HomeMy WebLinkAbout0043 STATICE LANE V y!L��C�� C� �C� �
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Town of Barnstable *Permit#
Expires 6 months from issue date
Regulatory Services Fee
Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint_
Map/parcel Number /0 0 ;�I..
Property Address 3 ,� :Z SLI (,(1111��1 P1 Cl: 1'O J
(Residential Value of Work (o , DO C) Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address C
V 3 S a 6 o J
Contractor's Name Gam- CZ-,t4— Telephone Numbers
Home Improvement Contractor License#(if applicable) o°Z S 3�0
Construction Supervisor's License#(if applicable) C
Oworkman's Compensation Insurance ESS PERMIT
Chedl�one: -)(.PR
❑ I am a sole proprietor APR 2 3 2008
❑ I am the Homeowner
ZI have Worker's Compensation Insurance -FOWN OF BARNSTABLE
n
Insurance Company Name T 6- ( �Ulm
U
Workman's Comp.Policy# 0 9 5O L. 3 5 6 o `
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
3-Re-roof(stripping old shingles) All construction debris will be taken toQ
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
_-.
***Note: Property Owner must sign Property Owner Letter of Perm
ission,
_A copy of the Home Improvement Contractors License is required.
SIGNATURE:
Q:Forms:ezpmtrg
Revise061306
The Commonwealth of Massachusetts
Department of Industrial Accidents
- Office of Investigations
' 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information ,{_ Please Print Legibly
Name (Business/Organization/Individual): ��} �'� �Q/(��1- LU—C' I C�'A-)
Address:
City/State/Zip: ( °d�,( L- -� iN- QZ,3_5Phone #:
Are you an employer? Check the appropriate box: Type of project(required):
1.X,I am a employer with_ ?f> 4. ❑ I am a general contractor and I
employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
workingfor me in an capacity. employees and have workers'
Y P h'• 9. ❑ Building addition
[No workers' comp. insurance comp. insurance.$
required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.KRoof 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 a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. 1 11 �
Insurance Company Name: ��Z 77'7n__r�Ey
Policy#or Self-ins.Lic.#: 0 '9 5 0 L 3 5S0� Expiration Date:
Job Site Address: 3 S ram oC aL,` City/State/Zip:—A
A P NO 64
Attach a copy of the workers' compensation policy declaration page(showing the policy num er and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi er the ains and flies of perjury that the information provided above is true and correct.
Signature: Date: l L� .3`
Phone#: c�O o� /ooC
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
One Ashb �®, �,� d S$a.d
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FRASEp ®NST ReglstMtlon: 112536 i
DEAN F R[1CTI®IV Co. fie: 0Sq
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CONSTRUCTION SaO.y l�®ft�3M ®�1®�
55g�T 2�ER
COTUIT,MA a2835
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PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTF,R OF INFORMATION
WISE & QUINN INS AGCY ONLY AND CONFERS NO RINTS UPON_ THE CERTIFICATE
449 PLEASANT ST HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIEi BELOW.
BROCKTON MA 02301 COMPANIES AFFORDING COVERAGE
24WCB COMPANY
INSURED A HARTFORD UNDERWRITERS COMPANY INSURANCE COMPANY
FRASER CONSTRUCTION LLC B
PO BOX 1845
COTUIT MA 02635 COMPANY
C
COMPANY
y,� D
HIS IS TO CERTIFY :.....::.:.::::::.r...:.::.::... ::....:..::.::.:<•::::.;.;::;;:.:x:::::;:.;;:;:-;::;:.:.:;.:;;;:.;::......:.:.::.:.::,::.:::.:.:.;;:.:.:.;;:..:.>;;;;:.;;:.;:.:;•::::::
THAT THE POLICIES OF INSURANCBEEN ::::.::.:.r.:::.;:.;:. ,: >:_:_<::«:sis::;':E:>>s>::>:<;:::::: »:<:>s:::>;<:::>:::<::
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM ORCONDITION OF ANY CONTRACT ISSUED OOR OTHER THE RDO DOCUMENT WITH ED NAMED E FOR THE POLICY.PE-RIOD
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.
