ebeckthis box rrmst ati cbcd;,m additional&beet showing the name of the sub-Cantraclnrs and stain whctha or not thosd mtNm bavo arzplo),cm. If the sub-conU-octDr;have anployces,they must prwi db their workrre comp.Pob ey ntunber. I arts an employer that is providing workers' compensation insurance for my employees. Below is[he policy and jab site informatiorL Insurance Company Name: Policy#or Self-ins. Lie. #-. 1' 2'L G&3 g5,)ti fY9I— 8 --06 Expiration Date: SI!`1�US Job Site Address: j[,3 5,. ALJ.e City/State/Zip: Attach a copy of the workers'compensation ' ompensation policy declaration page(showing the poU y number and expiration date). Failure to scct�c roveragc as required under Section 25A of MGL c. 152 can lead to the imposition of!Tm;na1 penalties of a 5ne tip to $1,500.00 and/or one-year imp = nsonnt, as well as ci5,il penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Bc advised that a copyof this statement may bo,forwarded to the Office of Invcsti ations of the DIA for insurance coves c verification.. I do hereby certify under fhe pains-andpcnaWzs cf perjury that the injarrnation provided¢hove is tract:astd correct Si CL Date: Phonc# O`r/' �L U Q-Acuzl use only. Do not wrUa rn this area, Lb be completed by ctly or town official City or Town: Permit/Liceme# Issuing Authority (circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone#:. Massachusetts Gcncral Laws chapter 152 requires all employers to provide workers' compensation for their employees: r pursuant to this statute,an employee is defined as "._.every person in the service of another under any contract of hire, t ,, express or implied, oral or written." Au employer is defined as "an individual,partacrsbip, association, corporation or other legal.entity, or any two or mr5re ' of the foregoing engaged in a joint catcrprisc, and including the legal representatives of a dcecasul employer, or the meiver 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 1welling house of imothcr who employs persons to do maintenance, construction or repair work on such dwelling house :)r on thr grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." vfGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or •enewal 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." ldditionally,MGL ohapter 152, §25C(7) states `Neither the commonwealth nor any of its political subdivisions shall Inter into any contract for the performance of public work until acceptable evidence of compliznce R iYh the in cquiremcnts of this chapter have been presented to the contracting authority.. ,pplicants lease fill out the workcrs' compensation affidavit complctr-ly, by checking the boxes that apply to.your situation and, if ecessary,supply sdib nfractor(s)name(s), address(cs) and phone number(s) along with their certificatc(s) of isurancc. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no cmployccs other than the to carry ts h workcrs' compensation innua„ce. If an LLC or LLP don icrnbers or partner, aim not rcqulred oployecs, a policy is rr, u ad. Be advised that this affidavit may be submitted to the Department of Industrial ccidcnts for should hoe of insvraucc covcragc. Also be sure to sign and date the aidavit. The affidavit confrrma zctiinacd to the city or town that the application for the permit or license is being zcqucstrd, not the Dcparhncnt of idustri-al Accidents. Should you have any questions regarding the law or if you arc required to obtain a workcrs' ,mpensa-tion policy,plcasc call the Department at the nur4bcr listed below. Sclf-insured companies should enter their If-awunmlGo liccmo number on the appropriate Hun. ity or Tow-t Officials case be sure that the afdavit is complete and printed legibly. The D cpartment has provided a space at the bottom 'tlic affidavit for you to fill out in the event the Office of Investigations has to coatact.you regarding the app)icant- case be sure to an in the permit/Eccnse number which will be used as a reference nitmbcr. In addition, an applicant rt must submit multiple pernoit/liccnse applications in any given year, need only submit onp affidavit indicating c=cnt licy information(if nrcessazy) and under"Job Site Address" the applicant should write"all locations in (city or A copy of the a$davit that has been officially stamped or marked by the city or town may be provided to the plicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit,must be filled out cash rr.Where a bnme owner or citizen is obtaining a license or permit not related fo any business or cornsacrcial venture :, a dog license or pcmoit to btirn leaves etc.) said person is NOT requirrd to complete this affidavit c Office of Investigations would 1t7ce to thank you in advance for your cooperation and should you have a y questions, asc do not hcsitatc to give us a calL Department's address, tcicphonc•and fax number. The Cammonwealth of Ma.ssaGhu. eC-t Depar mmt of Industrial AGCId�__}1ts Offke of Investig-at ons 6.00 washingtGn Street Boston, MA 02111 Tel. # 617-727-4900 ext 4-06 or 1-$77- IAS-SAFB Fax# (517-727-7749 . 