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0004 WACHUSETT AVENUE
4 Wzci-,� �t( a� 4O1YN_.OE.$ARNSTABLE BUILDING PERMIT APPLICATION f Map Z 61 Parcel 6� Application # D Health Division $j f, Date Issued /-2?-1�, Conservation Division �� Vf' "� �®impTlication Fee 0 0,00 I Planning Dept. T f�N08 Permit Fee Z l/U Date Definitive Plan Approved by Planning Board O1NOF 70,6 Historic - OKH _ Preservation / Hyannis R�STAt4�F Project Street Address Village Owner_ �� 'J rl 7191- / Address Telephone Permit Request I emshi&Z aeo &Aa6htd-, 16 Y ZZ 6,w'Li - oc firm a_/ - o Aea-i- _ u Square feet: 1 st floor: existing roposed 3S,7 2nd floor: existing_proposed Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type �yu�. Lot Size Grandfathered: XYes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other� �_ 1 ✓ C�> Basement Finished Area (sq.ft.) eO Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new-jo — Number of Bedrooms: existingo-new Total Room Count (not including baths): existing _D new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes XNo Fireplaces: Existing New Existinngg,)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 KNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) .Name `X elephone Number' Address A2 License # Q�3 1 l� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SfJ Eve 1P9LJVf AP SIGNATURE DATE / 1)6 S FOR OFFICIAL USE ONLY APPLICATION# 1 DATE ISSUED MAP/PARCELNO. "ADDRESS VILLAGE i "".OWNER DATE OF INSPECTION: FOUNDATION } FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL q PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ,DATE CLOSED OUT ASSOCIATION PLAN NO. �-� MCGRPOS-01 THORNE DATE(MM/DD/YYYY) C -TIrFICATE OF LIABILITY INSURANCEF 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(les)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 CONTACT . NAME: Rogers&Gray Insurance Agency,Inc. PHONE Ext: FAX No):(877)816-2156 434 Fite 134 E-MAIL South Dennis, MA 02660 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC k INSURERA:TRAVELERS INSURANCE COMPANIES 31194 INSURED - INSURER B:NorGUARD Insurance Company McGrath Post&Beam Corp INSURER C dba Pine Harbor Wood Products 259 Queen Anne Rd INSURER D Harwich,MA 02645 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. IN SR ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FXI OCCUR LU 16600368B196TCT15 01/31/2015 01/31/2016 PREMISES E RENI a occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY a PRO- ❑LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: AUTOMOBILE LIABILITY COEa acMBcidentINED SINGLE LIMIT $ 1,000,000 A ANY AUTO BA44871368615SEL 01/31/2015 01/31/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE. $ DED RETENTION$ $ ST WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNERIEXECUTIVE Y� 16 A T UTE ER N/A MCWC691686 07/08/2015 07/08/20 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? 100 000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ e If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 3 t` t)ff� e ofr ona-tmer Affairs and Business Regulation, 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Q(b� tilgtor Registration--, 1 , McGRATH POST & BEAM CO. _ . i ) m Massachusetts Department of Public SG iey JAMES McGRATH 4s) Board of Building Regulations and Standards 259 QUEEN ANNE RD. Construction Supen•isor 1 & 2 Famik HARWICH, MA 02645. License: CSFA-073865 �. JAMES R MCGR_TM 204 CRANVI.EW RD BREWSTERMA%02631} Ts zxpirition Commissioner 03/14/2016 �� Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C'p�::r_ac�tor Registration Registration: 132935 Type: Private Corporation Expiration: 10/31/2016 Trtt 259394 McGRATH POST & BEAM CO. . ` t JAMES McGRATH '. - 259 QUEEN ANNE RD. ` s HARWICH, MA 02645 `" --- Update Address and.return card.Mark reason_for change. �- Address n Renewal. n Employment Lost Card PS-CAI 0 5OM-04/04-G101216 - Office of Consumer Affairs&Business Regulation License or registration valid for individvl use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration:.:1.32935 Type:- Office of Consumer Affairs and Business Regulation Expiration: 10/31/2016 Private Corporation 10 Park Plaza-Suite 5170. E a = Boston,MA 02116 VM!FcRATH POST'& BEAM'�.Cb PINE HARBOR WQIOD,PRODUCTS, JAMES McGRATH:,. { 259 QUEEN ANNE RD HARWICH, MA 02645 Undersecretary Not valid without signature •-• 1 IZe Coraztazonlvealtla of 117assacTtusetts �} = Department oflndustrialAccidents Office of Investigations 600 Washington Street a" Boston,112- 02111 www.mass.-ov/di.a Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lei�ibl Name dual):MC-6 t 9-110tim Address: z 5 9 ecn A n oad City/State/Zip: flQrW� MAC) Phone#: �Q c3 UIJLJ Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6: ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees . These sub-contractors have g• ❑ Demolition- working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEJ 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 boa#I 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 thepolicy and job site information. Insurance Company Name: NCR 6 UA Policy#or Self-ins.Lic.#: Expiration Date: Q� Job Site Address: '��/�'/�- d! V City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the forin 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 Investimations of th A for insurance coverage verification. I do hereby certi y u der the pains /nalt' f erjury th h information.provided above is true and correct. .