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0170 TOBEY WAY
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel d� Application # Health Division Date Issued Conservation Division Application Fee rr�� Planning Dept. Permit Fee �lJ� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address O Village HPCI��il��S Owner� �r�� If Address Ek68nyjv1-5 Telephone l +rF PP _ Permit Request 40 `-DV1 tSc? '� ' 6"Ve -ruc ��C Y� �✓►��ic <</1� Gv&, Square feet: 1 st floor: existing proposed 0 2nd floor: existing proposed Total newt_ IVIV Z c� C Zoning VuLation istrict to F=d Plain Groundwater Overlay Project Construction Type wL ( C Lot Size A Grandfathered: ❑Yes ❑ No If yes, attach suppoang WcumUtation. W va Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) � r �,1 Age of Existing Structure Historic House: ❑Yes �No On Old King's Hi�vay: ❑Yes 2 IVO Basement Type: JXFull ❑ Crawl ❑,1Walkout ❑ Other K Basement Finished Area(sq.ft.) 1 d�y 1` �� Basement Unfinished Area (sq.ft) :3- Number of Baths: Full: existing ez new _— Half: existing new Number of Bedrooms: existing vnew Total Room Count (not including baths): existing V new First Floor Room Count Heat Type and Fuel: PKGas .Oil ❑ Electric ❑ Other Central Air: ❑Yes >No Fireplaces: Existing New Existing wood/coal stove: ❑Yes,;INo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garageA. xisting ❑ new size _Shed existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes lV0 If yes, site plan review# Current UseirY{, Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name CA" 2l`c/!2 :y AT5kO Telephone Number �� Z Address l �� X�`''lam License # dLiac� Home Improvement Contractor# Email C/I ,� �`/► `' tOyn 6r4� 1e lI Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULT G FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 Z l 2s k< .3 FOR OFFICIAL USE ONLY M APPLICATION # DATE ISSUED MAP/ PARCEL NO. t ADDRESS VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION t . FRAME INSULATION ti FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 17w C'ommomveahh of -Vast djusetts Departrmezzt efrnd.restrialAccide zits - l7,f, ke of1mv-s6gadons. 600 Waxshijiglon Street Bastin,M 02111 " win-n masmgovIdia ""TnrImrs' Campensation Insurance Affidavit:Bmlder-slContractarsJEleefricians/Phumbers Applicant Information Please Frinf f eeih Name(Businessganaationfla3ivdnal}: 1,GQiJ./a lu� Address: C) -VZAC%-1 City/stater 0 2(-Oo ` phcnt< rj( �7 (o&Z s . Are you an employer?Check the appropriate box: Type of project(required): I.ElI am a employer with 4 ❑I am a general contractor and 1 6- ❑New consf:ucfion employees:(full arNor part-ime).* have ltired.the sub-contractors 2.❑ I am a sole proprietor orpaituer- listed on the attached sheet ,. 7- ❑Remodeling ship and have no employees 'these sub-contractors have g- ❑Demolition working fir me in any capacity- employees and have workers' �. ❑Building addition ulxkers' comp-insurance comp.insurartmi required-] 5. ❑ We are a corporatim and its 10-1:1 Electrical repairs or additions 3>d I am a homeowner doing all work of"riceas have exercised their 11-❑Plumbing repairs or additions myself [No workers'damp- right of exemption per 1MfGL 12.❑Roof repairs insurance required-]o C.152, §1(4h and we have no employees.(No workers 13-Ul f?ther comp_insurance required.] •flay appEicaurtthat cherksl�as�l mast also filloutthe sectionbeIaars�rmsiag ttie¢u�or&eis'compensatinupoTicg infoemsFia�. t lomeowuers who submit this di-id-dt iudicatmg tb--y sue doing zU waalc sad then bim outside coat mctorsaamst submit a new affidavit inaif�ne swIL ICa=act+m that cherl rly 5 boat must attached=addi6an2l dbMt showing Nee acme of the sub-cc=zcto s aad state whether ar not those entities have employees.I€thesuh-watmc shave empicyw,theymnsipm-ide their Rorlrem'comp.policy number. lain an earip£oyer that is prodding iarrrkers'coaaapensatiora uasrirance for nary*enrpFo},ees $etoov is fire panty,and job site it foram om Insurance Company Name: Policy-'I'L or Self-ins.Iic--'Ik FbxpirationDate: Job Site.Address: Citylstatdzl p- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c 152 can lead to the imposition of crimitml penalties of a fine up to$1,5QDOD aadlor orie ye-arimprisourno s,as well as trail penalties.in ifie form of a STOP WORK ORDER and a fne of up to$250.00 a day against the tizolator- Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurano�co-uwage wrificatioa. I tiro hereby carkf}r and thapains d pena£t es ofpe>,jujy thatthe informafiw pt mi&d ab a isbw and ctrrrect Sitmature: L`Date: l Z,y l Phone o �1 U, ia£use and. Da not ivrite in titis area,ter be cvinpLetetd by c4 artotrn ojofciaL City or-fawn: PeramtUceane 4 Issuing Aathority(circle one): L Board of HwIth 2.Budding Department 3.City1rosrn Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other y Contact Person: Phone#: -Information and Instructions Massachnsefs General Laws chap'152 regrmss all employers%provide workem'compensation for their employees. purs�this state,an empkyee is defined as-"-every person in the service of another under any contract of hire, express or implied,oral or wofthmf An evpIoym_is defined as"an individual,partnecrship,association;corporation or other legal entity,or any two or more of the foregoing engaged is a Joint euterprsse,and including the legal representafives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,employing eu�loyees. However the owner of a.dwelling house having not more than three apartments and-who resides therein,or the occupant of the - dwelling house of another who employs pemsons to do maintenance,contraction or repair work.on such dwelling house or on the grounds or building appur t thereto shall not because of snch employment be daemed to be as employer." MGL chapter 152,§25C(6)also states that"every stain or local licensing agencyshaIIwitlihoId$ae issuance or renewal of a license or permit to operate a business or to construct burgdiags in the cornmouwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage regniz