11-22-06 vrww.mass.gov/dia f• ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: �'� (Ylo�c�,� Site Address: /L3 ��`�� print Town: t J Applicant Phone: t 09) 3-7L Zo-70 �— Applicant Signature: / Date of Application: ], S NEW CONSTRUCTION: goose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM _ Ceiling or Slab ❑ .Opti0n 1: Basement Fenestration exposed Wall Floor Perimeter Wall AFUE HSPF SGIR U-factor floors R-Value R-Value R-Value R Value R-Value and Depth National Appliruice Energy 3 5 R-3 8 R-19 R-19 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or greater as applicable Note: This form is not required if you choose either of the two.versions of REScheck as.listed below. ❑ Option 2: �. REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) IRE'Scheck--Web which can be accessed at http://wwvv.energ cy odes.gov/reschecly ,'ADDITIONS..OR ALTERATIONS TO`.EXISTING•BUILDINGS.OVER 5 VEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b a) ��►p SF 100 x /pp= 1.6 % of glazing (b) Glazing area-equals. j 6 ! SF 6 If glazing is <40%'tise.tlie chart below. If glazip :is>.40."/o proceed to "SUNROOM" section 780"CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter Fenestration Wall Floor .Basement Wall U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and De th 3 9 R-3 7 a R-13 R-19 R-7 0 R-10, 4 feet R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total 0 glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note:. Owner to fill out Consumerinformatzon Form (found in Appendix 120T) VEP, Town of Barnstable Regulatory Services RAx AS& Mass. Thomas F. Geiler, Director g4jp i63q. � rF0, ,ca 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 .AL wilder r �� as Owner of the subject property hereby authorize t M05C', to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of job) si e of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on tb:e reverse side. l Tovvr>! of Barnstable �pp(HErp�y yw Regulatory Services • Thomas F.Geller, Director sartxsrAmra, M`'S& Building Division PrFp �a Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.toym.barnsiable.ma.us Office: S08-862-4038 Fax: 5.08-790-6230 1101 fEOWNER 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. DEMITION 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. ROMEOWNER'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 1o9.I..1-Licensing of construction supervisors);provided that if the homeowner engages a parson(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption aie unaware that they are assuming the respons�bilities of a supervisor(sec Appendix err 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 Aith 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 Wshe 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/ccrtification for use in your community. • y — r .tom-••- a - ♦ - • 1 p .. .� �_ ,_ A a - .:� " � j .� z � i .. �. -. _ ... �I .. � �. �. . . ._ r .. . _ - - _ ._ _ .. . , - y V T . p '' � � � y •a R 1 � � Y 4 - 6.t . o� RightFax C2-1 7/29/2008 7:07-:41 AM PAGE 3/003 r-ax berver ACORD. CERTIFICATE OF INSURANCE DATE(MM\DD\YY) 07-29-08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE TD BAN"ORTH INS AGENCY HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 14 LOTS HOLLOW RD ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE ORLEANS,MA 02653 COMPANY 26T7F A TRAVELERS DIRECT ASSIGNMENT INSURED COMPANY B BRENNAN TIMOTHY DBA BLUEBOARD SPECIALISTS PLASTERING CO COMPANY , 117 SOUTH MAIN STREET' C CENTERVILLE,MA 02632 COMPANY D COVERAGE THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING AFFORDED BY THE POLICIES DESCRIBED BED HERON IS SUBJECT TNDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE O ALLTHETTERMS,,EXC US ONS AND CONDITIONS OF SUCH POLICIES.Y BE ISSUED OR MAY LIMIT SHOWN MAY HAVE BIN.THE EEN REDUCED BY INSURANCE PAID CLAIMS. CO POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER DATE(AAAA\DD\YY) DATE(MMIDD\YY) GENERAL AGGREGATE $ GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ COMMERCIAL GENERAL LIABILITY PERSONAL&&ADV.INJURY $ CLAIMS MADE OCCUR. EACH OCCURRENCE $ OWNER'S&&CONTRACTOR'S PROT. FIRE DAMAGE(Any one lire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ` ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED AUTOS BODILY INJURY(Per Accident).., $ SCHEDULE AUTOS PROPERTY DAMAGE $ HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY AUTO ONLY.EA ACCIDENT $ ANY AUTOS OTHER THAN AUTO ONLY: EACH ACCIDENT $ 5 AGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND A EMPOLVER'S LIABILITY UB-718X6879-08 03-03-08 03-03-09 STATUTORY LIMITS X100,000 EACH ACCIDENT $ THE PROPRIETOR/ DISEASE.POLICY LIMIT $ 500,000 PARTNERS/EXECUTIVE INCL DISEASE EACH EMPLOYEE $ 100,000 OFFICERS ARE: X EXCL OTHER DESCRIPTION OF OPERATIONSROCATIONS/VEHICLES/RESTRICMONSISPEGAL ITEMS THUS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE THE W ORKER S'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR BRENNAN TIMOTHY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE THE ED MORGAN EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 - i DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT 6H JOYCE ANNE RD FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. CENTERVILLE,MA 02632 AUTHORIZED REPRESENTATIVE Charles J Clark acoRo 25-5(Sias) 05/31/2006 15:52 FAX 508 428 6919 Goodspeed Insurance IA 001/002 ACORDq CERTIFICATE OF LIABILITY INSURANCE OP ID L DATE(MWOOIYYYY) JEFFR-1 05 31 06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Goodspeed Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 329, 43 Parker Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Osterville MA 02655 Phone: 508-428-6919 Fax:508-428-3774 INSURERS AFFORDING COVERAGE NAIL 8 INSURED INSURER Pravieeea W99*% Inwranw 15040 INSURER 8, JeffreyM. Morin dba INSURERC: J M Morin Con"ac�tor 55 Mountain AshINSURER0: Marston Mills MA ft648 INSURER E, COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIEB.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LT MAN NSR TYPE OF INSURANCE POLICY NUMBER_ DATE DATE(MM/091M LIMITS - GENERAL UABgJTY EACH OCCURRENCE $ 1,0 0 0,0 00 A COMMERCIAL GENERAL LIABILITY CPP0062504 06/23/06 06/23/07 PREMISES(EA 000W KO S f CLAIMS MADE DOCCUR - $ MEO EXP(Any aft pmaan) $5 0 0 0 I PERSONAL&ADV INJURY $ 1 000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE PLpIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICY dECOTT LOC Fire Dame 50 000 AUYOMOBILE LIABILITY - COMBINEO SINGLE LIMB $ ANY AUTO (Eaatxident) ALL OWNED AUTOS BODILY INJURY 3 SCHEDULED AUTOS - - - (PatParwn) HIRED AUTOS BODILY INJURY I NON-OWNED AUTOS (Par eoddenq PROPERTY DAMAGE i (Pereoadeng GARAGE LIABILITY AUTO ONLY-EA ACCIDENT s ANY AUTO OTHER THAN EAACC S AUTO ONLY: AGG S EXCESSNMBRELLA LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MADE AGGREGATE 9 DEDUCTIBLE } S RETENTION S - s WORKERS COMPENSATION AND TORY LIMITS I'JETRT- EMPLOYERS'UABILITY EL EACH ACCIDENT ; ANY PROPRIETORIPARTNEWEXECUTIVE I , OFFICEWMEMSER EXCLUDE09 I E.L.DISEASE•EA EMPLOYEE S tl es,Uy PROVISIONS P underVISIONS below EL DISEASE-POLICY LIMIT S S�C OTHER I DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Painter CERTIFICATE HOLDER CANCELLATION XO .GACOl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER INILL ENDEAVOR TO MAUL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Mogan Co. Inc IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR 68 Joyce Ann Road Centerville MA 02632" REPRESENTATWE& AUTHORIZED REPRESENTATIVE _ ACORD 25(2001108) 0 ACORD CORPORATION Isee DATE(MMIDDIYYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 03/13/2007 'RODUCER (508)795-0635 FAX (508)798-5008 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Small Business Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 542 Main St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Worcester, MA 01615 NAIC# Heather Belton INSURERS AFFORDING COVERAGE NSURED RJ FRANEY MECHANICAL SERVICES, INC. INSURERA Travelers Indemnity of Americ 25666 56 A NICOLETTA'S WAY INSURERe: Associated Employers Insurance MASHPEE, MA 02649 INSURER C: - INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR DD POLICY EFFECTIVE POLICY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBERDATE IMM1130MO LI&NM GENERAL LIABILITY I6803305CS67TIA07 02/11/2007 02/11/2008 EACH OCCURRENCE DAMAGE TO RENTED $ 1,000,00C. $ 300,00 X COMMERCIAL GENERAL LIABILITY S OO CLAIMS MADE X�OCCUR MED EXP(Any one person) $ , PERSONAL&ADV INJURY $ 11000,000 A GENERAL AGGREGATE $ 2,OOO,OOO ' PRODUCTS-COMP/OP AGG $ 2,000,000 GEN°L AGGREGATE LIMIT APPLIES PER POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE.LIMIT $ (Ea accident) ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY:EA ACCIDENT $ GARAGE LIABILITY ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ ~`\� AGGREGATE $ OCCUR El CLAIMS MADE $ DEDUCTIBLE RETENTION $ WC STATU- OTH- WORKERSCOMPENSATIONAND WCCSOO578SO12007 03/22/2 07 03/2Z/2008 EMPLOYERS'LIABILITY E. EACH ACCIDENT $ 1,OOO,OOO B ANY PROPRIETORIPARTNERIEXECUTIVE. ___ L:DISEASE-EA EMPLOYE OFFICERIMEMBER EXCLUDED?_ _ -- YE -- If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Heating Robert Franey is EXCLUDED from workers comp coverage. This certificate replaces any & all previously issued certificates. -CERTIFICATE HOLDER CANCELLATION a SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL F7 . . 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY Mr. Edward Morgan 68 Joyce Ann Road AN KIN UPON INSURER,ITS NTS O EP SENTATNES Centerville, MA 02632 A D RES / ACORD 25(2001108) FAX: (508)775-2731 ©ACORD CORPORATION 1988 04/22/2008 12:58 5088880550 ALMEIDA CARLSON INS PAGE 01/02 A--CC,�. CERTIFICATE OF LIABILITY INSURANCE DATE � PRODUCER PhonR(%M eW4=Fes (50M ees• M A(NATTER OF INFORMATION ALMEIDA A CARLSON INSURANCE AGENCY INC. ONLY AND Lg CER?(COWERS NO RIONTS UPON THE CERTIFICATE P.O.BOX 719 "OLDER. TIES COTIWICATE DOES NOT AMEND, EXTEND OR SANDWICH MA 02563 ALTM THE COVERAGE AFFORDED BY TINE POLICIES 08.OW. INSURERS AFFORDING COVERAGE NAIC 0 INSURED INSURER A: St Paul Tra Wom PAUL W SANDSORG INSURER 8: P0 Box I9 SANDWICH MA 02583 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWTINSTANDING ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY 9E ISSUED OR . MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS StMJECT TO ALLTHE TERMS,6XCLUBIONS AND COND=wS OF SUCH POLICIES.AGGREGATELBiR$SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. no ACM L1ii ZIfFmOFINSURANCE POUCYNUMM vaucvw1Q twc PatJCYEXPIIATIoa WMTS GE(iERALLIAMLftY 8B0S188BO1S 11M6I07 11l15/08 EACHOCCURIMCE Is 1.000.000 X Ctliv*ffRCIM.IIFAIERAI LU1&LrtY Pegw�6 eo o Is 300,000 CtAews MAoE a occuR MFJ).EIS(AM am