� e: / C[ �/ Date: 7 G, Si_natur J ✓�,�,�.y� _ Phone#: Official use onli!. Do not r+rite in this area, to be completed bh city or town n nfjcial 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 li AS +a PINE HARBOR WOOD PRODUCTS 326 Yarmouth Rd. I Hyannis,MA 02601 1 508.771.5007 1 Fax 508.771.7070 I hyannis@pineharbor.com 259 Queen Anne Rd. I Harwich,MA 02645 1 508.430.2800 1 Fax 508.430.1115 I info@pineharbor.com 1.800.368.SHED I Customer Service 1.866.SHEDKIT I www.pineharbor.com BUkU/N,3 l/� ®EPT N T JA08?016 LAj5p9z-,7Tj 2- /)ISO, pCj Mr6r . �n/�� �t T� � ��=��'�� Dom✓ /l 4/ U1#"C �/ ��-- DO DEC 2 3 2015 T6WN OF BARNSTABLE�BUryI LDM�PEt - � 4CATION Map Parcel Qf-:5 l Application # �� ls�� S Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee ' Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village l/I l�l l p o`ct Owner Address Phu, et N `lS Telephone 219 0 Permit Request Ci d c 2. Caly- ( J Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size ,. Z!) Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: 2/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 ; 1d _ 61WOrl,VS fr,6d PQ&le hone Number 5t5�J T)'�0 7� Y Address ,J?) l�0N`h"G� cd Str License # wa� ® Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Pt)UfY* -& SIGNATURE DATE l $ ' ;iQL FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER y, r DATE OF INSPECTION: r FOUNDATION y FRAME 4. INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ' r The Commonwealth of Massac �\ Department of Industrial Accidents c�ant Office of Investigations 600 Washington Street Boston,CIA 02111 www.mass.gov/dta Insurance Affidavit:Builders/Contractors/]w lectriaprint Le b Y Workers Compensation i Please A licant Information vV 1 Name(Business/orgenization/Individual): Address: 7 7 6 Phone#: City/State/Zip: Type of protect(required): Are ou an employer?Check the appropriate box: YP � 4• ❑ I am a general contractor and I 6, ❑Now construction 1•L9 1 am a employer with__, ____« have hired the sub-contractors ? ❑Remodeling employees(full and/or part-time)"' listed on,the attached sheet.= 8 ❑Demolition 2.❑ I am a sole propridtor or partner- These sub-contractors have ❑Building addition ship and have nq employees workers'!comp-insurance. 9. working for me in any capacity. 5. ❑ We are a'.corporation and its 10•0 Electrical repairs or additions [No workers' comp. insurance officers Have exercised their I I.❑plumbing repairs or additions required.] right of exemption per MGL 3.❑ I am a homeowner,doing all work c• 152,§;i(4),'and we have no 12.� Roof repairs d myself. [No workers' comp. employees.[No workers' 13 Other insurance required-]t comp.insurance required.] ensation policy informatlen. such. *Any applicant that checks box If i must also lift out dto:action below showing then workers come information. submit this affidavit indicadng they ere doing all Wonk the then hire 6ubd onaactors and their warkers6 comp.poll dlca ng it t Homeowners who s �$e oUcy and fob site SConVactors that check this box must attached an eddltlona!sheet showing to eBS. Below p . • I ant an errtployer that Is providing workerfi'eompensatlon�tnsurancefor my amp y Information. Insurance Company Name: Expiration Date: ,n Policy#or Self-ins..Lio.#: j � City/State/Zip: Job Site Address: a showing the policy number and exp ration date). Attach a copy of the workers'compensation policy dec,i,anon page( osition of criminal penalties of a lead to ORDER and a fine Failure to secure coverage as required under na 5w ll is civil penalties in the forme imp o a STOPe O to o Once of fine up to$1,500.00 and/or one-year imprisonment, of up to$250M a day against the violator. $e advised vised that a cation.copy�f this statement may be forwarded Investigations of the DIA for insurance co, f under file pains and penalties of perJur�that the lnformallon provided above is true and correct. I do hereby certify p i. Date, Si nature: j. Phone#: official use only. Do not write in this area;to be completed by city or town offictat ' f L Permit/License City or Town: # Issuing Authority(circle one): I' plumbing Inspector 1. Board of Health 2.Building Department 3.Cityown Clerk 4.Electrical Inspector 5.I 6. Other Phone#: Contact Person: ' j„ I ii I I ..... V/t6 (Q0�7VIftCNLfItP.Q•[tIL O��[LC/LS[dt� I Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistratlon: 143358 Type: Office of Consumer Affairs and Business Regulation xpfratlon 7/g'��GT18,, Ltd Liability Corpor 10 Park Plaza-Suite 5170 .ia 9'ston,MA 02116 CAPEWIDE ENTERPt (v .L C I RICHARD CAPEN I / 4507 R RTE 28 - COTUIT, MA 02635 Undersecretary of valid witho Ignature I' I : ubic feet . pwhich Unrestricted-Buildings of any • 991 m3)of contain less than 35;0W c Massachusetts Department of Public Safety enclosed space r Board of Building Regulations and Standards License: CS-089273 Construction Supervisor RICHARD M CAPEN usefts 122 WHITMAR RD Frllure to possess s current edition of the Masssch COTUIT MA 02636 stet!Building Code Is cause for revocstlon of this Ilcew". For bps Ucemins irtformetfon visit: www.M914.6or/1)PS Expiration: Commissioner 11/27/2017 . i i I. i t • Page'1 of l Fair, Marylou From: Laurie Young:[ovnonp@gmailcom] Sent: Saturday,,November.28„2015:11:02:AM To: Fair, Marylou Subject:TRE::Garage.�7-4 WWachusetts 1 q- r�tth— ;we;need to-considor this Iky From;Fair,Marylou[mailto:Marylou.Fair,,@town:barnstable,ma.us]J . R Sent:Wednesday,November 25,,2015,10:09 AM To:laurie young<ovnonp@gmail.com> Subject:Garage-4 Wachusetts Hi:Laurie, Not sure if your checking in(and`no big deal if this waits gnti, Monday) r The garage at 4 Wachusetts is proposed for full demolition , a See attached pictures,. ...there is.an inventory,,but no mention of,the.garage. . i Any.need for a public hearing A. Marylou Fair . Growth Management Department r 4' 200.Main Street Hyannis, MA 02.601 a 508.862,4787 r 5 � �tcr7 n�C.p.rr icirhutkcprnes com x` Steve G©ulct � s3.,a' �' Qn<S�tc Coristltane - 3 P.MAG4D�1? R'Y. SON:•Srncc'1923 Ofli � 508, 7.7 8877 a t 15 Col 508 360,40411 hpe.. N1A 02649 Fax Sf1&47?49?7 .11/30/2015: _' �v. � It G - t�.',� :jr � �j!! Jay,_ •�< l i . , .NtA1'r� jt i •.ate �-.'