ed." Additionally,MGL chapter 152,§25C(7)states-Neither the cammonwcahh nor any ofits political subdivisions shall enter min any contract for the perfonuance ofpublia worktil u acceptable evidence of compliance with the fi sorance._ requirements of this chapter have Been presented to the contracting authority_" Applicants - Please fll out the worms'compensation affidavit completely,by checking the boxes that apply to your sit aafion and,if necessary,supply sob-contractm(s)name(s), addresses)and phone numbers) along with their cer(ificste(s)of nL� _ - no Io ees other than theTce. L�itEd Lrabihty Companies(LLC}or LmmitedLiabrlxtYParinershrps(LLP)vrrth emp Y members or partners,are not required to carry workers' compensation iasur;mcj If an LLC or LLP does have employees,a policy isrequned. B e advised that this alRdayk may be submitt-d to the Department of Industrial Accidents for conErmation of inM1rMCe coverage_ Also be sure to sign and datethe afadavit The affidavit should be retrmmed to the city or town that the application for the p®it or license is being requested,not the Department of Indnstrial Accidents. Should you have any questions regarding the law or ifyou are required to obtain a workers' compensation policy,please call fb e Department at the number lisisd below Self-insured companies should enter their e number an the line. e -ice Iicens ro�E s If �P City or Town Officials f Please be mare that the affidavit is complete and printed leg5l)Iy. The Department has provided a space at the bottoms of the affidavit for you to fM out in the event the Office of Investigations has to contact You reo rri�c the applicant Pleas e b e srue to fill in the p eunit/licease number which will be used as a reference number. In addition, an applicant that must sabmnit multiple Perm Ucense applications in any given year,net only submit one affidavit in&catng caamt policy information(if necessary)and under"Job Site Ad 1�Tess"tLe applicant should wmite"all locations in (city or town)."A copy of the•affidavit that has been officially stamped or marked by tht city or town may be provided to the ' applicant as proof that a valid affidavit is on file for future pezmi�or licenses_ A new affidavitmust be fiI1ed out each year.Where a home owner or citizen is obtd iag a license or permit not=kited to any business or commercial T=bl e (Le. a dog license or permit to bum leaves etc.)said person is NOT reqa:irzd to complete this affidavit: The Office of Investigations would lilm to thank you is advance for your cooperation and should you have any questions, please do not hesitate to give us a caM The Departmenfs aE&ms,telephone and fax number_' Tht CD-MMMwealtbE of MRI' achmdfi-, . . . - IIegar�nent of liidn�ial Acci��nts toe of f vestkatio)vi 15w Waingi<an Bodon,MA O111 Tf,-L 617' -4 cmt 4-06 ar 1-V7 MAS � Fax 9 617-727 7M Revised 4-24-07 .ma. gQ�fca Town of Barnstable Regulatory Services oF�se roiy,� Richard V.ScaIi,Director o� Building Division RaRA .Q Tom Perry,Building Commissioner uass. 200 Main Street; Hyannis,MA 02601 www.town barnstable.ma.us Office: 508-862-4038 Fax 508-790-6230 HOMEOWNER LICENSE EXEMPTION I L�6 ' Please Print DATE: L L -�- JOB LOCATION ��� `"3p`-1 VW-1 k-A AJAJ`y number street village "HOMEOWNER": �ruhfi L3 6�25 name ;�,' /. home phone# work phone# CURRENT MAILING ADDRESS: jo ` a- -L&-3 —------- --- ----------- - 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. DEFINTITON 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 undersigns' ``homeo er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures an requirem is and that he/she will comply with said procedures and requirements. , 7 Sign of o Approval oftuildinOffitial " 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,RuIes&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.. QAWPFII.E 0RMS\buildiag permit fof==RESS.doc Revised 061313 Town of Barnstable ° Regulatory Services * anxxsx►ar� « MASS, Richard V.Scali,Director i6;g5g6. ♦0 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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by dais building permit application for. (Address of Job) V'Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:r0xMS:0VMExrEPMISSi0rrn00LS la C/1 9?9 . A VVvv/ CQ/2 . �OGfti ✓�'y0 �Qc�` �7g 4 - �tr w no IS �P *11 o� ��zo ---------------- t f VE Town of Barnstable -Regulatory Services— • BAR MABM • MAM Richard V. Scali,Director 639 �`� Building Division Tom Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.barnstable.ma.us Building Permit Procedure for Residential Addition Or Remodel Or Dock Determine map and parcel number and enter it on application. ❑ Historic District Commission,200 Main Street,approval required prior to construction/demolition for any properties located in a Historic District: • Old Kings Highway Historic District(north of the Mid Cape Highway) • Hyannis Main Street Waterfront Historic District(See map for boundaries) • Historic Preservation(if applicable). ❑ If ZBA relief(Special Permit or Variance is required for Project): ❑Copy of ZBA decision ❑Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date ❑ Approvals from-the.following departments are,required,and.can=be obtained at 200 Main St.: ❑Health Departments (8:00 _9 3.0 AM&3:30—4c30 PM" {as of March I'd,_2005} ❑Conservation Department (8:00 9c30 AM&3:30=4:30 P1Vi)-� ❑Tax Collector {can be obtained from Building Department} ❑Treasurer {can be obtained from Building Department} Permit must contain complete owner information, full description of project, correct square footage of project,valuation of project(do not include hvac),building detail for Assessor's_ Office, complete builders information,including signature and date of application. ❑ 5 sets of reduced house plans measuring 11"x 17".scaled 1/4"= 1' & fully dimensionalized are required. Plans must include a foundation, cross section,framing schedule, insulation detail & floor plan showing location of smoke detectors(located with a Red `S'.) ****** IF USING ENGINEERED