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0061 ANTICO LANE
{ ,4�'r � ` d r5'8; r �' f5-z t A:• 7f all -k3 a �, t► 4 f �1�t fiM s R �'/',' 0 u. s 4 A J :4 a 4 . a Y a e r o d 5' y[ TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION Map 7' o� Parcel b�Z Application # 40 0111k Health-Division Date Issued 1 q16 Conservation Division f` Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ��3J�cs,} Historic - OKH _Preservation/Hyannis Project Street Address INakn l.a^u Village �dr l�C Owner tl� �0 ''� `RM, E\kf v,- Address 50,4 • Telephone Permit Request "i r. k �' I�Vvves irr—L o'c Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatiA 16+06® Construction Type�,60 �, e Lot Size I � Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family'.'a Two Family , ❑ Multi-Family # units) Age of Existing Structure Historic House: ❑Yes 0'No On '9 9 Old King s Highway: ❑Yes D 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 g new First Floor Room Count �( Heat Type and Fuel: 3'6as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes CYN0 Fireplaces: Existing New Existing wood/coal stove: �Yes�-❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing D raew size_ Attached garage: xisting ❑ new size _Shed: ❑existing ❑ new size _ Other: '1 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# rm Current Use Proposed Use w - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name elephone Number � �� Address to License # C's Ws '"�Ae.►'Ta��� OZ�`?� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 111,56 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. , ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION II O, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL a GAS: ROUGH FINAL FINAL BUILDING Z&.aq d , DATE CLOSED OUT ASSOCIATION PLAN NO. i - - The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washing-ton Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Tusurance Affidavit: Builders/Contractors/Electricians/Plumbers AppUcant.Information A Please Print Legibly Name (Business/Organization/Individual): i � 'i"� eenc 7C.% Address: 10 E-F'kg�.City/State/Zip: - s- Phone-#: 'SO S-3- ct-7 1' 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 employees(full and/or part-time).* have hired the s'ub-contractors. 6. ❑N w construction 2. I am a•sole proprietor or artner- listed on the attached sheet 7. Remodeling ❑ P P P 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 insurancn.t 10. Electrical re airs or additions required.] S. e are a corporation and its ❑ P 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' 1312'Other comp.insurance required_] 'Any applicant that checlo;box#1 must also fill out the section below showing their workers' compmsafion policy.information. t Homcowncrs who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that cbcck this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt their workers'comp.policy number. lain an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information Insurance Company Name: .. Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: 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 crimitial penalties of a fine tip to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the bIA for insurance coverage verification. I do hereby c der pains-and penalties of perjury that the information provided above is true and correct Si afore: Date: Wo. Official use only. Do not write in this area, to be completed by city or town offtciaL 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#: i Information and Inst 'Uctions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the three apartments ents and who resides therein, or the occupant of the owner of a dwelling house having not more than p dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local Licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ohapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, i.f necessary,supply sub-contractor(s)name(s), address(cs) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the