Perron) s 5,000 A PERSONAL$ADVWMY s 1,000.000 GEHERALAGGREGATE $ 2.000,000 GEIILAGC,TtEC�11EL9lUfAPPL1ESPER PROOUCTS4;O PfOPAM i 2,509,ON POLICY PRC LOC AUTOMOBILELKNI FTY COMBINED SINGLE LIMIT Mitt AUTO (FA eecmenq ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Pe►pomm) s HIRE AtROS BODILY INJURY NON47AMWAUTOB <P"••�denq s PPRt ARTY DAMAGE S WAGE UABLITY AUTO ONLY-EA ACCIDENT s ANY AUTO - OTHER THAN EAACC i AUTO ONLY! AGO i Mtr.F88/Ue1BRELIALBIBAM EACHOCCLIRRENCE II OCCUR ❑CLAW MADE AGGREGATE ; DEDUCTIBLE RETENTION i S WDRI(ERBCOMPENSATIONAND y s m►IETI E.L.EACH ACCIDENT s OPFC01MOMM129iwoEM E.LOMEASE-FAEMPLOYEE s e�o re+eo�rl. saEeMlvrtaxanslse.le. EIDISEASE-POLICYLIMIT S OTTER: DESCRIPTION OF OPERATIONSILOCATION$AfO CLE&VXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCHES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.THE ISSUMt3 INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRnTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE MOGAN AND COMPANY TO DD 80$HALL DOSE No OBLIGATION OR LIABILITY OF ANY 90NO UPON THE INSURER. 48 JOYCE MN ROAD Rrs AGfNTs OR FEPRESENTaTIUEs. CENTERVILLE MA AMO RMEDREPRE$tWATnie AUsatkm: 5OI-778 Ml Maureen A.Rafmond ACORD 26(26DV06) C@KM=%111 47.40 0 ACORD CORPORATION 198E RightFax H1-3 12/27/2007 3:13:54 PM PAGE UO3/Uo:3 j�ax Server ACORD. CERTIFICATE OF INSURANCE DATE(MMIDDIYY) 12-27-07 PRODUCER THIS CERTIFICATE IS ISSUED AS AMATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HAROLD H WILLIAMS.INS HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 81 BASSETT LANE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE HYANNIS,MA 02601 COMPANY 728JG A TRAVELERS DIRECT ASSIGNMENT INSURED COMPANY ' B ASKEW DOUGLASJ COMPANY P0 BOX 1714 C COTIJIT,MA 02635 COMPANY D COVERAGES THE E TO CE nFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE ` POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . CO POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DATE(MMIDOWY) DATE(MMWO1YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE 8 COMMERCIAL GENERAL PRODUCTS-COMPIOPAGG. $ CLAIMS MADE OCCUR. PERSONAL&&ADV.INJURY $ OWNER'S&&CONTRACTORS PROT. EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Anyone person) $ AUTOMOBILE LIABILITY ANYAU70 COMBINED SINGLE LIMIT S ALL OWNED AUTOS BODILY INJURY(Per Person) S SCHEDULE AUTOS BODILY INJURY(Per Accident) $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS GARAGE LIABILITY : ANY AUTOS AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: t EACH ACCIDENT $ AGREGATE S EXCESS LIABILITY UMBRELLA FORM Q08-17-08 ACH OCCURRENCE 8 OTHER THAN UMBRELLA FORM GGREGATE 8 WORKER'S COMPENSATION AND A EMPOLYER'S LIABILITY UB-922X8895-07 08-17-07STATUTORY LIMITS X THE PROPRIETOR/ ACH ACCIDENT $ 100,000 PARTNERSIEXECUTNE INCL ISEASE-POUCY LIMIT $ 500,000 OFFICERS ARE- X EXCL ISEASE-EACH EMPLOYEE $ 100,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSAMMICLESIRESTRcnONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERnFICASE ISSUED TO THECE-RTINCATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR ASKEW DOUGLAS J. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE ED MOGAN THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRMEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE 68 JOYCE ANN RD. NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY.ITS AGENT'S OR REPRESENTATIVES ` CENTERVILLE,MA 02632 AUTHORUED REPRESENTATIVE ACORD 25-6(3193) Charles J Clark AC00. CERTIFICATE OF LIABILITY INSURANCE °05/1191200 'RODUCER 508-543-3131 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THE LOVELY INSURANCE AGENCY, LTD ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6 RAILROAD AVENUE ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P O BOX 374 FOXBOROUGH, MA 02035 INSURERS AFFORDING COVERAGE NAIC# NSURED INSURERA: ZURICH AMERICAN. MOGAN&CO., INC. INSURER B: 68 JOYCE ANN ROAD INSURERC: CENTERVILLE,MA 02632 INSURER D: INSURER E: OVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IND TED.NOVTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE M E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CO TIONS OF SUCH `POL-POLICIES TS-StIOWN MAY-I+AVE E EE-N-R-ED!4C-ED-B-Y-PAID-C{-A!>AS:-..---- --- -- — ----- - -- -._ VSR DD' POLICNEFFECTIVE POLICYEXPIRATION LIMITS TTYPFOF POLICY NUMBER DATE EACHOCCURRENCE $ GENERAL LIABILITY DAMAGE TO RENTE15-COMMERCIAL GENERAL LIABILITY _ PREMISES(Ea occurence $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL SADVINJURY $. • GENERALAGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS)COMP/OP AGG $ POLICY PRO, LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT- $; (Ea accident) ANY AUTO'.- ALLOWNEDAUTOS - BODILYINJURY > $ .. .