LUMBER AND/OR STRUCTURAL STEEL,ENGINEERING DATA MUST BE PROVIDED****** ❑ Plot plan or mortgage survey required for any addition. ❑ Workers Compensation,Insurance Affidavit form must be submitted for any workers hired. In the event the homeowner takes out the permit, subcontractors hired must supply this. Copy of Insurance Compliance Certificate must be submitted. ❑ Mass Compliance Checklist ❑ Construction Supervisors License&Home Improvement Contractor's License OR ❑ Homeowner License Exemption Form must be submitted if homeowner is acting as general contractor or builder for the project. ❑ Property owner must sign Property Owner Letter of Permission. ❑. A NON-REFUNDABLE Application Fee must be paid upon receipt of application number. All checks should be made out to the Town of Barnstable ❑ CHIIVINEYS: Need Home Improvement License,no plot plan required ❑ PIERS AND DOCKS:Need Construction Super License AND Home Improvement License. OWNER CANNOT PULL OWN PERMIT. ❑ , Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission t a0 i I0 -70��] �1 Town of Barnstable *Permit# Expires 6 th o lame date ;��,.. 201� Regulatory Services Fee • B&AM naLLt, 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 of Valid without Red X-Press Imprint /Ma arcel Number • - PP �v J Property Address 'Residential Value of Work ©(2) Mini um ee.of$35.00 for w k under$6000.00 Owner's Name&AddressA � — � C Contractor's Name 6 Telephone Number Home Improvement Contractor License#(if applicable") Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's`Com on IInsurance Insurance Company Name Workman's Comp.Policy# Qdm Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) al-e Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replace ent oors/sliders.U-Value (maximum.35)#of windows 'Wh re re ire Issuance o this pe `t does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ** ote: Pro erty O er must sign Property Owner Letter of Permission. A py of th Home Improvement Contractors License&Construction Supervisors License is re ired. SIGNATURE: C:\Users\decollik\AppData\L cal\Mi � indows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. 600 Washington Street N Boston,MA 02111 1• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: D9 City/State/Zip Phone#: (�07 2510 Are ou an employer?Check he appropriate box: Type of project(required): l. I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P ty• 9. ❑ Building addition [No workers'comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit 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'co pensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 2S �� Expiration Date: Job Site Address: 66, S73-71 w• City/State/Zip: Awn Attach a copy of the workers'compensation po ' y declaration age(showing the policy num'b'ef 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'$25 a aga t the violator: Be advised that a copy of this statement may be forwarded to the Office of In estig tons of the IA for surance coverage verification. do h eby certify nder the ains and penalties of perjury that the information provided above i true d]correct. Si atur Date: ll Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 4 TU PPE R CONSTRUCTION CO.LLc 79B Mid-Tech Drive West Yarmouth, MA 02673 Phone 508-778-0111 Fax 508-778-5010 Registration#121845 License#069058 Date: 11/08/11 Attn:Building Department I hereby authorize Tupper Construction Co.,LLC to pull the.permits necessary to complete the project described on the attached permit application form. Thank you, Owners' Signatures Print Owners'Names: A b CA P 17 v Street Address: 1$(oT69(� N J ANNLS ROR-1" )1NA OZG77, �I ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 11/09/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON.THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME CT Karen Bernier Southeastern Insurance Agency, Inc. PHONE (508)997-6061 FAx (508)990-2731 A/C No Ezt: A/C No 439 State Rd. E-MAIL - AD RESS: P.O. BOX 79398 PRODUCER CUSTOMER ID#: N. Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA: Arbella Protection Insurance Tupper Construction Co LLC INSURERB: AEIC INSURER C: CNA Surety 27 Roberta Drive INSURER0: West Yarmouth, MA 02673 INSURERE: ` INSURER F: COVERAGES CERTIFICATE NUMBER: 11/12 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DDiYYYY LIMITS GENERAL LIABILITY 8500008743 11/01/2011 11/0112012 EACH OCCURRENCE $. 1,000,0( X COMMERCIAL GENERAL LIABILITY PTo RMA SES EaGE Eoxu RENTED $ 100,0( CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,0 A PERSONAL&ADV INJURY $ 11 000,0( GENERAL AGGREGATE $ 2,000,0( GEN'C AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP%OP AGG .$ 2,000,0( POLICY PRO LOC JECT $ AUTOMOBILE LIABILITY 56662400002 12/01/2011 12/01/2012- COMBINED SINGLE LIMIT -ANY AUTO (Ea accident).. . $ 1,000,0( A LL OWNED AUTOS BODILY INJURY(Per person) $ A SCHEDULED AUTOS BODILY INJURY(Per accident) $ X PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ INC X NON-OWNED AUTOS $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LU1B CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ • $ WOR KERS WCCSOOSS0301200710103/2011 10/0$/2012 X' WCSTA U- ` OTH- AND EMPLOYERS'LIABILITY Y/N TORY.LIMITS ER ANY B OFFICER/MEMBER ER EXCLUDED PROPRIETOR/PARTNER/EXECUTIVE N/A RICHARD TOPPER IS E.L.EACH ACCIDENT $ SOO,00 (Mandatory In NH) I LUDED FOR WC COVERAGE E.L.DISEASE-EA EMPLOYEE $ S00 00 If yes,describe under r DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 C and for theft of money & r 71068811 02/21112011�02/21/2012 Limit of $10,000 roperty. FT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) i CERTIFICATE HOLDER CANCELLATION . SHOULD ANY OF THE ABOVE DESCRIBED,POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE'DELIVERED. IN. ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE "F r Information Only" Karen Ber I 01988-20 ACORD C RPO TION. AI rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of A ND • - Massachusetts- Ueparwicrit of Public SafetN A Board of Buildim: Re ulations and Standards Construction Supervisor License License: CS 69058 RICHARD S TUPPER 79 B MID-TECH DR WEST YARMOUTH;.MA 02673 Expiration: 12/31/2012 ( nnmisioner Tr#: 8340 Office� o83 �96i� 8 License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 121845 Type: Office of Consumer Affairs and Business Regulation Expiration: 6/19/2012 Individual 10 Par • e 5170 �vs ,MA.02116 114' D TUPPER RICHARD TUPPER 29 Roberta Drive W.YARMOUTH,MA:02613 Undersecretary Notvalid witho signature -N - TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY LPARCEL ID 268 003 GEOBASE ID 17005 ADDRESS 170 TOBEY WAY PHONE HYANNIS ZIP - LOT BLOCK LOT SIZE — DBA DEVELOPMENT DISTRICT HY PERMIT 81332 DESCRIPTION NEW 4BDRM SING.FAM.HM.BLDG.PMT.#71393 PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of ARCHITECTS: P TOTAL FEES: $25.00 Regulatory Services BOND $.00 CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE * IMMSTABLE, • MAW . 0 9. FD M!►�A BUIL IVISI N BY DATE ISSUED 12/17/2004 EXP;RATION DATE I TOWN OF BARNSTABLE BUILDING PERMIT PARCEL ID 268 003 GEOBASE . ID 17005 ADDRESS 170 TOBEY WAY , PHONE I HYANNIS ZIP - LOT BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT HY PERMIT 71393 DESCRIPTION NEW RES- 4/BR 2/BA ATT. GARAGE PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT CONTRACTORS: PROPERTY OWNER Department of ARCHITECTS: Regulatory Services TOTAL FEES: $1,022.80 BOND $.00 �t11E 1 _ j CONSTRUCTION COSTS $288,000.00 101 SINGLE FAM HOME DETACHED 1 PRIVATE MASS. 139. 1 I FD MP'�A BUILDI 7 D ISION BY DATE ISSUED 09/lO/2003 EXPIRATION DATE I I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,.MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS.. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. - - 1 s , i •_: BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APP OVALS (1)e_' ley gTAYG // /fltJ ^ � (� o G G 1�2 A -'= 3 AEATWG IN PECTION APPROVALS --—` ENGINEERING DEPARTMENT 2 -_ _-__._ _ BOARD OF HEALTH --- - a OTHER: SITE PLAN REVIEW APPROVAL kra P WORK SHALL NOT OCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HA APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 1 � - 3 ( -o3 ` (0.�1►�1�.t9 ��Pr� i Cc c� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � Map Parcel �' �!` ®� ,� Permit# 7 F PJAIR sS :ABLE Health Division 14545 Aw 3 q17 Date Issued Conservation Division cLld3 MUG 27 PP1 4' 23 Application Fee Tax Collector Permit Fee o d - Treasurer (�� Elm SION ��T SEPTIC SYSTEM M Planning Dept STALLED IN COMPLIMRCE Date Definitive Plan Approved by Planning Board Al 0 ✓� -S C.u 4S Z WITH TITLE 5 ENVIRONMENTAL CODE ANL Historic-OKH Preservation/Hyannis t `� TOWN REGULATIONS Project Street Address _ /4 .Village Owner :� .i� __ Address '� U)C,V Telephone � �)-) Permit Request Square feet: 1st floor: existing N A proposed C Q 2nd floor: existing proposed f`l Total new a 3 a 0 Zoning District Z3 Flood Plain .IU rA Groundwater Overlay Project Valuation 'f4w ;yu O s Construction Type ''Tttt 1 yjcy�> a� Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure N Historic House: ❑Yes )d No On Old King's Highway: ❑Yes _XNo Basement Type: )4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) NIA Basement Unfinished Area(sq.ft) 11 . 3 S Q Number of Baths: Full: existing N new 2- Half: existing N i new Number of Bedrooms: existing new I Total Room Count(not including baths): existing new First Floor Roor Count U Heat Type and Fuel: ❑Gas ' 'Oil ❑ Electric ❑Other Central Air: I�Yes ❑No Fireplaces: Existing New Existing wood/coa stove: `Ei Yes rn ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing 1 new size Shed: ❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes )qNo If yes, site plan review# -- -- -Current Use —- - - - _ __w _ _ - _ Proposed Use,,. BUILDER INFORMATION //ff Name Telephone Number Address License# Home Improvement Contractor# AN Worker's Compensation# ALL CONSTRUCTION DEBRI RESULTING F M THIS PRO ECT WILL BETAKEN TO - . SIGNATURE DATE �10 FOR OFFICIAL USE ONLY 3 PERMIT NO. DATE ISSUED _ MAP/PARCEUNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION b K lb -3 1 0 FRAME r INSULATION 7/2,7 f j�y- D 71251/OY FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH:, Z? t FINAL FINAL BUILDING c) DATE CLOSED OUT = z ASSOCIATION PLAN NO. ' t i FEES RESIDENTIAL BUILDING PERMIT APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $Z5.00 _ FEE VALUE WO JM EET NEW LIMG SPACE '3?CX square feet x$96/sq.foot= �"" x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPA x.0031= square feet x$64/sq.foot= plus m below(if applicable) ACCESSORY STRUCTURE>120 sq.1t y $35.00 >120 sf-500 sf >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 p 1 >1500 sf•Same as new building permit x.0031= square feet x$96/sq.foot= STAND ALONE PERMITS x$30.00 Open Porch n er Deck x$30.00= (number) Fireplace/Chimney �x$25.00= (number) in ground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) permit Fee — N 1 Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheckSoftware Version 3.4 Release la Data filename:C:\Program Files\Check\MECcheck\Atsalis-170 Tobey.cck TITLE:Atsalis Residence CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 09/08/03 DATE OF PLANS:6/06/2002 PROJECT INFORMATION: ��170 Tobey Lane est Hyannis Port,MA 02672 COMPLIANCE:Passes Maximum UA=537 Your Home=495 7.8%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R Value R-Value U-Factor.UA Ceiling 1:Flat Ceiling or Scissor Truss 2113 30.0 0.0 74 Ceiling 2:Cathedral Ceiling(no attic) 298 30.0 0.0 10 Wall 1: Wood Frame, 16"o.c. 2840 19.0 0.0 140 Window 1:Metal Frame:Double Pane with Low-E 403 0.340 137 Door 1:Glass 40 0.330 13 Door 2: Solid 60 0.420 25 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 1710 19.0 0.0 80 Floor 2:All-Wood Joist/Truss:Over Unconditioned Space 484 30.0 0.0 16 Furnace 1:Forced Hot Air, 80 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheckVersion 3.4 Release la and to comply with the mandatory requirements listed in the MECcheckInspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. e '`Builder/Designer Date '�MECcheck Inspection Checklist Massachusetts Energy Code MECcheckSoftware Version 3.4 Release la DATE:09/08/03 TITLE:Atsalis Residence Bldg. Dept. Use I Ceilings: [ ) I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: [ ] I 2. Ceiling 2:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: I , Above-Grade Walls: [ ) I 1. Wail 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Doors: [ ] ( 1. Door 2: Solid,U-factor:0.420 Comments: i Floors: [ ] I 1. Floor 1:All-Wood JoistJTruss:Over Unconditioned Space,R-19.0 cavity insulation Comments: [ ] I 2. Floor 2:All-Wood Joist/Truss:Over Unconditioned Space,R-30.0 cavity insulation Comments: Heating and Cooling Equipment: [ ] I 1. Furnace 1:Forced Hot Air, 80 AFUE or higher Make and Model Number I Air Leakage: [ ) I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cf n(0.944 Us)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: { ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ j I Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. r x I , Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] I All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] I Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ] I Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4, I Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. I Table 1: Minimum Insulation Phickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types_ Range F 2"Runouts V and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD (Building Department Use Only) Barnstable Assessing Search Results Page 1 of 2 k r , Home: Departments:Assessors Division: Property Assessment Search Results 0 SANDPIPER LANE 2003 Owner Information: - Owner Name Property Sketch Legend TROTT,ANNIE&BEDFORD,JAMES No sketch is available for this pa Map/Parcel/Parcel Extension 268 /003/ Mailing Address TROTT,ANNIE&BEDFORD,JAMES 2008 N PULASKI ST BALTIMORE, MD.21217 2004 Owner Information (as of January 1,2003) Owner Name ATSALIS,DEMETRIUS Address 0 SANDPIPER LANE 2004 Total Assessed Value $ 131,600 2003 Assessed Values: Appraised Value Assessed Value Building Value: $0 $0 Extra Features: $0 $0 Outbuildings: $0 $0 Land value: $68,100 $68,100 Interactive Property Ma ap requires Plug in: Totals:$68,100 $68,100 1 have visited the maps Fi before ', itl' Show Me The Map " April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: TROTT,ANNIE&BEDFORD,JAMES $0 2003 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $640.14 Town Fire District Rates Other Rates 9.40 Barnstable 2.88 Land Bank 3%of Town Tax Hyannis FD Tax $ 196.81 C.O.M.M. 1.54 Cotuit 1.88 http://www.town.bamstable.,ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/A... 9/8/2003 Barnstable Assessing Search Results Page 2 of 2 Land Bank Tax $ 19.20 Hyannis 2.89 West Barnstable 1.96 Total: $856.15 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 1.19 Year Built 0 Appraised Value $68,100 Living Area 0 Assessed Value $68,100 Replacement Cost$0 Depreciation 0 Building Value 0 Construction Details Style Vacant Land Interior Floors Model Vacant Interior Walls Grade Heat Fuel Stories Heat Type Exterior Walls AC Type Roof Structure Bedrooms Roof Cover Bathrooms Total Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) _ FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/A... 9/8/2003 i AV TT as VA Loa uus.a•u... - / Department of Regulatory Services �Im Public H61th Division Date ( uz 200 Main Street.Hyannis MA 02601 nam �9ntoy Date Scheduled 1 U Time jLj dA 1^^ Fee Pd. Soil Suitability Assessment for Selvage cDisposal Perforated Dr.A kmt � �� Witnessed Br. Of4lt� ia.,A+t;;-Y� oN OIm t.amlion Address Hpn - owner's Name A t S A C.IS - U�t`/_ y Address VV4Sf14A/1D 01A k'�Y AsesmesMap/Paral O�10 Plex11, Lrgiraer'sNeva Upy�n CRpP li✓1� NCw l;ON57'R UCHON REPAIR Tdcpiame s SOS- 6 -y Nf r'0 v Land Use l?<r a -Fr iel Slopes(*A) — Surfacestatms /Vyfy€ r,19 Dislatrecs from: Olen Water Body/V/A n Possible wet Area 11(�n Dunking wafer wd1 OwrV n wAtt 2 V Drainage way AlN n Property Ltac 1S I m it Other n SKETCH:(S(reet mm,e,diTmiom of lot exact koatiom of test boles&Pere tests,locale wetlands in proxhnity 10 boles) ' ylI 1210 � 3 3S= I z IVJ+ 00 5`t 5/p,.P10 pr" uNConyST) , Parent material(gtDwc)01ACi 4 o uiwo Sh Depth to Bedrock 3400 4— Depth to Groundwater Standing Water in 1lolatJo VJ AVt Q Weeping from Pit Fat Ne vv�— Estimated Searonal ltigb Gmandwater Nol- A Q Q lNethod lhed: N � G ' .Depth 06served sWrding in off.bole: N�N� in. Depib to so7 mottles: I�r�►`r�L. in: _ DePOi to act{ring from side of obs.bola N U N Y in. Groundwater Adjratment N r A R lndu Wen 6 Rung Data Index Weil keel Adj.fader Adj.Grormdvreter Isvd_ t . Hole 0 alien Depthoffere lo Time at61 Start Pre-soak Time® -2, Tana(9"6) End Pm-soak :o G 1 ak Q4Q �C f+Jr►J Rate Minllnch 2 1 rvck Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YRq Original:Public iicalth Division Observation Rote Data To Be Completed on Back n•tme r-n rrumlFFRf:F0RM .o Other .�. Soil Texture Son Coles � Soil Depth fiwn Soil ltorlmn Molds Strodure,Stones.Doutderes. Sudan(in.) (USDA) (Mansell) v—!� ,4 Ifru L,Su t,�f /oY23/2 Nov-C Aoose_` Aa �•Surtd . 6 C . �/�So.+d /O���5� IVON�.. L o o5•tr - - Now - t l�fry R 1`'•�?;o�e .aQ93�id: Ze..ax. atlC( . . Soil tIor�aon Soil Texture. Color Depth from NSDA) (Munsell) Mottling (Structure,$long,nouideres. Surface(in.) - � Irk 5 4 10yR5/4 NdNf- GoaSe u �� "San' � Diller Depth from Sall llwizotu Soil Texhno Soil Coles (USDA) (Munsell) Molding (Strudwe.Slants.Boulderes. swface(m.) 1tSiL-- WIN WWI F. '1si �. ro so�l Olhu 0 Texture Sol Colbr Defith from Sail Ifodwn (USDA) (MunselQ Molding (Structure.Stones,Doaldues. Swracc(in.) f2loyinxnrance Rate Man: - Abase 500 year(load boundary No— Yes • Within 100 yew 110-dart' No_ Yes Wllhin 100 year flood boundary No_ Yet Death of Naturnbby meaning Perrviou4 Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? y5 S if not,what is the depth of naturally occurring pervious material? t:erliticall0n ,� 1 certify that on/.