} .Y'' r• a t �: c i !" ,. �£'_ ;: ;,;. .:� - .R .' "�..ti, 9t sy �� �Q�C`,1b1�Q '" I G �7 December 10, 2015 Town of Barnstable Building Department 200 Main Street Hyannis, MA 02601 RE: Garage Demo; 4 Wachusett Ave. Hyannisport To Whom It May Concern, I am writing in regards to the demolition of the detached garage currently at 4 Wachusett Ave. Hyannisport. I, as homeowner, grant Capewide Enterprises LLC permission to demolish said garage. If there are any questions, I can be reached at (908) 239-0247. Sincerely, Terry Finan ���7 ide k1--apewl ENTERPRISES, LLC J.P. MACOMBER& SON • Since 1928 153 Commercial Street - Mashpee, MA 02649 December 9, 2015 Town of Barnstable Building Department 200 Main Street Hyannis, MA 02601 Capewide Enterprises 153 Commercial Street Mashpee, MA 02649 RE: Garage; 4 Wachusett Ave, Hyannisport To whom it may concern: I'm writing in regards to the demolition of the detached garage currently at 4 Wachusett Ave, Hyannisport. The garage does not have any plumbing or gas lines hooked up to it. If there are any questions you can reach me at the office(508) 477-8877. Sincerel om�MM Connell -Master Plumber, MPL#9061 Phone: 508.477.8877 Fax: 508.477.4977 Rich@CapewideEnterprises.com Joao@CapewideEnterprises.com www.CapewideEnterprises.com � � lJ�•G mil• 'ZoiS _ ., O5 /.��ct�1. � _ _mac���`70�•�' _ - - -- '_ - - - ' LZ� 4 s. ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 4/22/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS i CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES II 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 endorsements. PRODUCER NAME: Kelly Estano Rogers&Gray Ins.-Kingston Branch PHONE FAx No 63 Smith Lane Mcna t: 78-72 -020 A/c 8 7-8 -2 56 Kingston MA 02364 j ADDREss: es a noQcQgersg ray.corn INSURERS AFFORDING COVERAGE' NAIC# INSURER A C 1 60 INSURED CAPEENT-01 INSURER B Arbella IndemnityInsurance Capewide Enterprises LLC I INSURERC: J.P.Macomber&Sons 153 Commercial Street INSURERD: Mashpee MA 02649 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:4529303711 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDD MM/DO LIMITS A GENERAL LIABILITY 8500050813 ! /30/2015 /30/2016 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DA AG 7 R TED --- PREMISES Ea occurrence $250,000 CLAIMS-MADE a OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 j GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY 1020017539 20/2015 412012016 Ea accident $1 00,000 ANY AUTO BODILY INJURY(Per person) $ALL OWNED 1xx SCHEDULEDBODILY INJURY Peraccdent $ AUTOS AUTOS ( )X HIRED AUTOS AUTOS Perraccid accident) DAMAGE $ I $ B X UMBRELLA LIAB X OCCUR 4600050814 /30/2015 /30/2016 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X I RETENTION$10 000 $ B WORKERS COMPENSATION 9120510414 1 1/14/2015 /14/2016 X WC STATI I- OTH- AND EMPLOYERS'LIABILITY Y/N OR II ER _ ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EAIEMPLOYE $1,000,000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Leased Rented Equip 8500050813 86 /30/2015 /30/2016 LR Limit 0,000 Property � Building Limit 0,000 Business Property 80,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H 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 Evidence Of Insurance ACCORDANCE WITH THE POLICY PROVISIONS. AU ED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I > Town of Barnstable • >"'n",z���` � �� = .ff�� V�<`",'.`L?'. �.� �a"wr w•-'"'�' �,� :"'~ ,� w„ t �a � � �" � a �Z: Build�i■y ig P Permif ostTh�s Card So Thati"' "' `" "yet A ovedPlans'M tube Retained on'Job°and this'CardMust be§Ke t gi i enaxtrewea a � t,sVrsible Fromthe St a pp us ,r p �,.. 1,. M. Posted RFinal ilns ectionHas'Been:Made� z k „ , =g a ° Wh �� ere a�Certifieate of Occu anc isRe wired sucFiBu�ldm :'shall'Notbe.Oc �,ed.untii a Firial Ins ectlon has Leenmade ;. � >;� ....:'s� Permit.NO. B-16-127 Applicant Name: ALEXANDER C. BLAIR Map/Lot: 287_051 Date Issued: 01/28/2016 Current Use: Zoning District: RF-1 Contractor Name: ALEXANDER C. BLAIR Expiration Date: 07/28/2016 Permit Type: Siding/Windows/Roof/Doors P , Location: 4 WACHUSETT AVENUE, HYANNIS Est. Project Cost $ 10,000.00 Contractor License : 100038 Owner on Record: STEWART,NANCY P&FINAN, HEATHER& sPermit Fee $51.00 Address: 43 PARK PLACE 3 Fee Pald- $51.00 '`- SHORT HILLS, NJ 07078. �� Dafe 1/28/2016 Description: reroof(stripping old shingles) ._ 4 i p Project Review Req : r r Building Official This permit shall be deemed abandoned and invalid unless the work auth mmenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the,approved�construction document's for which this permit has been granted. All construction,alterations and changes of use of any building and structures shallbe m compliance with the local zoning by laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing s N 2.`Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest fluerlibing is iristalledx .� 4.Wiring&-Plumbing Inspections to be completed prior to Frame Inspection; 5.Prior to Covering Structural Members(Frame Inspection) , , j s01 N 6.Insulation 7.final Inspection before Occupancy 's ..... •..a Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on"site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT t Town of Barnstable -*Permit# Expires 6 months from issue date yT Regulatory Services Fee Baxrtsrasis, • M"M 1639. Richard V. Scali,Director ♦0 Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6236 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address aesidential Value of Work$ , �� Minimum fee of$35.00 for work under$6000.00 T Owner's Name&Address ek ky6 z_ Iss . /-� L Contractor's Name ► L�1 Telephone Number — — Home Improvement Contractor License#(if applicable)./ 0U 3 S-' Email: St_%]d w /&i Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Chefttc one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) 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 ❑ Replacement Window_ s/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. - *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 Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: / Q MPFILESTORWbuilding permit forms\EXPRESS.doc Revised 040215 e ,�� Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I, , as Owner of the subject property hereby authorize ' �/i A16 f j to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature ca Owner Date Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. , Q:\WPHLESTORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services ~1 ��rte rti Richard V.Scali,Director Building Division saaNsr BLF. Tom Perry,Building Commissioner MASS. 1659. � 200 Main Street, Hyannis,MA 02601 ATED" 6 www.town.barnstable.ma.us Office: 508-862-403 8 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,govided 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 Y 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doo Revised 040215 The Comn:oyriveaith Q,f Massachusetts Department of Industrial Acciderds - awe of-1hrmtigadons, 600 Washington Street Boston,1MA 02111 ft Ymv niass gov1dia Workers' Compensation Insurance Affidavit: BmldersiCiantractors/Elec riciansiPlu nbers Applicant Information Please Print 1e0'bIy Name(Busiueessf0rg=fi3fi h&vid=1Y- M Address: b Cityfsta&zip: Phase i�: Are you an employer?Check the appropriate e= Tyke of project(required): 1.❑ I am a employer urith 4 ❑I am a general'contractor and I employees(frill azrdlor part-time)'* have hired the sub-contractors6 ❑New construction2.[�I am a sole proprietor or partner- Listed on the attached sheet. 7. ❑Remodeling ship and have no employees. These sob-confractors have g_ ❑Demolition , working for me in any capacity- employees and have workers' comp.i �411-oZ�rS�'camp.insurance cnsuran e-1 q• ❑Building addition. required-] 5. ❑ We are a corporation and its 10.[_1 Electrical repairs or additions 3-❑ I am.a homeovrmer doing all wank officers have esercised their 1LE]Plumbing repairs or'additions mysel€[No workers'camp- fight of exemption per MGI 12.❑Rnofrepairs, insurancerequire&]a c.152,§1(4),and we havens employees-[No workers' 13.❑other G comp-insurance required.] *Any WKcavtfat checks box 91 mast also SIloutthe section belowshowmg[hers woesere compensation poRcg iafunnatim I Homemmrs who submit this d5dMIA imd=tmg they axe daiag all we*and rhea hire outside contactors amst submit a new affidavit indicmag such- •Coauactars thst ehect this boar mast sttached as additional sheet showing the none of the sub-contrac=and state whether ar not those entities have emp3oyees.If the sub{ontrectutshwe employees,theynntsrpmvide their workers'comp.pally number. Ian[an euepIr�g�rrr fJeat is prolzdil[g warl€ers'cotrrper[satfo[[i[[szirar[ce for[�[}*en[pta,}�ees ;8'etaav is the poky arud jab site information Insurance Company Name: Policy,4*or Self-ins.Lic-#: Mxpiration Date: Job Site Address: City/State/Zip: Attach a copy of the corkers'compensationp.olicy declaration page(showing the policy number aad expiration date). Failure to secure coverage as required.under Section 25A o€MGL c- 15'7 can lead to the imposition of criminal penalti s of a fine up to$1,500:00 andf or one-year imprisonment,as well as ci-0 penalties.in ihe form of a STOP WORK ORDER and a Em of up to$250-0!0 a day against the--violator. Be adtased that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage y ecificatioa_ I do hereby ccet�zf}-undeer t e pain s and penalties ofped my Aattha u[formationprovided abm a is true and carrect Sitmature: �r - I}atc- f �7 C/!/ Phone Official use only. ,Do not asr[te in this area,to be completed by city orton!n of ciat City or To-nu: PermitlLieense if , Issuing Authority(tdrde one): 1.Board of Health 2.Building Department 3.City/rown Clerk d.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Ph-one#• ------------------ 1 aformatzon and Iastructions hassarhusett:s Geamral Laws chapter 152 retpmes all e33PIoyer3 to provide works'compensation for their employ(--es. pMMIMnt-•m this statute-,ate-,an.errPIayee is defined as."-.every person i a the service of another under any contract of hire, express or implied,oral or wnten" 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 Cr trustee of an individual,partnership,association or other Iegal entity,employing employees_ However the owner of a dweIling 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 mai„tenan ce,cons'f.ucti on or repair work on such dweIIi ag house or on the grounds or bolding apprutenaut thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that"every saata 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 commaowealth nor fay ofits political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the i„sura cei._ rcquir-em ents of this chapter have keen presented to the contracting authoiity." , Appl3cartts , Please fill out the workers'compensation affidavit completely,by Cher-® &a boxes that apply to your situation and,if necessary,supply sub-contiactor(s)name(s), address(es)and phone number(s) along with.their certificates) of bus rran .e. Limited Liability Companies(LLC)or Limited Liability Parbaerships(LLP)withi no employees other than the members or partners,are not mgaired to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affdayit may be submittr.;d to the Department of. Industrial. Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retumed to time city or town that time 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 reqmired to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-;ign-ance license n=ber on the appropriate line. City or Town.Officials Please be sure that the affidavit is complete and pried.