E OF INSURANCE CO
LTAR TYPE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
GENERAL LIABILITY DATE(MMIDDX" DATE(MMIDDIVY) LIMITS
� i
COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $
CLAIMS MADE1:1 OCCUR. PRODUCTS-COMP/OP ARG. $
OWNER'S&CONTRACTOR'S PROT. PERSONAL 4,ADV.INJURY $
EACH OCCURRENCE $
FIRE DAMAGE(Any one fire) $
AUTOMOBILE LL413JUT V MED.EXPENSE(Any one person) $
ANY AUTO COMBINED SINGLE
ALL OWNED AUTOS
LIMIT $
SCHEDULED AUTOS BODILY INJURY
(Per Person) $
HIRED AUTOS i
NON-OWNED AUTOS BODILY INJURY
(PerAccldent) $
GARAGE LIABILITYI
PROPERTY DAMAGE $
ANY AUTO AUTO ONLY-EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
EXCESS LIABILITY AGGREGATE $
UMBRELLA FORM EACH OCCURRENCE $
OTHER THAN UMBRELLA FORM AGGREGATE $
A WORKER'S COMPENSATION AND
EMPLOYER'S LIABILITY (6S60US-085OL35-5-07 STATUTORY LIMBS
THE PROPRIETOR/ 09-26-08 �•���%�=�%��--
PARTNERSIEXECUTIVE INCL EACH ACCIDENT $
OFFICERS ARE: X EXCL DISEASE—POLICY LIMIT $ I
OTHER DISEASE—EACH EMPLOYEE $
500 000
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DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/pESTRICTIONS/SPECIAL ITENdS
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THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATEHOLDER AFFECT I ING WORKERS CO
..........::.�:.�:::._::::.::.;:.;:_::::;.::;.::.:;;:.;:.:::.:�;:.;::.:.;:.;::;.::.;:.:::::;.;:�:.;:;.:::;;;:-;::.;;:.:.:;• .. :..; :. . :.::.>•::.:.;:.:.:�:.;:;:.;:::.;:<:.;>:.:.;>;;:::.�:::::::.::............. COVERAGE.
wo
SHOULD ANY OF TILE ABOVE DESCRIBED POLICIES BE.CANCELLED BEFORE...THE
EXPIRATIOPo DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ERASER ENTERPRISES LLC 10 DAYS WRITTEPo NOTICETpT9gECERTIFICATEHOLDER NAMED ToTHE
PO BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
. COTU IT MA 02635 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA
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�ONsrRUcnoN Fra
3er c
on S tru c tl®11
P.O. B LLC
ox1845 �
508. Email: Cotuit MA. 02635
428_2292 fi aser construction
veri
se zon.net
'oofing.com
FAX 1 511_428-0123
RZ-R® f� -�r-
0ATE: March 31� 2008 OFING ®?®���
jgiME: Aaele Gaviaas
SAIL ADDS: same PHONE: 5pg-775_3578
JOB ADDR�S: 43 Statice PHONE: 774_
Laae H 48'-1586
��SEIt CONSTRUCTIONYaaais, MA 02601
a d professional like hereby pro
specifications and local building ner and in a proposes to perform the folio
-Rernove
-Re-nail all d Haul away l code.f ice with the nl�uf�u errvices in a neat
plywood sheathing a e old needed fmg material
.._.