nuirtbcr listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Towii Officials Please be sure that the affidavit is complete and printed legibly. .Thc Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/licensc number which will be used as a reference number. In addition, an applicant that must submit multiple permit/licensc applications in any given yeax, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations is (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would hlce 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: Thy cbmmonu,F,a o Massachu a� 1jeputmmt of hail s� d AccidQz1:S OffiCc of Wyes>rIgati011s 600 Washingtm Street B utan, MA 02111 Tel. # 617-727-490.0 ext 406 or 1 -M-MASSAFE Fax# 617-727-7749 Revised 11-22-06 wwsy.mass.gov/dia �oFrHero�s Town of Barnstable ~` Regulatory Services �BM MASS. �` Thomas F. Geiler, Director r6DMA�b Building ]division Tom perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.toiYn.barnstable.ma.us Office. 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete. and Sign. This Section ff Using A Builder l ZZ� as Owner of the subject ro er�'�J�. ID p T ' J property hereby authorize Si' t( CL2 f�V-**%, CF-J�EP-J Y to act on my behalf, in all matters relative to work authorized by this building permit application. for: (Address of Job) r Signature of Owner Dale Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. k Town of Barnstable �oFTHE r � Regulatory Services + r BARNSTABLE, Thomas F. Geiler,Director 9 MASS. ,679. A,� Building Division rFD � Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 www.town.barnstabie.ma.us Office; 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": ' name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwc inlrs 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 t 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.L 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 Horreovner 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.rcquired shall be exempt from the provisions of this section.(Section I09.1.I-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 s 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. 5,000 of encce 00 enclosed spa E ` -3 IA-Masonry only " - C - . -2 Family Sowes ossess a curreat edition of the y . . .� - , - � �-�oo�vnta9craea�l� Failure to p, Code i� d Massachusetts State Building '` Board of Banding Regulations and Standards ` is cause for revocation of this license. Constructicn supervisor Cleanse m'. Ucer�se: CS 75281 . Sift ste.: 3/iWi967 Ex plratlon: 311212009 Tr# 11056 tia -Res trlc 00' TODD J CANTARA 10 ECHO RD ' Comm►ssloner W YARMOUTH,MA 02673 JOB ,.5rii.0 C.vs�'o K c,►.�a.��w tn� TAYLOR DESIGN ASSOC., INC. SHEET NO. OF P.O. Box 1313 FORESTDALE, MA 02644 CALCULATED BY CK T DATE t Z+-Z4—®g TEL./FAX: (508) 790-4686 CHECKED BY DAT SCALE T LO .. t-., ... -� .... t .. .... ;... _.. ....... - ... ._. .. ._ r .. • ..... ... tto ...... ... .... .. k a ... .. .... _. . k 8 Z tic: pc -z. t.c.�2 t�i��' .rt.. 7-11 . ...... ..... ..... . ...... _ vs . k .,.. ..- ..... ...... ...., .. ..... .: �A•y .. i �OT_ r,uvjvv t C7. Cis" �a, s .... = ..[ t. 4 o �4 GIF JOB 6cwdn cawbmd C#��Aeew2nw • TAYLOR DESIGN ASSOC., INC. SHEET NO. Z. OF ?I P.O. Box 1313 c FORESTDALE, MA 02644 CALCULATED BY m DATE TEL./FAX: (508) 790-4686 CHECKED BY DATE SCALE .........................i-............ ............ ........... .......... .......... .................................................... dill .......... .............. .............. ................ . ..... .......... ............ .............. &t ................................. tS .................. ........... 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Pgnni t"M4.1 M,&Ch*Xl M-1 MWAdi f Appttcamt: r m en o locahiott of Property: nteryille, x z o, r 3��,rehz t9 6 3 ae� Q/J by n°.-�`�: el 4 co COO � 4.z ot� co, o ',Aan� tie1f992 143 od �,.-2500010015Cff04 . 