(Per person) SCHEDULEDAUTOS - - - HIRED AUTOS BODILY INJURY'" $ _ - - (Per accident) NOWOWNEDAUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY,EA ACCIDENT S ANY AUTO OTHERTHAN EAACC $ AUTOONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE _ AGGREGATE $ $ $ DEDUCTIBLE RETENTION $ WCSTATW OTW WORKERS COMPENSATION AND _ X TORY LIMITS ER A" EMPLOYERS'LIABILITY 6ZZUB-9574A81-8-06 5/14/08 5/14/09 E.L.EACH ACCIDENT $ 100,000 ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED7 E.L.DISEASE)EAEMPLOYEE 1$ SOOOOO If yes,describe under E.L.DISEASE,POLICY LIMIT $ 100,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS USUAL TO THE OPERATION OF THE.INSURED CERTIFICATE HOLDER CANCELLATION - _ SHOULD ANY OFTHE ABOVE DESCRIBED.POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL- 10 DAYS WRITTEN TOWN OF BARNSTABLE I NOTICE TO THE CERTIFICATE HOLDS AM TO THE LEFT,BUT FAILURE TO DO SO SHALL 200 MAIN STREET HYANNIS, MA 02601 IMPOSE NO OBLI ,TION OR NY IND UPON THE INSURER,ITS AGENTS OR RE ES. AUTHOR D REP ESENTATI FAX 508-790-6230 i ACORD 25(2001108) A ORD CORPORATION 1988 Board of Building g Regulations and Standards HOME IMPROVEMENT CONTRACTOR l.icense.or reglstra toii`vaLd toL individul use only registratiori:N f - e or a the eahu atlon d,te It found return to: 100718 pad of Buitdi119 KegulatronS aril Standards Expiration t 6j23/20.10 Tr# 267851 Ooe ASIluurton Rlace Rm 1301 � tT- Pit to Corporation F3.o'siw�,ij7a 02108 1 MOGAN&CO.,INC f' Francis Mogan,Jr QYCE-ANNE RD i/ A _ ant "e MA 02632 Administrator — !;. N.. slid►►rt�tout signature I' :. '+ �gMtseyn'��@4 - �✓'uCOdCLCfLCIQ�.• � .� Board,of Building Regulations and Standards Coristructton Superviso#License LI ii s}: e.�CS 26071 Birthdate 10/3/1.947 I ' jjEz ra-� f x;Lp � =10/3/�2g09 Tr* 5081 Resfrlctlon"00 T Y',, c ;. 17 FRANCIS.E MOGAP tc; _ ' {. 68 JOYCEANN RD ' CENTERVILLE,MA 02632 Commissioner f�� BOISE- Double 1-3/4" x 9-1/2"VERSA-LAW 2.0 3100 SP Floor Beam1FB01 BC CALCO 2.0 Design Report- US 1 span No cantilevers 1 0/12 slope Friday, September 19, 2008 09:22 Build 276 File Name: E Mogan_Robards.BCC Job Name: J Robards Description: FB01 Address: 163 Seventh Avenue Specifier: Joe Madera City, State,Zip: West Hyannisport, MA Designer: Customer: Ed Mogan -Company: Shepley Wood Products Code reports: ESR-1040 'Misc: 2 -ar 12-00-00 BO,3-1/2" LL 720 lbs LC 720 bs 61, 0 lbs DL 1,496 Ibs DL 1,496 Ibs SL 1,800 Ibs SL 1,800lbs Total Horizontal Product Length=12-00-00 Load Summary Live Dead Snow Wind Roof Live Tag Description , Load Type Ref. Start End 100% 90% 115% 1330% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 12-00-00 20 10 06-00-00 2 Unf.Area(psf) Left 00-00-00 12-00-00 15 25 12-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 11,146 ft-Ibs 69.4% 115% 13, 1 - Internal Completeness and accuracy of input must End Shear 3,291 Ibs 45.3% 115% 2 ` 1 -Left be verified by anyone who would rely on Total Load Defl. U259(0.534") 92.6% 2 1 output as evidence of suitability for Live Load Defl. L/413 (0.335") 87.2% 2 1 particular application.Output here based Max Defl. 0.534" 53.4% 2 1 on building code-accepted design properties and analysis methods. Span/Depth 14.6 n/a 1 Installation of BOISE engineered Wood. products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2".x 3-1/2" 4,016 Ibs n/a 38.0% Unspecified or ask questions,please call B1 Post 3-1/2"x 3-1/2" 4,016 Ibs n/a 38.0% Unspecified (800)232-0788 before installation. BC CALCO, BC FRAMER@,AJSTA9, Notes ALLJOISTO, BC RIM BOARD- BCIO, BOISE GLULAMTm SIMPLE FRAMING Design meets Code minimum(U240)Total load deflection criteria. SYSTEM@,VERSA-LAM@,VERSA-RIM Design meets Code minimum(U360) Live load deflection criteria. PLUSO,VERSA-RIM@, Design meets arbitrary(1") Maximum load deflection criteria. VERSA-STRANDO,VERSA-STUD@)are trademarks of Boise Wood Products, Connection Diagram L.L.C. a I I I c a a minimum=2" c=2-3/4" b minimum= 3" d= 12" Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 06 The Commonwealth of Massachusetts Department of Industrial Accidents rp Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers -Applicant Information Please Print Lezibly Name(Business/Organization/Individual): 0G G,1 (") L Address: F-> -31.2t4 T City/State/Zip: v�(/L VV\,P Oat.3 Z Phone.#: �)0 7I G ;W-7 y Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with / 4. ❑ I am a general contractor and I �`� 6. Q New construction employees(frill and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet 7. []�'JZemodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 �uilding addition [No workers' comp.-insurance comp.insurance.# required.] 5. We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.)t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then lure outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sbeet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contmctors have employees,they must provide their workers'comp.policy number. lam an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Z�•:,r't,� Policy#or Self-ins.Lie.M r 7 Z U_R cis 7 y i Expiration Date: Job Site Address: LQ ScUL-J— Pt—n- City/State/Zip:'(„) � w� VVXA 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 crimirial 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 WA for insurance coverage verification. I do hereby certify und,q the pains•and penalties of perjury that the information provided above is true and correct Signature: Date: 6 /� 4/ I. Phone# Official use only. Do not write in this area,to be completed by city or town offcIaL City or Town: Permit/License# . Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for•the performance of public work until acceptable evidence of compliance azth the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificates)of insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested.,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town.Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit P multiple ermittlicense applications in any given year,need only submit one affidavit indicating current P policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit:. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone.and fax number: The C6mmonwWth of Mamrhusetts Department of Industrial Accidents Office of Investigati.Qns 600 Washington Street Boston, MA 02111 Tel. #617-727-440.0 ext 406 or 1-977-MASSAFE Fax#617-727-7744 Revised 11-22-06 www.mass-gov/dia oF'THE r Town of Barnstable Regulatory Services �QBA"GrAllIE� Thomas F. Geiler,Director -ijp t63q. �0 TFo„�,rA 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 Ry���5 , as Owner of the subject property hereby authorize �� JOGS to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Sign re of Owner Date VIQ Print Name . If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. ()-MPMQ•r)VVWPRP6RMLCQ1nV Town of Barnstable_ �OFTHE h Regulatory Services ` " Thomas F. Geiler,Director BARNSTABLE, v MASS. tes9. Building Division lf0 � 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, 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. ACORD. CERTIFICATE OF LIABILITY INSURANCE °05i19/2008 PRODUCER 508-543-3131 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION THE LOVELY INSURANCE AGENCY, LTD ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6 RAILROAD AVENUE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 374 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. , FOXBOROUGH,MA 02035 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: ZURICH AMERICAN, MOGAN&CO., INC. INSURER8: 68 JOYCE ANN ROAD INSURERC: CENTERVILLE,MA 02632 INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IND TED.NO TANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE M E ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY.THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CO TIONS OF SUCH —POLICIES:AGGREGATE-tlfittT-S-S"OWN#AY-HAVE EEA4- EDUCED-BY-PAID-C4AJMS----, INSR.ADD'L POLH:YNUMBER POLICY EFFECIMMIDDTIVE POLICY EXPIRATION4(Any LIMITS GENERALLIABILITY EACE $ TIllff- COMMERCIAL GENERAL LIABILITY - - PRErsnce S CLAIMS MADE OCCUR MEDerson) $ te. PERSONAL 8 ADV INJURY $ GENERALAGGREGATE S GEN'LAGGREGATE LIMIT APPLIES PER: + %,.f PRODUCTS,COMPIOP AGG $ POLICY PRO+ pLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALLOWNEDAUTOS - - - - BODILY INJURY SCHEDULEDAUTOS "' '(Per person) $ HIRED AUTOS . BODILY INJURY NON+OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY , - AUTO ONLY,EA ACCIDENT $ ANYAUTO OTHERTHAN EAACC $ AUTO ONLY:, AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE - AGGREGATE $ 5 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC + X TORYSTATU+ TH IMITS O R A EMPLOYERS'LIABILITY 6ZZUB-9574A81-8-06" .5/14/08 5/14/09 EL.EACHACCIDENT $ 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE - OFFICER/MEMBEREXCLUDED? - E.L.DISEASE>EA EMPLOYEE S 500,000 B Yes,describe under SPECIAL PROVISIONS below E.L.DISEASE>POLICY LIMIT $ 100,000 OTHER I DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS USUAL TO THE OPERATION OF THE INSURED 6ERTIFICATE HOLDER CANCELLATION SHOULDANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWN OF BARNSTABLE DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 200 MAIN STREET NOTICE TO THE CERTIFICATE HOLDS AM TO THE LEFT,BUT FAILURE TO DO SO SHALL HYANNIS, MA 02601 IMPOSE NO OBLI _TION OR NY IND UPON THE INSURER ITS AGENTS OR- RE ES. FAX 508-790-6230 AUTHOR DRE�ESFNTATI7 � i WORD 25(2001108) 'ACORD CORPORATION 1988 ( I \ Board of Building It and Standards. License or registration valid for►ndiviett use roily HOME IMPROVEMENT CONTRACTOR i before the expiration date.'.if found re!,urn to: ; Registration; 100718. Board of Bailding Regulations d Sta�c.:irds Expiration 6723/2008 . Trta 130119lug One Ashburton Place Rm 1301 :Type .Private Corporation Boston,Al i.-0210.8 MOGAN&CO.,INC' Francis Mogan, 68 JOYCE-ANNE RD ou=t s—ign-a tureAdministrator of vald th Centerville, 44 02632 -- I r wj - - - � ✓fie tr�artvrrea7uu :� ge ulations and Standards ' Board of Building g. Construction Supervisor License `. q f License: CS 26071 i Blrlhdate�10/311947 5081 (EXp ra,ot 0/31b2009 Tr# f2 Rt E 1esnctro 00 i y FRANCIS 68 JOYCE ANN RD� _ Commissioner. CENTERVILLE,MA 02632 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ++e Map - Parcel Oil Application # 0 ®-6z Health'Division Date Issued ; roz�S��-y7ZS Conservation Division �/1Lo6l Gf Application Fee . i . PlanningDe pi. Permit Fee U " Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address c-.e.>c,,4L, Village Owner 1`�y �cQS Address Telephone , ` i Permit Request st�c.�\ r►cJ �e�� d cw.ycY� 2.,�, ��lac -c-v� nc W;+•.���.,s n t-w-i��L. c�� c�c�u✓ CA,.