wu I and Install
arranty, 5 year Sure SRTAINTEED LAND
,,t,a Heavy Weight, Self Set Protection, CL SSRK / DDSCApE
Based Asphalt Shin fig, Multi - A.FIRE .. R 30. 3
Bull 10 Year WarrantY a New Engl MWs Layered) ArchiteRcAtu S. 0
a Resistantar
resistance warranty or g against ALGAE Cont Exclusive COppER/CE le, Fiberglass '
S� nails in common bond 0 mph win -resi . 5 Year 70 1VIIC Stones with,
Spec details d-resistane ph wind_and mutations. ' for an additional c e Warranty available
ost. See actual warranty for h
Color
**payable by check imme PRZ E- $6,000
ly up°n cOmpleti *Initial q-!�von �
&u j & Install = Certain
Waterproof
Winter- Guar
vane proof,Underla d: (ice g� water
Ys, 18 Yment S ste shield)
°n rakes, walls Y m (3ft. on eves and
Su 1 da Install--:Roof er's and skylights)
Select Underlayrnent paper
by CertainTeed)
(as recommended
Reuse Ex�stin - Hick's Ventilated Dri =
&u l Install -Alumina p Edge (REUSE STING)
Install - & Neoprene Soil pi
Su 1 & Aar Vent m pe plashing
Ridge Vent (as recornmen -----. ..
Cleap�a Remove -Debris fro � ded,by Cert
m work ainTeed)
area daily,
X4 Star Warranty Upgrade will be applied if proposal is signed and
returned within 10 days. (see enclosed brochure)
NO MONEY DOWN- NO Payment at the start or part way thru
Payments accepted are:
CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS
*Any payments not made within 30 days of completion will be charged 1.5%for every 30 days the
payment is late.
Possible Extra -After the shingles are removed from the roof, we will lift one sheet of
plywood to make sure that the insulation is not up against the plywood sheathing
preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be
installed by; removing the plywood sheathing, installing the panels, turning the
plywood over and then re-installing the plywood. If needed, this would be charged for
as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6
Panels per sheet of plywood.
Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing,
lead flashing, or other carpentry needing replacement will be done and charged for as
an extra at the rate of$55.00 per hour, plus materials, plus 15% overhead mark-up
on total extras.
FRASER CONSTRUCTION Warranties the labor for 12 years
FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years.
CERTAINTEED Warranties the shingles and labor 100% through the Sure Start
Warranty duration.
CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the
Sure Start Warranty depending on the shingle that was purchased.
Any deviation or alteration from above specification will be executed upon written
orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents or delays are beyond our control. Owner should
carry fire, tornado and other necessary insurance upon the above work. We, if not
accepted within thirty days may withdraw this proposal.
FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public
Liability Insurance on the above work, certificate available upon request.
DATE OF ACCEPTANCE:
Homeowner Fraser Construction, LLC
Assessor's office(1st Floor): Q g( 1 0 PC ES. SEFMC sY ` T `
Assessor's map and lot number vZ 7 3, ����� THE o e
Board of Health(3rd floor): / INSTALLED IN Com��p 9-
Sewage Permit number O Y ` gyp .
WITH r�T L4� � Z BABIISTSDLL i
Engineering Department(3rd floor): �//�� °� ��, � � 9 rasa
House number 'tom CjS' R ' ���`"` a}9'
Definitive Plan Approved by Planning Board — 19 TOVIA`REGULA, l 106
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO C�UN�%�V�� Iq S/'41G� I`;IlnlL
TYPE OF CONSTRUCTION I'a0ze)p f �
cl2f x IL /.2- 19
TO.THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location (-oT -!-02 2 -rzC d- LeguE /--ly.4AjA//S
Proposed Use
Zoning District C— Fire District YAIIVAI`s
Name of Owner , A9 YJ/1)F I.3(✓1 LI)IN& Address 6r- d•. /34 D( �f.� ��Al-l-EX V 1
Name of Builder 5 Address
Name of Architect Address 7- T
Number of Rooms ' Foundation �d bl� Gd A/C lC',C Tit
Exterior 66410i3dd iieD 5 111/"/51-C Roofing q S /1 A4L 7—
Floors c d,6/�Z Interior 101NE `- C-1P SUM
Heating Ho / !W&/g/C Plumbing f 1/C CI)PP6e
Fireplace CoNC-,eF—T6 /3 LQC K 16/e l C K Approximate Cost ` o (vo
Area
Diagram of Lot and Building with Dimensions Fee
�0
C
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 or,
Construction Supervisor's License
1
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s
BAYSIDE BUILDING CO.