0 zone. As AUL o J here cent ''ff1CLr tf115 e MISS tton was;p r c T. r6 etfc Costa?C �el�vmmunl an/C.� a 4 - u 131 y ale Uing stwwty hereon, esnoec{a11, in speciad. EI,.jkfoo& e hamu (yuc wi�,an eWechve daft of 19 85and nhe locahbn, O U ° the dwetti ves conform.rro fhe wcal,& -laws im w. wt�the ttmm�Fcommxrim wilt respect to hori� fat dimertst�ona� � Scale: 1" - setback. or is ewnpr4rom, Vtolatl.� m M OrCel'1'I�t L't—' Date: 6- r IL ,.tLOt'l, =1rv.. GeatErat laws Cha tw40A-.5eetLOYV?'. File No, PLEASE NOTE: The structures as shown on this plot plan are approximate only. An actual survey is necessary for a precise determination of the building location and encroachments,. if any exist, either way across property lines. This plan must not be used,'for' recording purposes or for use in preparing deed descriptions and must not be used for variance or building plan. purposes. This plan must not be used to locate property lines. Verification of building locations, property- line dimensions, fences or lot configuration can only be accomplished by an accurate instrument survey which may reflect different information than what, o is shown hereon. Please note that this is "NOT A BOUNDARY SURVEY" and is FOR MORTGAGE PURPOSES ONLY".., :. W COLONIAL LAND SURVEYING COMPANY, INCR3 269 Hanover Street Hanover, Mass. 02339 Phone: 781-826-7186 Fax: 781-826-4823 , ' a . b o_ 06 (0 i � �o9reasaea�e Beard Of Aulidiug Regulations and Standards HO IMPROVEMENT C I teease or'registratiou YAUd for oneTRn lndividul �I CONTRACTOR DefOre the-expiratlon datc. I�f foubd retV to d Y Re��gtlgh 159211 SOard of 1Bttildln F,>kp'ir t►cn g k�cgul8tious and Stalid 10/20.10 Tr# 266397 . Out Ashburton.Place ]30>i IYpe:. Partnership 13ost'pl{;.Ma.Oil0$ ECHO CUSTOM t A'RPENTRY'' TQDD CAN TARA t 10 ECHO Rb= W.YARMOUTH; t. AdmtnisErafor Ot N va11d wlth0ut 49nature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map" ( r7 6`1 Parcel 9, `� _ 00z�/ Permit# __3S 8rO 7 13 � Health Division Date Issued c �9.� Conservation Division � � . '�.. _• Fee• ' Tax Collector' �. g.,'�""'. f D ��� SEPTIC SYSTEM MUST BE'. Treasurer, j-� -' 1 INSTALLED IN COMPLIANCE WITH TITLE 8 Planning Dept. ' NVIRONMENTAL CODE AND Date Definitive Plan Approved by Pinning Board —�'�? �� 'j TOWN REGULATIONS f` Historic,-_OKH Preservation/Hyannis 5�: Project Street Address 1. /7VF le-V ��'"S/ ` Village L Owner c� �c Address .O bIR Telephone (goo 1 S39 - *1515 Permit Request �To�e �V� ���ct� 1�P u) �� Square feet: 1 st floor: existing proposed shy 2nd floor: existing - proposed (964 Total new . Estimated Project Cos Zoning District Flood Plain Groundwater Overlay Construction Type W O O"0 FlIKW Lot Size (o(v 0 5 a q4 Grandfathered: R(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: U(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ e(�N Sri �4 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 L Heat Type and Fuel: ❑Gas YOil ❑Electric ❑Other Central Air: ❑Yes Ao Fireplaces: Existing, New. 1 Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing 0 new size Barn:❑existing ❑new size Attached garage:❑existing Knew. sizes—If Y Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# . Current Use Proposed Use BUILDER INFORMATION Name T sGA: L NV2�D Telephone Number 3 00`S 3 9 S 5 Address -?, O License# C4 Z 1�� wall_ _`cam VP� P>nF�71 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTI DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE — FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. { k ADDRESS .►,. VILLAGE f w� OWNER DATE OF INSPECTION" FOUNDATION FRAME "( (Z� - 1C4� - - INSULATION FIREPLACE •= ELECTRICAL: ROUGH rr� FINALS PLUMBING: ROUGH- FINAL GAS: ROUGh" �` :155 s FINAL FINAL BUILDING mn,go ~- r DATE CLOSED OUT r cu ASSOCIATION-PLAN NO,.'I R • N 7a 1r' _ �.x i.r�..-,�.<s... ,uo;,.: a,s..,..-.eu' -....; .s�c..,w:�.•tr ..: �;. .r:-a-.tY.r.�.:x ..iv a, r a..+.i��.r.:,5�;:,ux-.>..X°tl:�a�,:6 7F.�...,�}ertl:...J�F'drr`.'•a ;:vi�'atiti?ztw�r:v!'.,.«. :.it„4:#o-.B7+aim:.�':ma}+::gX�f.4kw:ti^.ry.,`ra{lra,.'.::!.su ls�.x..r<:isAs�?Nr:?