�Q M.t��` 'V1 c,.J rYr�u✓ � A s � Square feet: 1 st floor: existing 122 Eproposed 55-0 2nd.floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ru,/C Project Valuation Construction Type u �ar Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sup'portingcumentation "°ter- Dwelling Type: Single Family W' Two Family ❑ Multi-Family # units Age of Existing Structure t Diu Historic House: ❑Yes U-No On Old Kings` laghway: ❑YEFsd Ul-No w Basement Type: mull O'rawl ❑Walkout ❑ Other } �- Basement Finished Area(sq.ft.) -- Basement Unfinished Area (sq.ft) A2LO w- sw. Number of Baths: Full: existing 3 new Half: existing new Number of Bedrooms: 3 existing _new Total Room Count (not including baths): existing 6 new First Floor Room Count C Heat Type and Fuel: lrGas : ❑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 CK Telephone Number S&S ??C 20-y Address G `a License # 2 c,v7/ w VVI-A u 1 (_3 -L Home Improvement Contractor# /GC) -7 I l Worker's Compensation # t Z Z-u 516 ALL CONSTRUCTION DEBRIS RESULTING /,FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 1 s DATE 6/SkD� ,* ._ f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION y� FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING � r DATE CLOSED OUT Fx ASSOCIATION PLAN NO. A o - o ZONING DISTRICT: RB DISTRICT. MIN. LOT SIZE 43,560 SQ. FT. roigv' e B o h R MIN. LOT FRONTAGE 20' MIN. LOT WIDTH 100' MIN. FRONT SETBACK 20' r st MIN. SIDE SETBACK 10 Locu MIN. REAR SETBACK 10' eon MAX. BUILDING HEIGHT 30' LOCUS IS WITHIN FEMA FLOOD ZONE B & Al (EL. 11) Q AS SHOWN ON COMMUNITY PANEL #250001 0008 D DATED JULY 2, 1992 (ELEVATIONS BASED ON NGVD) TIDAL CREEK GREATER THAN 250' TO PROPOSED DECK -Nantucket Sound WETLAND RESOURCE AREAS FLAGGED BY VACCARO ENVIRONMENTAL CONSULTANTS LOCUS MAP EXIST. CONCRETE WITHIN 50'.BUFFER ZONE TO C. BANK = 602 -SF. SCALE 1"=2000'f PROPOSED DECK WITHIN 50' = 417 SF. ASSESSORS MAP 245 PARCEL 49 (NET LOSS OF HARDSCAPE = 185 SF) - SITE IS LOCATED WITHIN AP OVERLAY DISTRICT EXIST. 3 BEDROOM SEPTIC SYSTEM, INSTALLED 2001, TO REMAIN BENCH MARK — CTR OF (NO INCREASE IN BEDROOMS PROPOSED) C.BASIN EL. = 8.85 DOWNSPOUTS TO DRYWELLS PROPOSED TITLE 5 SEPTIC SYSTEM IS IN I FRONT YARD SM 105 AREA OF. I 9fl8 85 M111GA'ION HEDGE PLANTINGS M"FORRIM91� MR! 140'f _ PAVED PLANTINGS i 6.93 . v 47 DRIVE 1 593 8 1-2----�r-681--16.95 9 D' 26.7_ _ 61 f I la 1.08 ; 41. (O .. X y6:1 6.20 �' �: 7.0 EXISTING DWELLING' LOTS 552 & 554 SM 104 9, I 1 / ., FF 11.1 11.400t SF (UPLAND) O I✓ wi ` W W W OD Ig o /6 Sz X Je _ _ ._ - —EXIST. a . J ti CONC. ° PROP. 24' x 24' SALT MARSH % X X �� PATIO 2> SECOND FLOOR - 10 .75 � U) 1 6.45 LAWN (REMOVE LL 33°aa ..�. .: ° ADDITION 9.37 I of PATIO UNDER I: ° (WITHIN EXIST. ❑ ❑ .67 R� I z 91 DECK) ° FOOTPRINT) ❑47 9 SM 103 g 4 \t'07 FAX I °o� PROP. ° y �9 I a� DECK ° a\. APP. d� I °\ SEPTIC SM 102 6 I 7 .�, 743 °7.46 AREA° 1:� SYSTEM �I \'f \ g r\OX . 1 - - � 55 f/ 1 -•__-mott 4 6 EXIST. PLA NGSOi g0 9 °. l _. 7. 9�G82 O g 0 25. co \ ° K7RE o 1.9-30 SM 101 ��� 9Vw ^� HEDGE HEDGE \ 5. 5 4.79 1 2 IRON PIPE 117.4' CONC. BND�T� IRON PIPE CONCRETE & CONC. BOUND �A\ FLAGSTONE F` 1 1 PATIO s W/BBQ 41-v, THIS PLAN IS FOR THE PURPOSE - OF OBTAINING CONSERVATION COMMISSION APPROVAL AND IS NOT TO BE USED FOR LOT LINE LOT 550 STAKING OR ANY OTHER PURPOSE. Scale:!"= 20' 0 10 20 30 40 50 -.FEET SITE PLAIN off 508-362-4541 fax 508 362-9680 SHOWING PROPOSED DECK ' & SECOND FLOOR ADDITION IN down cape engineering,- inc. - W. HYANNISPORT Cl VIL ENGINEERS LAND SURVEYORS y�kA�jH oF,ygssq NTH OFM o� DANIEL `yam . � ASs9� 163 SEVENTH AVENUE 939 Main Street — YARMOUTHPORT, MASS. N o? y� - o q. � � DANIELA. �, PREPARED FOR OJALA CPo OJALA 0.40980 CIVIL N JEFF ROBARDS 46 3�27(D� MARCH 27, 2008 o Fs , 810 A I S 07-338 DATE I L A. OJALA, PE, PLS 07-338 ROBARDS BASE.DWG (DDF) - W q On cEvnnC�. %SJd" Ce'-%S,'@" Ce'-%Si@" -%�•.J@" r f!4" n � ^6 o"on n6n6 n9w J& f � j , aimpr.ons bM rd1 r a,Hur. r O' n � „ � I I B"p�z 4'-U"hono+ubamf 4 O"payfou+m I I Illplll Iryryl pour"j bonus+'dsck pie.-�wf sainp..anm I I Le Ml4 4 po..+bate..f+yp.l I I � 1 I I O i j I J I I 0 �Pr LILJ_- I m,p«ns ai-tars H Nryr a'ppfHlplur pry' epp�+�ix 0 r ts"a.�. ` r ` r I n t�I FHH- p F Z @ ioi.+c® r.a'o.<. H II 11 Y Ilan W I i pigfoc+s`-1 poured eonbrs+e deck 4�f,.j wf aaimp,.anm X L I w ^t. an93:i-jars'LU�Z @ hp nger d r fs"o.c. _ LL pJ4 4 po a.F ba c++l+yp.l a >aimp.ons ri+ens r 4 h Ifl II II II q s,imF�,ns a,-iars L u�1 @ hang.d r to•"....�. , i I I � ! I I I I ----------i ---- ------ 3 >r -----� ----------------------------- ----------------- m I I w � I �1FIE=foT'FLG�G��-Fh1`1 I10° goals: r14„_ I,_o„ I O ... 0. 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IV-p—c 4TP11 I/4"y D"auswom f 0"0.4. � ,---p.T.K y l 0 r?sck J oi..•hs a r G"oc. v 0 • ... ...... 1 %��.rpanno 2.}-{pro{{r hJrr�GAns �-1'.T. ..i.....L....i.. �fl�xtaaono zM..ya AG 4 1-4,Lwp F.T.4y4 auppa 4,Fa4,1- h d.Ma%,LGpD 4 4 Fo 44 fa + � �' y '�- a ,:✓' << iBc�"�,b �+ }} j # j «a 0 m &"b�4'-0"r7ono+ubsl I2 yfaa+r+B C $���^•� °'�� a 12 K n�� DRAWING TYPE: FoundA l on plan FrfmmA pl.,n r-,)aLk heLVvn SHEET NUl•1SER: A100 or— � m maw 00 tl y Q r Cy 0= 0= fl J c_ 5 r+ S A 0— Ha,.+-N-Glcm 4—li,,az+1r.n+ S r r r!Z"(4s p—a firsplple.'4-000TFIA G Fr.Y%r ofra mina Q Up PYG mr Pibmraf p..c rPl nq�Y�+am Andmrtcnm rwz 8 46 ; M-V inm S/a%e la civa+am of Llrr -r-r/Y" S'-r I r/Z'r i+s p—ul 4aXI�rI NG PAMI LYF- ,VMI PINI NG '"9'Y -4 K 2 r-7" p` g N o c Wi y ankh+cokha r.m,AYn-d artmnm TY494 S0&e ,AL G!8 �f Andr. r v r84-9 ! 4 v f UP— �:12 to L. -.-.�. 9.W..o�.. w 0 'V b <E -.