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 stn e to fill in the pe�it/license nvnber which will be used as a reference number:.In n addition,a applicant that must submit multiple pennitllicense applications in any given year,need only submit one affidavit indicating current policy iaf j:iznation r~ifnecrosary)and under"Job Site Address"the applicant should write"all locations n (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 fufire 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 ern.)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. Tht C-o-MMM- th of Massaahu&-,,As ' Dega�m�nfi czf Iad�ial Aunts �it�e r��[,ve�gatZo-� Tf,-1.4 617 t�7-4900 iaxt 4-€6 or 1-977-MAS IE� Fax 617-727-774 Revised 4-24-07 .ma sg gQgldia e�panvmaivae a�C�/l/ladoccdccde6z `rce of Consumer Affairs&Business.Regnlation OME IMPROVEMENT CONTRACTOR, `. egistration: 100038 Type:' - Expiration;- /8/2ff16.a Individual AL ER C BL 'I i I t • S � 1�\ C J 'Al lair �� }92 4 �RBOR PT ROAb ��;�1,MA�IUID MA 02637 Underse& ' lugMassachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-016187 Construction Supervisor I IN ALEXANDER C BLIAIR PO BOX 22 �y CUMMAQUID M9 02 EXDlratlOp,... License or r6gistration valid for individu►use ui i } a before tl►e,expiration date. If found return to: � Office of Consumer Affairs and Business Regulation 10 Park Piaza-`Suite 5170 Boston;MX1 02116 Not valid withou, ►gnature - Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code-is cause for revocation of this license. DPS Licensing information visit:WWW.MASS.GOV/DPS d t Board of Building Regulations and Standards License: CS-016187 Construction Supervisor ALEXANDER C BL`AIR L\ PO BOX 22 % ' CUMMAQUID M4 0 .1 NO Exp.iration: Commissioner 07/16/2017 r • y J �VE Town of Barnstable *Permit# ,yi p F.Vires 6 months from issue date "7 Regulatory Services Fee MAM s�rrsram E. Richard V.Scali,Director A 2 Building Division Tom Perry,CBO,Building Commissioner —200 Main Street,Hyannis,MA U2601- 72, -_ -=--- - -- --- - - wwwto_wn.barnstable.ma us �_�0 111 .� i Office: 508-862-4038 t- A 3aVIBLE 5 80-6230 EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONL 2 -d C�I Not Valid without Red X-Press Imprint Map/parcel Number �J � - Property Address e Qyjn,,IS ❑Residential Value of Work$ (v � i Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name ��CE!^•d ,�C� f2� Telephone Number � �6 Home Improvement Contractor License#(if applicable) K 10-9 l Email: 5-C A)S�/C Construction Supervisor's License#(if applicable) Csr 01 b S77 ❑Workman's Compensation Insurance Ch k one: Fe I am a sole proprietor, ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ 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 F. [� Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town depar anent regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: QAWPFILES\FORMS\building permit fonm\02RESS.doc Revised 040215 ' i le Commompeakh of-ifasse djusetts Deparhment of rndushzal Accirlera fI,Twe of Imesdgidims 60O Was tgion Street .Boston,SSA 021I1 bpFm7f asmgorldi 1 --- �t}rkers' iCaffipensa>`nt�n 7nsuranc� �a��>�dersiCflntract�rslElecErj,�ianslP�umhers Print-Legl y-- ---- { CAIW Phone I�sme�Sansme�gan�onllo�dnal� �?CZ� C ��ptr�,` ' Are YOU an employer?Check the apfhopriate bom Type of project(required): I.❑ I am a employer vda 4 ❑I am a general contractor and I * have hiredthe sub-contmctms 6: [-]New ooms ctinri ,_/�Ployees(full aztc�or part-time. ' 2.1 I am a sale proprietor orpartuer- �d oathe at shed sit I. ❑Remodeling ship and have no employees nese sob-contractors have 8- ❑Demolition. worizing forme in any capacity. employees andhne,wadrers' [No worlmrs,comp.fiumranre comp.Msuran-C I 9. ❑Budding addition regnired] 5. ❑ We are a-corporatim and its 10-❑Electrical repairs or adds 3.❑ I ama homeoumer doing all warp officers have•exercised their 1L❑Plumbingrepairs or additions. myself[No workers'comp. right of exemption per MGL 12❑Roof repairs iusu ante required.]i c.I52,.§I(4)6 andwe have ua employees.[No workers' aEl Other camp-iasumnce required] 'Auy wKcsntfat chedsboa ff1 mast Elsa fM out the sedion below sho►oug theawo&me compensation pormyininmeauon_ ?Hnmiamunem who submit this af5datit indnratmg they axe doing RU wmt mi rhea here nub-ide contmctorsmnst submit a new afadarit mdic-ir, sari- . Zan that rhea tlds boa mast attached as addilirma,sheet showing the name of the sub-cam and state whe&er or not those entities have employees.Ifthesub-caatmctvtshave employees,theynaurpmride their worltexs c p.policy number I arri an eutplayer tliatis pranidilw ivarkers'cougrensalurrt inmarance for my enrplg.yes Below is MerpaUcy anew)job site informathn. Insurance Company.\ame: Policy i'r or Self-ins.Lic- ` EkpiratioaDate. Job Site Address: city/State/ : Attach a copy of the workers'compensation policy declaration page(showing the policy number and eiph-ation date). Failure to secure coverage as requireduuder Section 25A o€MGL c 152 can lead to the imposition of criminal penalties of a fine up to$150D Oa andlor one-year inT:dsDnm=zk as wall as civil penalties is the form of a STOP WO RIK ORDER and a Eme of up to Wi0-09 a clay against the-violator. Be adiised that a copy of this statement may.be forwarided to the Office of lavestrgations of t he DIA for insurazice•coverage verification- Ida her-eby cer ;f�ander the -is"mrdponatties ofperjmy thatfFie irrformafivaPM h-W aabM ff is but mid carrect Si�ature: ^ IJhate= J (���� • Phone A ` jOL-idZ use urt£y. Da trot Error in this Area,to be camp£eted by city rrrtotnn official City or Fawn: Pe-rmitff&ense if Issuing Authar€tp(circle one2: 1.Board of Health 2.Building Department 3.Cityffuwn Qerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person Phone#: Taformation. and Instructions � Massachusetts C7e=ral Laws chapter 152 req=rs all empIoyers Yn provides workers'compeusaticm far their employees. Pm-saantto fhis sty,an.m7grIayee is defined as"_.every pers6nin I e service of muff m under any contract ofhil