>I%�.3j— (date.)1 have passed the soil evaluator oxaminatton approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with a. .�rnti.rrl rrnininr.cxurrtise and experienea describes in 310 Ctvlbt IS.OIT. , c , _ Affidavit of Substantial Financial Interest / s 1 �� y 1 of f c N NC� on oath dWseandstate as fo lows: 1. 1 am an applicant for a building permit for the property located at Map , Parcel The address of the property is 2. 1 have 100 % legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above. 3. Within in the last twelve months from today s date, which is 0 , the following individuals or entities have had a 1% or greater legal or equitable interest in the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address * V'k -6r, ,tv I �b from toda 's date which is �f , I have had 4. Within the last twelve months, f y , a 1% or greater legal or equitable interest in the following properties which have been the subject of a building permit application: Map/Parcel Address 5. Within this calendar year, I have submitted building permit applications for property in which I have a 1%o or greater legal or equitable interest. g. Within the last ten days, I have submitted building permit applications for property in which I have a 1% or greater legal or equitable interest. . 7. Within this month, I have submitted 41 building permit applications for property in which I have a 1% legal or equitable interest. , 8. Within this month, I have received 0 building permits for property in which I have a 1% legal or equitable interest. Signed under the pains and penalties of perjury,,thi97 day _ , 200,E 2001-0050/affin 1 O/LOTTERY/AFFIDAVIT r The Commonwealth of Massachusetts Department of Industrial Accidents gfffce ofloyeslfgatiaas 600 Washington Street Boston,Mass. 02111 - � Workers, Coniliensaticu Insurance Affidavit / name: location: � �/r C. 7V' am a homeowner performing all work myself. i I am a sole rietor sad have no one workin in ca acitp l �%/ %%%/////G////////////%%%/G%%%%/%%//%///////%�%//G%/O/%�////////%�%/%/G/ ation for my ogees working on this job. 3„ •}} : p} workers ca ens '" .:.t:•:::..}}t:}).+.}7^:`.•ta.Sra:$C•`:£f:<,:`;•}}.{..:?: ',n,•;:y::`;}'.:r..r• t ; ;}::af :•av'r:+y�}s::+xa3Y,!C;::3:}t? 5 to V1 r��g ; ,v,f.;...h4 :?•iiti•}:•:t Y;::F$$f:?$i vh•n v:b:nY.n .5}f'.,.,.:$v. :Sr .Y:•i?!v H,•,tah: an em :{.}C3:••{.a'...4Y}....7}3:$$f ..t....: :?:�a"„ {{�?£<:�.: .}�.<:<?�:• .,:€•{: am Y ••: . .....,,...... .:. ,.{.. ... r:..,....£ ..!.,•, :r:?:'•):.,... ......::::•::.:<+::.:+-:::::::..•:,}}•}•::•:5:•}...• ......r.•�:.}.r: }fi•:`•i':..},},:•::.:r. ..3,..,: „a :rar�,�f"U., .. .:::::•.. r.....:...:,:•:::•.,.......:•::•.. ,r:<•,...,:•::.:.•.,: .:. •:.:.{,-•:.,-,,::•:::••. ,:rY.•::• ... •., .. .. ...\,•t•. .u^ :co.4Tt`a+. ra.. ..:?•)'a::•::•}:•::., r? .{, .!:.. .a. .k: •::R55'' ,:+3., ,\+..t„ :;:Sy+•;;7`{k^f",`?'a:`t:'•,w" •t. .r..:....:..:...v?•:•.,•.,+:4x;:;,-:••:.,.r. .Jryv: .:.•.:.hv:•:••:::)T}:::: r..:::..;4::•a,nr{•::w:,, �£j ,. n::....r...:..:....-.:....5:. ..v... r.rrf.,..,T.^.+...rr. :.. :••.... .....,....,. .v.,..?i4:4!'+,:{}^}.}+'�•:;r:iA.;)T,'?{?$•,+..tr:•:.• y .. ... •.{::,,-••:r,v:,.,.•-.. .. .: }......:v::^^..r.:.,t`{-....,..:--;?.^},.:.......,�}:x.vr.v:}?^:?:vr......:-.:.,, ,? ,::..r:r3iv :rr}}:v�..r.:".:. .., 0 �{........?r.............^......./.....x.. :...^^.. t,..: .,... ..... ;......:•:fw}.,.....:...,v.•::::::::.nt•.v::;rx• :•}+'r:•..v:{:.:::x:.v:..:.,:v;.....;v.. .::...7..?.:.........,...:......^:. ....r r.:. ::.x..,...,.v.M1:... n •r:.:...........:•.........:•v.,,, :::?4':. ^.}!1'; 'v'Y%:} e .r.....�....... ::.....r.:. ,.,•..t.:rr....,.........., a .......... .. ...4}::•:'•.v.•.L .,,�in;'•• .$€5$S{..,5�',v{a<: .ti} {{.., Yw,a:....... ., !•:.:..•,w::.•.,,.r.:•::.:r.:.......:. ...... ... ....:::.. :.....4:5:•::.,{.{'vti•}i, r.{Lft:•,n,• ;}:5{•: ! ...:.v:... ..:...... ... :..............}:.::.v:}•x}::r..:::?:•).r,.,........,.:v... :•:v+ hY•}a••:;{\ti!1':4}7'a`,.Y }Y{ .,.€ •:/i;'"'V !•vimv;ytin'•.}'??. .,:�;};j;' �'.•I18III$-. .v'4+;{,a:^Sr,•.n..J}{. t,$.?.1�,:4'v S.}:Y•:::$SG'a.}.';.;•:?�r{t;•�f�. ,�.•+:�o'.`r.��a.:+.,..n fi:•?:{{ •!ri.: :S..r. ..{ ^ .;{.r}x„4:.a::f•$;`.:::•:.,• }};}•}:i:•::'a:' ,•r:.:Y};x! ;•?. ,•..^f. ..,/Ja} t•::.:?•.••:^w5,••.?,.} .v.�?v. v.\+:x..0...r.},rr. :.0.?,+.,�.}�. ..a:ir :•r.c;}.,:.}:.:f},•,r:,. 5:5:r}::af.. •.;...?t:: .£}.:•.., .ro.. .w?T.'•:: •::.. .�c ::ia.•:•: .. .:.. ....:,•}:.:•.,,..::•........::...t....., .:r{•}:}::a:•}: r.:??:::••$r•::>:rr:;;^•.?�,:•r ..:...,. .v,Y•t... .' }.,•:.:•::Y• ...v: :1. •:..,:.::r. :...:,•r-:$:}....:aR..::�....,+,a::`-:r.R.,t•:.}„)r. !..:.::••........::•.:,%•}: .....::::•<}:•:.,::.:.?.•r.f.::•:::: f,n}}:.:•:•.:r....;.•k,,n ..,;L':>•}:••..v,..`'•.�£4:S^c:y;•�3::�,�. .•7>}•., •:}: :...?;/,r-.::...,:.r»:....... 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' penalties of a&te up to s1,500.00 mdlor Baibsre secure coverage rcgtzTredEdSection SSA of MGL 152 csalead to the imposition of of S10 .0 one yeprisoent as well penalties in the form of a STOP WORK ORDER" a�e at s100.00 a day against ma I tmdetstand that a copy of this statem meet a w forwarded to the Office of Investigations of the DIA for coverage verification under the and penalti of perjury that the information provided above is true ci co d I do hereby certify Z �. > Date signature Phone print name official 10e only do notwrite in this area to be completed by city or town official ' � . perudt/license# • ❑Building Depar{mrnt city or town: ❑Licensing Board []selectn ews Office C3 rherk if immediate rrsporm is required ❑Health Department -" ❑Outer phone#; contact person: rmviud 9195 pi Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the `law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. partnership, association corporation or other legal entity, or any two or more of An einployer is defined as an individual, p p, 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 shall not because of such employment be deemed to be an employer. building appurtenant thereto MGL chapter 152 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate'of inc►,rance as all affidavits maybe submitted to the Department of industrial Accidents for confirmation of umuance 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' compensatioil policy,please call the Department at the number listed below. City or Towns 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 p etcense number which will be used as a reference number. The affidavits may be ret®ed*tn the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents amce of lnvesugau ns 600 Washington Street Boston, Ma. 02111 i fax#: (617) 727-7749 �• (Al 7) 727-4900 ext. 406. 