No 33727 Permit For One Story
Single Family Dw 11 ; nq
Location Lot #2 . 43 Statice Lane
Hyannis '
Owner Bayside Build; n!q Co
Type of Construction Frame
Plot Lot '
Permit Granted. May 3, 19 90
Date of Inspection 19
Date Completed `,Az 7Ad 19
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y •� .; J ,.w a.y,-..-+� c.R ...w �,,.+.«f.r'ip,:;r'..* -T11-1- t;.'w'
411 Ad
Assessor's office(1st Floor):
Assessor's map and lot number (9P'(- 1;7S• d'"Q�of THE>O�♦�
Board of Health(3rd floor):
'C Sewage Permit number
t BAUSTADLL i
Engineering Department(3rd floor): rnaa
House number
Definitive Plan Approved by Planning Board - r 19
APPLICATIONS'PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only G
TOWN OF BARNSTABLE
M
BUILDING INSPECTOR A-
APPLICATION FOR PERMIT TO 5/If/G1_4� rlIiJ/� �fO�E s i
TYPE OF CONSTRUCTION f,(/(�J 15
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location 1-07- �a / ST�77ee- LiaAu,,e;- 1-4/,NN/S
Proposed Use
,Zoning District Fire District /7 y/9AXAIPs
lame of Owner 0� Y.� /�3f' f�U/L IAI tp Address 6'. (�. /34 Y '9�
Name of Builder f Address
Name of Architect /- , l 4 5 6&,W Address C,�70 l 7-
Number of Rooms Foundation 1,0/)6/ D CdNCRZ-7 T,
Exterior
11'Ltlf/JdAe1Q S II/A164C Roofing � Pd?q- 7
Floors � /� Interior �/V (Y-
Heating ' /1-5 IV 0 7 W A T FAC Plumbing JAY C
Fireplace QWCeCTr J3LOCK Y ►e/CSC Approximate Cost /00, 000
Area
Diagram of Lot and Building with Dimensions Fee
C '
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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.
r
x. Name
Construction Supervisor's License ��� J�`' ���
BAYSIDE BUILDING CO.
No 33727 Permit For One Story
Single Family Dwelling
Location Lot #2, 43 Statice Lane
Hyannis
Owner Bayside Building Co.
Type of Construction Frame
Plot Lot
i
Permit Granted May 3, 19 90
Date of Inspection 19
Date Completed 19
PERMIT COMPLETED 1/1/-- L
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- >e7 snt-aetPPROVED
--—
L -- —. — — HAN �s�Ys�n
- - —' _
-VO—WkOF BA NSTABLE
Building Irpectamr, Department
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FRONT ELEVATION
• ;! � G.W W.A.
CEILING ASSEMBLY 1.
TOTAL R= 3/ G r1 .
_TOP SURFACE U= 6 3 WINDOWS:
��
R=0.61
9" FIBERGLASS
INSULATION -
SHEETROCR , i
— DOORS
—�r -i R 0.45 - L9,
`—BOTTOM SURFACE -- ---
/ i� R= 0.61
1/2"PLYWOOD_ T —INSIDE SURFACE WALL ASSEMBLY
R= 0.62 REAR ELEVATION
:i R= 0.68 TOTAL R= a•1,-7 G.W.A. /
�.
WOOD I ,, #" SHEETROCR u ��
SHINGLES R= 0.45 --
R= 0.87 WINDOWS: [)
OUTSIDE =3j" FIBERGLASS p i.
INSULATION .
SURFACE
R= 0.17 R=ll .
SURFACE RESISTANCE +, ----
�J;� \R=
1 FLOOR ASSEMBLY,
DOORS
INISH FLOOR TOTAL R= 32= 0.91 U= D31
PLYWOOD .,
RIGHT SIDE ELEVATI(
SUBFLOOR "
R= 0.62
OUTSIDE— ,1
_ G.W.A.