e, express or implied,oral or wriftea.." An.e rg7&yer is defined as`pan indi7idnal,partnersbin,association,axporition or other legal entity,or any two or more of the fxegomg in a joint Asa,andinchzdmgthe Iegal represeatafives of a deceased employez,or the receiver or trustee of an mdividnal,partnership,association or other-legal entity,employing employees- However the owner of a dwelling horse having not more than#hrea aparbueats and who resides fh=dn,or the occ¢pant of the - dwelling house of anal er who employs persons to do maiienanm,c^ns:ftuc''on or repair work on such dwelling house or on the grounds or btu7dmg agpurteD.a3tthemb shall notbecanse of such eurploymeast be deemed to be an employer." MGL chapter I.52,§25C(fi)also sfatts that"every sty or local I=riling agency shall whhhDId fhe issuance or renewal of a license or permit to operate a business or to construct buildmgs in the commonwealth for any applicant who has not produced accepptable-evidence of cd nprance Wn the ins-nr-ance coverage require " Additionally,MCI,chapter 152,§25C(7)states'Weiffimfhe commonweahh.nor nay ofits:poIifical subdivisions shall ent-Z inti any coaifr .act for the p ante ofpnbIic work tmfil acceptable evidence of compliance wrlh the mcrrrance.- requirements of this chaptEx have been presented to fbc contracting auf c)dty" AppHcan s Please fill obt the w oDi3o s'compensation affidavit completely,by checking the boxes that apply to your sitnmfion and,if necessary,supply sub-contractors)name(s), address(es)and phone numbers)alongwiththeir certificates) of „cr„- =. Lfi itedLiabBity Compauies(LLC)or United Liah ityPartnemhips(LIP)withno employees other thanfhe members or partners,are not requed to casy workers'compensation i osmance If an LLC or UP dDes have employees, apolicy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for con in ation of instrrHIIce coverage. Also be sure to sign and date the affidavit The affidavit should be rebored to the city or town that the application for the permit or license is being regnest not the Department of Ind gtial A=cleats. Shouldyou have any questions regarding the Iaw or ifyou are required to obtain a workers' compensation policy,please call the Deparfinemrt at the rmmber listed below: Self--msm ed companies should eater their self-mince license nuber on the appragdafE line. City or Town Officials . f - Please be sui a 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 coact you regarding the applicant Please b e sure to fill in fat pew iYlicense mrnber which will be used as a refrrence number. In addition,an applicant that must sabia t multiple pemzitllicense applications in.any giv=year,need only submit one affidavit indicating current p olicy i afbimatioa(if necessary)and under`Job Site A Ju—Irm "the applicant should write"all locations in (may or town)"A copy of the affidavit that has been officially sf moped or marked by tae city or to may be provided to the ' applicant as proof that a valid affidavit is on file for fninre 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 commemial venture (it_ a dog license orpennit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigation would at to thank you i u.advance for your coopeafion and should you have any questions, please do not hesitate to give us a caIl- The DepartmwfS address,telephone and fax number: T t f:G.MMM ttb�of MassachustM Delta dment cif I-ictisftial Acc ident% Off!=of ufve.Srdgatio= ' ��4�ashin�tan t ��o-rrz�E1IF T61.4 617' -4.��G Qxt 4-06 W I Fax-617 727 7749 Revise d4-24-07 MBZ EgQgldza MASS. ,�� Town of Barnstable QED MIS� Regulatory Services Richard V.Scali,Director -- -- - Building Division- - - ----Thomas.Perry,CBO.-.— Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section". If Using A Builder I, , as Owner of the subject property hereby authorize to act on ray beh4 in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name L erty Owner is applying for permit,please complete the Homeowners License Exemption Form on the side. ES\FORMS\building permit forms\ESPRESS.doc 040215 r Town of Barnstable Regulatory Services �oFj rti Richard V.Scali,Director Building Division * 13MMS*"1, Tom Perry,Building Commissioner 516 200 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: cityhown 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 ofBuilding 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. Q:\WPFILESIFORMS\building permit forms\EXPRESS.doc Revised m215 g�- ;�• ,. ,_: Vhe o�nvrrcu?zcoea�i o�O��ara�accaeGt , ce of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOP, egistration ?60038 Type: ^. y • �.� :•Expiration- li/812f19f:_; Individual Blair .� �' • �•1 a Y:: �'..' •�'_�1 _ 192 SOR f?T`RO ;i �t,iJ1NcIU.113;'MA 02637y _ y _ Undersetr Massachusetts Department of Public Safety lug Board of Building Regulations and Standards License: CS-016187 Construction Supervisor ALEXANDER C BLAIR :�\ PO BOX 22 CUMMAQUID M9 02 �..M .1.� _ ._Ex� ratio�•t,,. l °License or registration valid for individui use���:' before the.expi ration date. If found return to: Office of Consumer Affairs and Business Regulation 10_ParkPiazh-S6ite-5170 Boston;M• '02116 Not valid withou . ignature - I Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS License: CS-016187 Construction Supervisor ALEXANDER C BL.SAIR PO BOX 22 s CUMMAQUID M4 0 CA-- Expiration: t Commissioner 07/16/2017 VE 4 F 'A lYt S k 3- r s639. Town of Barnstable �p ��� rED MA'I Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax:, 5.08-790-6230 Property'Owner Must Complete and Sign This Section. If Using A Builder I ,as Owner of the subject property hereby authorize �i!?�df to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signatuxe Owner Date . Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\MRESS.doc Revised 040215 PIN n_PRODUCTS _ BUI LDI N(' pEP7 WOO 326 Yarmouth Rd. I Hyannis, MA 02601 1 508.771.5007 1 Fax 508.771.7070 1 hyan^is(pineharbot.com JAN®8 2016 259 0oeer,Anne Fd. i Harwich, W.02645 1508.430.2800 I Fax 508.430.?115 I info@pineharbcr.com TOVV 1.800.368.SHED I Customer Service 1.866.SHEDKIT I www.pineharbor.com N OF ggRNSTpBLE I nn F V ' I-L I W. ---- - -- F�l S _ t 6 � I { b� w �r,., c..�`f` !tJ Wit''"Ll . e i t , I I a SCALE: I APPROVED BY: DRAWN BY It DATE: , ;` REVISED -J a T DRAWING NUMBER " P r 1 f t SCALE: APPROVED BY: DkAWN BY DATE: REVISED 1 r i pf� DRAWING NUMBER 1 p �� �l • i 1 lb r o) : u • 1 '' r y 1. i A t u Ta L A TE.15I o re"e IN Iff Ti nt PANe t rc j' JO�xZo` PC. vi.C. i�Fa I Sf A t0, L J�' 1 � , i 1 v.Y/!V J i 1. I�.T. 30('S11_L — f j G �E�-�1 0t.1 Uri�"+-I ' �` �t�J�- � ��--��. �� ���/�,•�'•� ;y. S-4 F:R. f m1 SCALE. I � _ APPROVED BY: DRAWN EY R t GATE: 1 REVISED ' �"t''._ L•. LCl LJ.F:.-J IIJ��/f �� • J 1 ' �•r� at '�C'N k i Yam•„ , 1 Dn:'NIN� ^JUMBEP FINISH GRADE OVER D-BOX= 39.5t PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE GENERAL NOTE REMOVABLE WATER-TIGHT COVER OVER . TOP OF FOUNDATION = 38.3 t FINISH GRADE OVER CHAMBERS= 39.4� - 40.7� ` f- PROVIDE EXTENSION RISER SLOPE @ 2% MIN OVER SYSTEM 314"TO 1-1/2" DOUBLE WASHED STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION WITH COVER OVER INLET& FINISH GRADE OVER TANK EL.= RISER TO WITHIN 6" OF FINISHED GRADE OUTLET TO WITHIN 6"OF F.G. 39 $, MAX 4" SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISHED GRADE 5" DI A. OUTLET(S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 21) 2' OF 1/8 TO X DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. @FOUNDATION = VARIES - STONE OR GEOTEXTILE FILTER FABRIC 20"MIN.ACCESS 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE COVER(3 TYP.) 3.T MAX• 1 , PLACE RISERS ON ALL DESIGN ENGINEER. SEE NOTE 22 TOP OF SAS=34.70 PROP. SCH. 40 LISE MAX. 6.0'MAX. CHAMBERS WITH 3. 4" SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL PVC SEWER PROP. SCH. 40 NOTE 22 33.70' SEE NOTE 22 ' INLET PIPES TO 6"OF SYSTEM UNLESS OTHERWISE NOTED. PVC SEWER BREAKOUT EL= 34.20 FINISHED GRADE 6" 3" 2" DROP MIN. 3" 9" L-26'± 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN MIN.SLOPE @ 1% 3 DROP MAX. - MIN.SLOPE 19'o PROVIDE WATERTIGHT o ELEVATION = 34.20 FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A 13" 4" PVC IN FROM -JOINTS (TYP.) 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF -A=35.U '� 14„ 34.50' SEPTIC TANK 4" PVC OUT TO 0 O 0 0 0 0 °° 0 0 O 0 0 o THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. B=34.9' O LEACHING FACILITY o0 0 0 Ci-36.2't � � � � � 0 5. SLOPE ALL SOLID PIPE AT 1.0%MINIMUM. '- 12„ „ pp o 0 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. 48" OUTLET TEE 34.17' MIN. 34.00' 2' p 0 00 CXD 0 0 0> 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK 34.75' 6" CRUSHED STONE 0 0 C 0 po FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS GAS BAFFLE OVER MECHANICALLY p� °° _ NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH 11.V OFFSET TO FND COMPACTED BASE I AND DESIGN ENGINEER. TEES TO 8E CENTERED 4.0 8.5' (TYP) 4.0' 4.0' 4.0' 5 OUTLET DISTRIBUTION BOX 4.83' 8- ELEVATIONS ARE BASED ON APPROXIMATE M.S.L. DATUM. ELEVATION OF 40.00, 6" CRUSHED STONE DIRECTLY UNDER RISERS TO BE INSTALLED ON A LEVEL STABLE 42.0' (NP ) ESTABLISHED ON THE CORNER OF A CONCRETE PAD AS SHOWN ON PLAN. OVER MECHANICALLY BASE. FIRST TWO FEET OF OUTLET < 26.40' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION COMPACTED BASE C 31 .70' GROUND WATER ELEV.= 12.83' PROPOSED 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT 5'_10" ' " (Dimensions per Wiggin 4-500 GALLON CHAMBER"- 5' MIN. CHAMBER END VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES LENGTH 10 -8 WIDTH DEPTH 6 -2 CROSS SECTION VIEW TO THE DESIGN ENGINEER. `JERIFY ExISTIIv�, pp Precast Corp., Pocasset, MA) TYPICAL CHAMBER PROFILE .- ELEVATION PRIOR TO ANY WORK& H-20 S E PT t(- -t A R 1 t< f- RO F 111 � H-2 0 D I ST IR!P' I T!O N! P r)X DETAIL H-2 0 �'������ � DETAILS 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE STRUCTURES SHALL BE MADE NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE WATERTIGHT. - REMOVE UNSUITABLE MATERIAL ''' ,�i; �7 sv r `fi\ -�'- _r F ST I� MA TA MT . 4,. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING DOWN TO C-2 SOIL & REPLACE w/ PROPOSED INSPECTION PORT t.. r ' '` MAP 287 l i' � - PERC NO. 14819 REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM CLEAN SAND PER 310 CMR 255(3) ■S -011• �., f. t r APPROPRIATE AUTHORITY. PARCEL 50 __f, . ■may • �4 , * �' INSPECTOR: David W. Stanton, IRS PROPOSED 4 500 GALLON PROPOSED 4' PVC VENT PIPE; ',,4 fy :_ I ( ) EXACT LOCATION PER OWNER r * i t y fii �ti• �e( EVALUATOR: Michael Pimentel, EIT, CSE 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS -42- H-20 LEACHING CHAMBFRS *ti ! ' . ly ti� iI 'I �.. � LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE S88°48'00"E +�1•Mti' wl' • � a ! I� ti •f�. C.S.E. APPROVAL DATE: Oct. 1999 / 93.60' � ,.,• i y tom- I THEY SHALL WITHSTAND H-20 LOADING. t+ � DATE: September 16, 2015 r� (.- y ' ( 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. I / `"? _ -41- DRUB Lif ao '� ZONEG ti S� it '� TEST PIT#: 1 n ! ' / J� Of a X "' X I�r . f �c �I (L � �i� Y ELEV TOP= 39.40' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE C w / � w • ~-. M `'�-� 1 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. p 0 (4 2.0 5) l 7 1, �' 41 � 1 '. ELEV WATER= < 26.40 REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, n i / - - - - _ 2L �PR i� .�,,' '�'�- . FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). PERC RATE= see sieve results below Z EX. �'r �' A - 108"- 156" 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN ..I >• N ' DEPTH OF SIEVE= SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. v C I O O O O PROPOSED • l - - i .:. .