�. c.L..g�- 4r --------- a�-- y�p=a m 6�t 3 4 L w B m m p�Fj C �e2i«� wON a a m mo aS,« w0` o nasr+ J � pLAq =J J Ke 3=� DRA YVIN&TYPE. All new w odl—.shall L-pro.,ided Mr5k f loor PIA n w�+-h weed t+r�[.h ir-a l pane k w�+-h a m�n�m�m+h�cknec.t eF 7f f Cm"and a ma%mom cyan eF e'yh+fee,. Fallow y ac c.r Talvle 5 1�o r.4.r.4 5HEET NUMBER: -For facts n mm)c.;he d 0 le. �4200 m ���da3i nEa R `E � � VO�a�VVo�oa O Q F7�- IF-7 ® L ® < o El MIME S � I I I --------- ---------- J --�I IL-----II LI------- I I I I I I I 'T ___________________________________ L--------------------------------------------J ra No rHCLOVATION E=A -- -- L-------------------------------------------J d -! Q ��vaurH eLevkrlc�N Q �) '�v m x Jr- .._ . ...z .. B yi IL� a fl M- IrL----------------------------------------- _____________________________J ---------------------------------------J �3L�rE g.8'dc n\titi r LayAT-1oN m�a�s 4 id3� DRA MIN&TYPE: Ela.lak�ana SHEET NUMBER: A ;,00 6o E�i=«„A'L' y S 6E°««fin 6RE 1. 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L r k � H Y, t wAse h rs and nUks in GonGCeke x 4 x fookind, y;, ;: f 2"�pouredGonGre+efoPkm�, �y�a�� �� F � 4'"., "�'.•, .. .. ..?� tk ?"r3�':y rrt,y��� Q�3�-�E�E 4(1 L J xis« gns 9 c L ua W AO F,RA YVIN6 TYPE: 5HEET NUMBER: 0 } } G d ��' 06'o��g^ps°• Ean� o d L O w c O i O _O L yyy OF4- n �`�. r-A TING PAMILyp.00M/PINING V/�• Lr 494X4f 7 C L > -� L Q 9 r!4"x 9 r/4"V --Lp 4 11+o I,^.,aw , �} `�Q •r — — 4x4+c..alid basr nq a x .r.^hd b s wr mq '-----1 I I Ii I-_-•I p�.�,I ® Andxcenm 7'W44%G } P ♦ Q r .. r Andur%nm AW 4 B r 0 I r w - .+<rw. o mw- rum PG r e ; ro -_...._ 0 f I ® hndrra Il W4 4 4G7 Q -...U �_ I r � !B"x 4'-e /9" Mdo-r .AWEBr LI"144 R-9oM ..- GGC77R-G'CM' C- J A. d �t d e t V o r : ' D r i r w -A P rar FLaO�PLAN Q p� € All—wmd-4A bs PrmvUsd mp s$o mm;mum+hGknsttoFYfrG"wndw a'omo� L g, +nwxlmu,n LPwn of syh+-fss+. Follow Y aP G yy JL 7'1fs Twmis 500 r.S.r.$for fwa4sn�nmr aGhsduls. r am a 1 } } Ua 4 DRA ININ6 TYPE: F�trsk floor Ill,-n SHEET NUMBER: A2 00 nth' a°E��3a„ar o� asa `2A1 4a « u J� F } 7� O ® lL L. Li w` � L � xx S s�� 1 I I n0 < _S --------------------------------- 4 01 ___________1 I (� I �l - ___------- A- IL___________________________________________ r5l1 NCP-rH Lev/noN L-_________________________-__-______________-______-____________-----__-________________ � _JJ A. r/a'- r'-o^ t n \ v Q IU 1— � Q 0 � � o 6 2 Cb .. L. � V.4Am.. U F b! FFR i .0=1i l Fh �N s a;sµ s I a=85 0 � ¢ I ___ I I I $a�ga,�- l i i I I I I I I I I _ 9 I I I I I I I i t 1 I kq�'9�= >+ L_____ J II II II II II omo� n L r i -- - L----------------J �--� �-----� L------- J L IL-- --- , --- }�� ---- E}�J --- E��-- t.-�� !��\ I I I I I I I I m z a$_m a 4 4 L----------------------------------------------------------------------------- ------------ E__� E__� E—� E❑_d L�w��r�Lev/.rlaN 'I acals: r;a o" ts` �vourNuLGVhrla}7 f Ja"- f'-t" L•R.A 4VIN6 TYPE: Iz,,4,oOtis SHEET NUMBER: 500 0 ZONING DISTRICT: RB DISTRICT MIN. LOT SIZE 43,560 SQ. FT. vil e B a h R MIN. LOT FRONTAGE 20' roig MIN. LOT WIDTH 100' Cb MIN. FRONT SETBACK 20' r st MIN. SIDE SETBACK 10' Locu MIN. REAR SETBACK 10' � on MAX. BUILDING HEIGHT 30' LOCUS IS WITHIN FEMA FLOOD ZONE B & A10 (EL. 11) AS SHOWN ON COMMUNITY PANEL #250001 0008 D DATED JULY 2, 1992 (ELEVATIONS BASED ON NGVD) Nantucket TIDAL CREEK GREATER THAN 250' TO PROPOSED DECK Sound WETLAND RESOURCE AREAS FLAGGED BY VACCARO ENVIRONMENTAL CONSULTANTS EXIST. CONCRETE WITHIN 50' BUFFER ZONE LOCUS MAP TO C. BANK = 602 SF. SCALE 1"=2000'f PROPOSED DECK WITHIN 50' = 417 SF. ASSESSORS MAP 245 PARCEL 49 (NET LOSS OF HARDSCAPE = 185 SF) ,SITE IS LOCATED WITHIN AP OVERLAY DISTRICT C` EXIST. 3 BEDROOM SEPTIC SYSTEM, INSTALLED 2001, TO REMAIN t BENCH MARK — CTR OF (NO INCREASE IN BEDROOMS PROPOSED) c. C.BASIN EL. = 8.85 DOWNSPOUTS TO DRYWELLS PROPOSED TITLE 5 SEPTIC S STEM IS IN I FRONT YARD SM 105 AREA OF � I ®�85 EDGE MITIGATION 140't PLANTINGS PAVED 0) PLANTINGS g �� 6.9, � CO DRIVE 9 5 93 -fr1�---� -�6.95 9 — — — — 87 0' ' co %� X y6:1 6.20 �� 7.0. EXISTING DWELLING LOTS 552 & 554 SM 104 47. 9 I I/ FF = 11.1 11,400t SF (UPLAND) O / I `/ I ` vV -W W AL,J m r t' CONC. PROP. 24' x 24' SALT MARSHN I I ; PAT10_� ° SECOND FLOOR 70 LAWN Y (REMOVE ALL ADDITION 9 37 6.45 W' 7 33 1, a\ WITHIN EXIST. ❑ �, I o: PATIO UNDER a ( [�❑ 67 7 z 3� DECK) FOOTPRINT) ❑ t7 3i 7.07 ' SM 103 0 �^X ° ' PROP. - 9 4 \\0 o 9 W: DECK a� APP. \ ° °\ SEPTIC C SM 102 3 \\ 6 I a^°0° 1° SYSTEM �I \� 7.46. AREA 9 Q \ 6EXIST. PLA TINGS ,�0. 7. 9 \ G� 5 9 ,Y a _ 4 L 25 o °o \ o SM 101 6VW �° `b-��. HEDGE HEDGE 5. 5 � 4.79 1 2 g W IRON PIPE 117.4' CONC. BND�T� ON PIPE CONCRETE & ��'\ CONC. BOUND 1 1 FLAGSTONE ( PATIO 1 W/BBQ � THIS PLAN IS FOR THE PURPOSE �Lr OF OBTAINING CONSERVATION COMMISSION APPROVAL AND IS LOT 550 NOT TO BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE. Scale: 1"= 20' 0 10 20 30 40 50 FEET SITE PLAN off 508-362-4541 fax 508 362-9880 SHOWING PROPOSED DECK & SECOND FLOOR ADDITION down cope engineering, inc. IN W. HYANNISPORT Cl VIL ENGINEERS — LAND SURVEYORS OF OF yASSyc ��1H OF MA S S 163 SEVENTH AVENUE 939 Main Street — YARMOUTHPORT, MASS. ��� DAIEL yG DANIELA.�cy�N PREPARED FOR OJALA a o OJALA - 0.40980 CIVIL N JEFF ROBARDS 9 P o 46 <gNFFss�o o`�` r �� 'rj�27���$ MARCH 27, 2008 DATE I L A. OJALA, PE, PLS 07-338 07-338 ROBARDS BASE.DWG (DDF)