SURFACE `
R= 0.17 WINDOWS:
i I I o
//-6j" FIBERGLASS
I . ; INSULATION FOUNDATION
CONCRETE R= 11 WALL ASSEMBLY
FOUNDATION (may be used instead DOORS:
WALL SURFACE RESISTANCE
4 of floor insulation) 0
R= R= 0.61
TOTAL R= LEFT SIDE ELEVATIOA
G.W.A. ?3
—INSIDE SURFACE
R= 0.68
/8" SHEETROCR
WINDOWS:
R=..O.32
" STYROFOAM
DOORS:
t _
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NOTES:
PERMANENTLY INSTALLED STORM 4'07 a -KE/c,tf f cif
WINDOWS TO BE USED
GROSS WALL AREA 7 IJ yA"?5 A0918F4,0-Y PLACE
DW�oW _ q 7 / 3 A l 5 /ate ' A�,6C 4rO,
z FENESTRATION=
TOWNbF BARNSTABLE -Permit No. .33727
BUILDING DEPARTMENT
I ' I TOWN OFFICE BUILDING Cash ..
....
679• X O
HYANNIS,MASS.02601 Bond
CERTIFICATE OF USE AND OCCUPANCY
Issued to ;
Bayside Building Co.
Address. Lot #2, 43 Statice Lane
Hyannis, Mass.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
.............. $.. , 19... 91....... ../... •.... f
Building Inspector
s
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
2 �aaaar : TOWN OFFICE BUILDING
9 i639 � HYANNIS, MASS. 02601
�OIUY M.
4
MEMO TO: Town Clerk
FROM: Building Department
DATE:
An Occupancy Permit has been issued for the building authorized by
BuildingPermit #......... ... `?.._. Z. ...............................................................................................»..................._...............
issued t IA� .....�� ... ......Z
1_ �D' S _ ....., .
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W61
Please release the performance bond. /
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINAL (S)
I A ,
m / IL
DATA
'TO�WN OF BARNSTABLE, MASSACHUSETTS BUILDING PERM)
i- _73. 091 C't 6
r)...i ' . . 0
DATE ) 19 PERMIT NO.,, 3"79'7
APPLICANT
G Cl 5 6 4'
ADDRESS
(NO.) (STREET) (CONTR'S LICENSE)
.PERMIT TO i .4 NUMBER OF
STORY DWELLING UNITS
(TYPE OF IMPROVEMENT) N0. (PROPOSED USE)
AT (LOCATION)
ZONING
DISTRICT
(NO.) (STREET)
BETWEEN AND
(CROSS STREET) (CROSS STREET)
SUBDIVISION LOT
LOT—BLOCK SIZE
BUILDING IS TO BE FT, WIDE By FT. LONG BY ----FT. IN HEIGHT.AND SHALL CONFORM IN CONSTRUCTI
TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION
(TYPE)
z
REMARKS:
AREA OR
VOLUME PERMIT $
(CUBIC/SQUARE FEET) ESTIMATED COST FEE 0
OWNER
ADDRESS 9 5 1 �.V.1. 1. BUILDING DEPT.
BY
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY,PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE4
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAIN[
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR
ALL CONSTRUCTION WORK: CARD KEPT.POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQ,UIREO FOR
ELECTR CAL, PLUMBING AND
1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE MECHANICAL INSTALLATIONS.
2. P'?IOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MEMBERS(READY TO LATH).
3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
OCCUPANCY.
-- POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVAL PLUMBING INSPECTION APPROVALS A VALS ELECTRICAL INSPECTION APPROVALS
a
2
2 2 ..........
2
3 HEATING INSPECTION APPROVALS ENGINEER! G EPARTM T
O*THt-R:"
7—
_T'Lj -1 0- - 6 ABOARD F HEALTH
C"C�
WORk SHA N'OT TIl T SPEC- PERMIT 'vv!LL BECOME NULL AND VOID IF CONSTRUCTION
kS APPROVED TH-EEM UUS INSPECTIONS INDICATED ON THIS CARD,�AN i
PRO'C
°tGONSl
TOR H THE VIRI ES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE I ARRANGED FOR BY TELEPHONc OR VVRITTF
QTi Uj PERMt%T-IS ISSUE-AS NOTB QY E. NOTIFICATION.