- c �'� - ■�, 't t - TEXTURAL CLASS: 1 16 PROPOSED PROJECT IS LOCATED WITHIN: C7 ITl i / o° GARAGE ) t: ) , �,1� '+ �s.� �' ''�i. TP 1 ZCD + '' 6 �( " ASSESSOR'S MAP 287 PARCEL 51 06 C TP 2 39x4' 0 16'x 22' .. �,, +11' I t,->' _>, ti a _��r - ' ' +' OWNER OF RECORD: NANCY P. STEWART 01 M m / / 39x4' I if tt r„ `; M a / m 10.0' 10.1' _ j;;� i •:. , 5 �i .� -.: 0" 39.40' �O N p (6 6.T _ _ ,ti ! t `+� ,� HEATHER FINAN & TERENCE FINAN rn�bd9 ►� 3('ri Fill w` m J 3) PR. �( -' . �'� f- , -►�: :'�jr�'i 12" 38.40' ADDRESS: 43 PARK PLACE rn , ,. 14 SHORT HILLS, NJ 07078 01 i PROPOSED H-20 r EXISTING GARAGE �' HY ~` - `"' I B 10 L 10Yr 5/8 oamy d FEMA FLOOD ZONE X D DISTRIBUTION BOX / 5 0� (TO BE REMOVED) yf ��N '4=J �+ m i / EX ` tArl +-t „ '"C�+ ,� 1 LOCUS 36 36.40' COMMUNITY PANEL# 25001C0568J Ld� m ! \ { . H H f �__ - . 5�. - 17. DEED REFERENCE: BOOK 29089, PAGE 273 ` ,r ,� 1 18. PLAN REFERENCES: 1. PLAN BOOK 38, PG. 47 Benchmark �`�, _. 0 99 } -�' . I t '� # �, Sift Loam 2. PLAN BOOK 40, PG. 67 Concrete Comer :.:=' ` �''!`r` w �( 'gyp, i C-1 ., 2.5Y 6/6 / Elev. =40.00' `" ; 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. Approx. M.S.L. 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY i y. �. FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY 15/2' PROPOSED0 SWEEPINGLONG x - �' E .r'` '`. 108" 30.40' FOR USES OF THIS PLAN OTHER THAN ITS INTENDED B PURPOSE. PROPOSED H-20 1,500 / BEND P OF 2) 21. A 4 PERFORATED SCH. 40 PVC PIPES E PLACED IN A VERTICAL POSITION TO A GALLON SEPTIC TANK -- (2 / Medium Sand DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3" OF FINISH GRADE. A ►,� -----y o LOCUS PLAN C-2 2.5Y 6/6 REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. p, EXISTING CESSPOOL TO BE 22. IN ACCORDANCE WITH 310 CMR 15.401 -15.405,THE FOLLOWING LOCAL UPGRADE (1 C-2 HC- �-PUMPED, FILLED w/ CLEAN SCALE: 1" = 1000' APPROVALS ARE REQUESTED FROM 310 CMR 15.221(7): / SAND & ABANDONED 156" 26.40'Q/N/W. _. � / �8" (1.) A 3.00'WAIVER (3.00'-6.00') FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. I cF No Mottling, Standing or Weeping Observed (2.) A 1.30'WAIVER (3.00' -4.30') FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. U.Pt9/61 �- 39 � ----.---- ------------------ - (3.) A 0.70'WAIVER (3.00'- 3.70') FOR THE MAXIMUM COVER OVER THE SEPTIC TANK. - _f PIT � ;�ATA ------- PROPOSED DESIGN DATA I P r-,F N,n CLEAN-OUT PERC NO. 14819 I / (TYP OF 6) INSPECTOR: David W. Stanton, RS NUMBER OF BEDROOMS 5 EVALUATOR: Michael Pimentel, EIT, CSE EXISTING CONTOUR I MAP 287 C.S.E. APPROVAL DATE:_Oct. 1999 r� C-1 PARCEL 52 DESIGN FLOW 110 GAUDAY/BEDROOM ;,� PROPOSED CONTOUR September 16, 2015 TOTAL DESIGN FLOW 550 GAUDAY DATE: EXISTING OVERHEAD UTILITIES EXISTING CESSPOOL TO BE PUMPED & REMOVED IN ACCORDANCE U TITLE 5 j #4 DESIGN FLOW X 200 % = 1,100 GAUDAY TEST PIT#: 2 EXISTING ELEV TOP = 39.40' EXISTING GAS LINE "r. 5-BEDROOM USE PROPOSED 1,500 GALLON SEPTIC TANK < 26.40' -_,, EXISTING WATER LINE ELEV WATER = zo DWELLING TOF = 38.3'± PERC RATE _ 0) o % TEST PIT LOCATION N o DEPTH OF SIEVE _ ! o �� PROPOSED 1,500 GALLON H-20 SEPTIC TANK / INSTALL 4 - 500 GALLON LEACHING CHAMBERS Eo 7(p] I TEXTURAL CLASS: 1 �- EXISTING CLEAN OUT SIDEWALL CAPACITY EXISTING CESSPOOL (LENGTH + WIDTH)(2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GAUDAY / (42.0'+ 12.83') (2 ) (2' ) ( 0.74 GPD/S.F.) = 162.3 GAUDAY 0" 39.40' Fill .. ..._.. .... -._._. PROPOSED 4" SOLID SCHEDULE 40 PVC PIPE 0 12" 38.40' >q PROPOSED H-20 DISTRIBUTION BOX i 1 tNV.-36.0'± BOTTOM CAPACITY Loamy Sand / t 3 o - B 10Yr 5/8 INV.(A)=35.8'± u) (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY PROPOSED H-20 500 GALLON LEACHING CHAMBER - (42.0'x 12.83') (0.74 GPD/S.F.) 398.8 GAL/DAY 36" 36.40' JLC t CP 3 REV. 1 DATES BY AP D. AddedDESCRIPTION MAP 287 TOTALS: -_--1 PARCEL 51 Silt Loam PROPOSED SEPTIC SYSTEM UPGRADE \ TOTAL NUMBER OF CHAMBERS 4 C-1 2.5Y 6/6 t''� ` ��s� 11,971 S.F.± TOTAL LEACHING AREA 758.2 SQ.FT. r� � 3 i � ,- "� •., �' PREPARED FOR: I! TOTAL LEACHING CAPACITY 561.1 GAL./DAY APPROXIMATE LOCATION OF EXISTING CAPEWIDE ENTERPRISES is ir , TO BE PUMPED, FILLED wl CESSPOOL SAND &ABANDONED(NOT 'A�� - 108" 30.40' f ` LOCATED AT � SIEVE ANALYSIS RESULTS 4 FOUND AT TIME OF SURVEY) (Soil sample taken from C-2 soil in TP1) 8 r f 4 WACHUSETT AVENUE NOTES: SWING-TIES ° C-2 2.5Y6/6 ' HYANNIS, MA 02601 Medium Sand \ SAND 91.4/o -�- j 1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE 3 DESCRIPTION HC-1 HC-2 GC-1 SILT 5.2% CLAY 3.4% „ SCALE: 1 INCH = 10 FT. DATE: OCTOBER 7, 2015 i OF EACH SEPTIC SYSTEM COMPONENT. \ TANK INLET COVER (1) 12.5 21.T -- 156 26.40 0 5 10 20 40 FEET I 47.88 ► PER TITLE 5 ALTERNATIVE TO No Mottling, Standing or Weeping Observed ` 2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF 3 N86°08'00"V1/ 20.5' 21.0' -- THE PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TANK OUTLET COVER (2) PERCOLATION TESTING GUIDANCE PREPARED BY: FOR SYSTEM UPGRADES JOHN L. 50.6' -- 62.9' JC ENGINEERING INC. TEST PIT DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL CHAMBER CORNER(3) (EFFECTIVE DATE: MAY 3, 2006) `s CHURCHgL JR. <"" BOARD OF HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. WACHUSETT AVENUE 2854 CRANBERRY HIGHWAY _ Ct it 63.2' 66.2' UNDER POLICY BRP/DWM/PeP-P00-4: N :'a180� --- - - (PUBLIC-50'WIDE LAYOUT) CHAMBER CORNER (4) _ 3.) ENTIRE PROPERTY IS NOT LOCATED WITHIN A DEP APPROVED ZONE 2 _ SOIL TYPE: "UNCOMPACTED" ��'.> INE WATERHSED. CHAMBER CORNER (5) 68.2' 30.6' EFFLUENT LOADING RATE FOR 1, - ,�T EAST WAREHAM, MA 02538 OR ESTUARINE SITE PLAN __ CLASS 1, >85/° SAND= 0.74 GDP/SF 508.273.0377 CHAMBER CORNER (6) 56.8' 22.5' ASSUMED PERC RATE < 2 mpi Drawn By: BSM Designed By:MCP Checked By: JLC JOB No. 3243 4.) PROPERTY IS LOCATED WITHIN THE RF-1 ZONING DISTRICT. SCALE: 1" - 10' y/f