409 or 375 Town of Barnstable F1HE l� Regulatory Services Thomas F. Geiler,Director BMWSTABM MASS& 9ebA i63g• a,� Building Division rfo 1A°� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �j Please Print DATE: ��� O ✓ JOB LOCATION:. number AIMI-6-5 street village "HOMEOWNER': n rr home phone# work phone# CURRENT MAn.ING ADDRESS: 1., �` V 1 VAS -J M5 N,& GAG( city/town state zip code The current exemption for"homeowners"was extended to include owner-occuDied 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 Barn table Building Department minimum inspection ocedures requirements and that he/she will comply with said procedures and requirements. Signs omeo er 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 forrn/certification for use.in your community. Q:forms:homeexempt oFTHEi�,ti The Town of Barnstable BARNSTABLE. ' Department of Health Safety and Environmental Services Y MASS 0a � �a3v. �0 °rEo IMA '• Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection n vi >rA' 0 / Location I,, o�c , Permit Number r7 J 3 13 Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: Z v _ f Please call: 508-862-4038 for re-inspection. Inspected by Date 1/11 `� . ' N ' O 0 / I�ob P 3qq/� 501 51 I certify that this pro�outside . th6 •500 erty is located C TI FI ED PLOT PLAN in flood hazard zone C year flood) as identified by the Depart- LOCATION ment of Housing and .Urban Development(HUD) SCALE � . .. DATE � ?003 Date OC7'3/ Zoo-3 �P`NN OF bgsf9 PLAN REFERENCE EDWAD J KILLk N . . ... . . . . .. .. . . . . . . . . . . Re26 . . . . .. . . . . . .. . . . . . . . . IST oMAL LAND . . .. . . . CERTIFY THAT THE I certify to its title insurance company SHOWN ON THIS PLAN IS LOCATED ON THE,GROUND that there are no visible encroachments As SHOWN HEREON. or easements except' as shown and that this plan was prepared under my immediate 'DATE ocT.3 j �003 supervision. ' ' ' ' 7)�ri�T�z�us 19TS�94/S,— R&7. REGISTERED LAND SURVE R G r G G G u G ! 6 G G Western Surety il n P 9 G J G 9 LICENSE AND PERMIT BOND For County, City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, ; Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. u KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P-4 313 24 8 3 Thatwe, Derietrius J and r1onika Atsalis , 7 Locust Street of the t own of Hy a n n i s , State of Massachusetts , as Principal, and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the State of Massachusetts , as Surety, are held and firmly bound unto the Town of Barnstable , State of Massachusetts , Obligee, in the amount (Valid only when a County,City,Town or Village is named as Obligee) of one thousand dollars DOLLARS ($ 1000.00 ), (NOT VALID FOR MORE THAN$25,000) lawful money of the United States, to be paid to the said Obligee, for which payment well and truly to be made, we bind ourselves and our legal representatives,jointly and severally. THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been licensed street opening bond for lot located at 003 Sandpiper and Tobey G,Tay r West Hyannisport , MA by the Obligee. NQ,W �On FORE, if the Principal shall faithfully perform the duties and comply with the laws and or iariTces (i' ft all amendments), pertaining to the license or permit, then this obligation to be void, 0l'1rwi'setoemt'Pn full force and effect for a period commencing on the 2n d, day of �'' nteii <r«• 2003 , and ending on the 9nd day af�AA�n t e r_i h e` s '' • 2 0 n a , unless renewed by continuation certificate. +3 hi on may 4:terminated at any time by the Surety upon sending notice in writing to the Obligee and to thQ inclp l m a `6 the Obligee or at such other address as the Surety deems reasonable, and at the expira- tions` ,�t1I .. �e43 ) days from the mailing of notice or as soon thereafter as permitted by applicable law, w iich6V ri e4',this bond shall terminate and the Surety shall be relieved from any liability for any subsequent acts or omissions of the Principal. Dated this 2nd day of September X22,o03 Principal Principal Countersigned WESTERN S U E T Y C O A N Y G f By By Resident Agent President ACKNOWLEDGMENT OF SURETY G STATE OF SOUTH DAKOTA 1 ss (Corporate Officer) FCounty of Minnehaha f b On this 2nd day of ,� ,t p e b er' ; 2�)3 ,before me, the undersigned officer,personally F appeared Stephen T.Pate ,who acknowledged himself to be the aforesaid officer of WESTERN SURETY COMPANY,a corporation,and that he as such officer,being authorized so to do,executed the foregoing ; instrument for the purpose therein contained; by signing the name of the corpo n by himself as such officer. ; R IN WITNESS WHEREOF, I have hereunto set my hand and official se G 9 J. RHONE NOTARY PUBLIC �� r nSEAL SOUTH DAKOTA SL s otary Public, South Dakota My Commission Expires 6-12-2004 Western Surety Company • 101 S. Phillips Ave. G Form 849-A—12-97 "'+ Sioux Falls, SD 57104 • 1-605-336-0850 , c il ACKNOWLEDGMENT OF PRINCIPAL (Individual or Partners) STATE OF G P ss Y County of F , F n F n On this day of ,before me personally appeared F G il i n i tl F F 'r Y known to me to be the individual_ described in and who executed the foregoing instrument and h G tl r. il acknowledged to me that_he_ executed the same. G My commission expires P Notary Public ACKNOWLEDGMENT OF PRINCIPAL (Corporate Officer) - STATE OF ss County of r On this day of ,before me, personally appeared , who acknowledged himself to be the of , a corporation, and that he as such officer being authorized so to do, executed the foregoing instrument for the pur- poses therein contained by signing the name of the corporation by himself as such officer. F My commission expires , t Notary Public G R G � R r R . � r r � n P F P 09,y tl r R G P R �A p., P z Z Z - D P P c o z z W i SMO DETECTORS O.K. BARNSTABLE BUILDING DEPT. - - r-i 1 r r � _ j --�-�� ! : -- -►_- _ n I I � 1 : I �I - i ! Ell] � IL .