S
S$� L
� 83�
A) - o
47' U
8s' LoT #
s
�o
1
�\ O ZoT
0
0�
CERTIFIED PLOT PLAN
s LOCATION
o SCALE . .!.��-. ` �. .... DATE Mom. 3
PLAN REFERENCE
.' . . . . . . . . .. . . . . . . . . . . . . .. . . . . . . . . . . . .. .
p �gryVvr aK sTr,�
ELLEY
1 CERTIFY THAT THE
No. 26ia�
r �9 SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
AS SHOWN HEREON AND THAT IT CONFORMS TO THE
ti SETBACK REQUIREMENTS OF THE TOWN OF
... . . . .WHEN CONSTRUCTED.
DATE !. J7o• f '�
8.�ys��� By/GD/�/G �, — P�Ti�•,�c-�Z �
REGISTERED LAND SURVE R
Na �
r
TOP OF FOUNDATION c�
` CONCRETE COVER
�,. CONCRETE COVERS
'7L /
CAST IRON 12°MAX. 12"MAX.
OR SCHEDULE 40 4"SCHEDULE 40 PV-C.( LY)ON /
P.V--C. PIPE
' PITCH 1/4"PER.
PIPE MIN. LEACH ?%:�
PITCH 1/4"PER.FT. PITNflcL
o � PRECAST
,'. INVERT ! a LEACHING
.o EL...4�1 INVERT INVER P - pl- PIT OR
SEPTIC TANK G DIST. G w ; �c EQUIV. ' 1�? _ Ste•✓ GrvE
o INVERT BOX '`' WASHED / _ �,
EL...`J•...8 INVERT v n. 0• 3/4 TO I t/2 / Y i(-/ \,
.,, 7a
.. GAL. INVERT 6 w S"
:.� ELGpd� EL.GB Co U. �_ b `tcvF
o w STONE
6'DIA. —►-� ,✓�c_ i / A � /:���°�:/ � ' �
DIA—��v
PROR LE OF GROUND WATER T�E �l P` �
c r � 1 r
SEWAGE DISPOSAL SYSTEM LOTS/ zr B';T
�r}
NO SCALE Op
'/a �(b� 0
SOIL LOG WITNESSED BY :
DATE ."16 /71YA TIME//.'°c? ,!!y •4riC > }-iit7 S BOARD OF HEALTH
TEST HOLE I TEST HOLE 2 ENGINEER �3Q
ELEV. . 7A Ga . . . ELEV. .7/,Sd j
71;
I � //�::�c�afo,�-yy . .
j DESIGN DATA
NUMBER OF BEDROOMS 3. f
4a" CoR Sys N� Cater s�� r`,,g LoT Z \
Pp7• WiT1/GAyG�LS wiT3/ L �azs 3.30 p
TOTAL ESTIMATED FLOW - . . . . . . GALLONS/DAY \ /3 B// S[�?/FT •�
4-Z•eC•Go G,5o BOTTOM LEACHING AREA SO.FT. /PITIC.!?D.
/88 So
SIDE LEACHING AREA . . . . . . . . . . . SO.FT./ PIT/¢7/C,PD.
�}yG GARBAGE DISPOSAL .N°'/� (50o/a AREA INCREASE) !
TOTAL LEACHING AREA67 a. . SQ.FT �, 0
PERCOLATION RATE 4CC3s'.7'71l'9w 7Wo MIN/INCH Q T
LEACHING AREA PER PERCOLATION RATE SQ.FT./G'P.D.
N. . .WATER ENCOUNTERED
NUMBER OF LEACHING PITS
s
APPROVED . .. . . . . . . . . . BOARD OF HEALTH �• • • • • • • .o /
DATE. . .
AGENT OR INSPECTOR
IN OF
2oT '✓° i „
Rk � y
�isrea
,/• ��6�.'a'F�i 7 s'`�,.r:� `rANlTARtAh ,��'
PETITIONER L3,9�j.S/1j� �j�U/GD/�c/G C[�, ,• _` Ar+