� I 0110 z; T. of ri W'�r VIG-i:-1 l,•�o�:-Irl'a Ir�To t..-j ,<.:--f� ve I;19 IS:e In s 9, 71 I r11 4�1 - I , ZED`-•-' � � � ! �t�"� ';'�l YI � ' t' �.-,; , � :� ,;._..� ,-, �: , r•'_ 'G - - .,f"j.P_I_ ice_ i_O'i ., _ - .. ,. II I I 1 - , it — - ..... ._'-. ,-_ _._. — !_•7 Ji' �PC-.�?_ - �.. li I i d.; I / /.' I r,✓� � �� i '.' lid I t/�. j i �j � I"/.':_>j-.^_�-- .} � ; _ -I .�j Ji.[.r;_RfW' �M�'� �� --� t7�ola.-� - •�i:7r.1i�:i t - Li fib I. . 1 I i lmi-I = i .. �t• �I ' ' \�``'�I c I � 1, I . J I I I �. -- --._..._.-.. TF i GENERAL NOTES AND MATERIAL SPECIFICATIONS " _ FOUNDATIONS, 1. All workmanship to conform to the requirements of the. Massachusetts State Building Code, latest edition. - 2. For site location and grading Information, see Site Plan, by . others. .. - CALLED. NORTH • • 3. Soils, Assumed net allowable soil bearing cncount q= Son psi, _ For n sand/gravel composition. Other"Bolls enountered,c tact the Engineer of Record. Compact backfill soils around perimeter with a portable vibratory compactor. Add.sand/gravet mix S.R. as required during compaction to provide final grading a. Cacrete, Minimum 28 day strength, F'c = 3000 psi, .3/4' .. i aggregate, designed per.American Concrete Ins-titute Code, latest. - - issue, nax. stump = 4'. - aJ Steel reinforcing bars: New billet steel, ASTM A-615, Grade 60. . Provide 2 #5 top bars in wail, one bar each-Face, max. 2' from top; also, below all beam pockets,openings, etc. bJ Anchor botts, ASTM A307 galvanized, 1/2' diameter x 12' long - - - w/2'.hook, spaced at 4'-0' o"c• max., unless otherwise noted. - ' - c.) Welded WireFabric: OPTIONAL Add ASTM AIDS Flat sheets. 6x6-W2.9xW2.9 in,top I' of qll slabs-on-grade. d.) Control Joints, Provide control joints In walls and slabs-on-grade, spaced 25' o/C max., minimum V deep.',Pattern by 5. Masonry, (Optional) Minimum compressive and prism strength = 1500 psi. - 6. Reinforcement Unless otherwise shown, vertical reinForcement shop be #5 @ 48' a/c. and horizontal reln F.rcen—t shall be 'Durowail' wire truss type reinforcement @ 8' o/c horizontally. FRAMING;- - " 1. All workmanship to comform.to the requirements OF the .. Massachusetts State Building Code, latest edition. Ali nailing Shall be In accordance with Appendix C. unless noted herein specifically. 2. Timber framing, - - - 35'-6' IB'-6' a AM new timber Framing, Spruce-Pine-Fir No 2 with Fb=1000 psi, £=1,300 000 psi, or better. b. Pressure treated timber (P.T.)� Southern Pine with Fb=1300 psi, E 1 600,000 psi, or better. Deckmolting ,shalt be stointess steel, d may use screws to nttnch decking . — — — — — — c L mnated Veneer Lumber, All LVi. shall be 19E S.P. .MICRO=LAM LVL <ML) w'th Fb=2925'psi, M 00 ,Connectors,85 psi. Fc-R =750 psi, Fc-par =3035 psi. 9 e As manufactured mtn1 by Simpson Strong Tie Co shalt be handled and 7-- — — — �.. - - installed.per manufacturer req i ements, with it mail hales filled, - with the size mall as specified herein. 4. Bolts: CAS REQUIRED) - — — — — Botts s wood framing shall be standard machine bolts unless noted — — — — — — — — — — — — — I diameter. se Bolt holes in wood shall be I/32' larger than bolt o - _, ameter Bolt heads and nuts shall bear on standard malleable it htered all n I ned at Minimum of 2'.wood edge distance s s:Alt nuts shall be ?requ J � completion of square Hen to wn round baits. . — — — = — — — — — — — — — — — — — Table ea 360626 0 3 , all other per State Building Code use 2%6 s e- MA S ulldin C d 6 truc ura ➢esgn Lo d t I I Dead Loads Weight of Building Components • I PROVIDE ALL - I I - Live Loads, nd Wi LoadLoad = 21 P25 s Plus drift . BASEMENT - - - First Floor = 40 psF CONC. 1' or"NDN.WALL I I WINDOV (((��� _ I I .. - - Second Flo - 30 psf B' X 7'-10'HI •/ I OPENINGS FOR - - _ i. 7 BLocking: - 2 #5 RING ALL CODE _ ` I - Blocking shall be solid blocking.-2 minimum, and full-depth of VENTILATION t I ' AROUND T.O.WALL I (. � member _ .. m. ' (TYP:) - 'I REQUIREMENTS - I I _ �- —I �' 1_ — — J — — — t - - - b Stud Wait.: provide btackng. t g-0''o C, maximum. / I PER - 3YJ- DIA.LALLY 'jp'�� � - Nailing Sche ale use MA _ _, iding Code' d appendix C CONC. FOOTING I I Itl D Stag But o e, side 24'. 30' DEEP COLUMN ' cBloc ngockin em Benrin '2-10 toenails ea. end w/SIMPSON Blocking BeB tween Studs 2-IOd toenails en end, o —� —.— _ - (TYPJ =. L.: J I 1 —' I 2-ibtl end malls eo entl r " PARALLAM - --,.LCC-SERIES —, - PSLCOLUMN CAPS ON w/S IMPSON 2'-6' x 2'-6' 3CAPS/BASE"0 Oz 10' DEEP - 10' DEEP FTG. , - (7HIS ROW . I ONLY) � ❑ � _.. I' 1. � � I. _ _ , � I I � REQUIREMENT FOR BEAM - POCKETS.TO BC - COORDINATED I I w/ Ti SHOP c' - - _ — —D W G S. L _ — _ _ — — _ — — _ — II .. II lam/— —.— --- —,— � � " � o� Mwc.A�s .� _ — — _ _ _ — _36_a,_ _ _ FOUNDATION 'PLAN - SCALE 1/4'=1"-0' - 1 00 INITIAL ISSUE 07/17/03 _ NO. REVISIONS- DATE TITLE, T FOUNDATION PLAN PROJECT, aPROPOSED RESIDENCE .. - Atsatis Residence FOR: DEMETRIUS J. ATSALIS 7'LOCUST ST.,HYANNIS, MA 02601 MICHELE C. TUDOR, P.E.. Consulting Structural Engineers 123 COTTONWOOD LANE,CENTERVILLE,MASSACHUSETfS 02632(508)771-7601 JOB NUMBER: 2003-67 IDRAWN BYiMCT/BCW -DRAWING,NUMBER: i 1 -- - SCALE: 1/4' F 0- DATE! JULY 17,"2003 S— I ASSESSORS MAP : __-- Z�B ._ TEST R PARCEL: - ------ SOIL EVALUA^: FLOOD ZONE: /� �� �� J1^I�� WITNESS : T REFERENCE:_. . . .c../oT DATE: 5 PERCOLATION -lb V,1 1b TH- 1 L� � � •� ��I bsDpru� d�;-(I L C✓L�t��P�1C. , 4 LOCAT ION MA S�R��— 4—lvoxYru �049% 04, SEP FL -- An 10 - - 7 - -- - � -- - _ o 3� I f SE '40 XDV 1 lJC At faO t,4, t 4