+'s�.e.:Fw.A"zit:^:.�.wseA:in'aA�a�.n(: V.b:.a:Ex:�xL¢luir, . 136. 37 �" ^ ANTICO h, �� LOT 5 �, •• ,� 13660f S.F. .� � � ROAD 97 A ` 33 50 �� 0 N f 0A e � r �` �P�qN OF Mgss9c PAUL ti o� R. m RYLL -+ No.32448 PLOT PLAN -- LOT 5 ANTICO ROAD BARNSTABLE MA SCALE 1 u = 30 ' MA Y 24, 1999 THE FOUNDA TON SHOWN ON THIS PLAN 1s'AS L OCA TED BY AN INSTRUMENT SURVEY ON 5124199 AND EXISTS CANAL L AND- SURYEYING - ON THE GROUND AS HOWN. 'i 306 OLD PL MOUTH ROAD BUZZARDS BA Y, MA - - PROJECT NUMBER 99-044-05 DATE PROFESS A LAND SURVE OR S . 17 136.37� - ` C) oe• 0 -- as, 0 z PR%MARy �o' ��� • Gus 9 � TN-i® � c� 070 •0 �° D-Box V o •P ILI SEPTIC J \0 .5 p�po �d TANK ae Q,E s LOCUS PLAN a AaEA ,� 13,6bO S,F, Scale: I =2000 �� 4 P'ER� SUI_I_n/A PLAN VIEW - LOT 5 0 1110.29733 CIVIL Scale:I"=40' 9 O z70.5 Indicates Proposed FG'f$�E ", Spot Grade Top of Proposed Foundation 71.25 EL, 70. 5 011 TH-2 EL, 70,s C1 'PINE NEEDLES 0 PINE NC-6DLGS oRcANIC MAT. 2„ ORGANIIC MAT, A VRY.pRKGRAY LOANI A VRJ. DRK. GRA`I LOAM 8� FINE SAt\kD ly,, FINS SAND VGL. BRN. LOAM YrLL, BRN, LOAM Q FINE SAND [3 FINE SAND. d 3 PERK TEST (02" P1=RK T[-ST LT.-1EL. 13Rnl. LT, yEL. DRN, 12o,� C V. PINS 5AN0 12i� C VRy, FINE SAND PERCOLATION TEST PERCOLATION TCST , CLASS I MATERIAL ' CLASS 1 MATE.RIAL t)EPTA — ,HH" DEPTH - 62" Le55 THAN Z MIN,,/IKICN LE55 THAN IP1 11404CFI No WATEK SNCOUNITED NO WATER ENCOUNTMO DATGI 05 f 14 1 98 r No, P-91S1 ENGINEER SULLIVAN ENGINEERING INC. • WITNEss:S,DUNNING',TOFC3,, O, oFFI.- ' PROPOSED SEPTIC SYSTEM 1. Plan Reference, Cluster Subdivision No. 755 AT 'ANTICO WOODS", Endorsed Feb 10,1997 LOT No. 5,ANTI CO WOODS Book 531 Page 83 2. Map 172 Reconfigured Lots 3-1,3-2,3-3, 4-1, 4-2&•5-3 C ENTERVI LLE , MA 3. Set Backs Front=20' Rear/Side=10' FOR 4. The proposed foundation shown hereon complies with OLD CENTRE REALTY the Town of Barnstable Zoning Set backs and is not within SCALE; I"=40' DATE: DEC. 30, 1998 a flood plain SULLIVAN ENGINEERING INC. SHEET I Of 2 OSTERVILLE, MA NOTES DESIGN DATA 1.Water Supply ForThis Lot is Municipal Water. Single Family-3 Bedroom With no Garbage Grinder 2 Location of Utilities Shown on This Plan Are Approx. Daily Flow=110x3=330 GPD At Least 72 Hours Prior to Any Excavation ForThis Septic Tank:330 GPD x 200%=660 GPD Project The ContractorSholl Make The Required Use 1500 Gallon Septic Tank •Notification to Dig Safe(I-800-322-4844) AREA LEACHING 3 The Contractor is Required to Secure Appropriats� 330 GPD/0.T4=446 SF Required Permits From Town Agencies For Construction q Defined byThis Plan. Sidewall=2(12+25.)2=148 S.F. Install Risers as Re uiredto Within 12°of Bottom Area= 12 z25 300 S F. q 448 S.F.Total Provided Finished Grade. LEACHING CHAMBER DESIGN 5.All Structures Buried Four Feet or More or Subject Al I Pipes to be Schedule 40.Use to Vehicular Traffic to be H-20 Loading. 2-500 Gal.Leaching Chambers in 6. Septic System to be Installed in Accordance With 12'x 25'Washed Stone Field as Shown 310 CMR 15.00 Latest Revision And The Townof Barnstable Board of Health Regulations 7 All Piping to be Sch.40 PVC. FOLLNO 71.25 FG.70.5 F.G.70.5 68.5 7 68.3 n,.t 681Tep EI. 68.5 679 Sot.El.65.5 67.7 Bedding as Per Title 5 5.0' 10' 10.5, ' 10 12' Bottom of Test Hole E1.60.5,No Water DEVELOPED PROFILE OF PROPOSED SEPTIb SYSTEM' ' Not to Scale OF There are no wetlands within 100 feet of the proposed leaching facility. PETER There are no private wells within 150 feet of the proposed septic system. SULLIVAN There is no increase in flow and/or change in use proposed. NO.29733 ro There are no variances requested or needed. CIVIL If the proposed leaching facility will be located within 250 feet of any wetlands, the 9 �1 R,Q bottom of the proposed leaching facility will not be located less than(14)feet above the maximum adjusted ground water table elevation. Finish Grade Filter - ro Fabric �--Compacted Fill N A& Pea Stone in Leaching"v Chamber 3/4„—1 1/2„ N Double Washed Stone LOT No. 5 ANTICO WOODS CROSS SECTION. OF CHAMBER CENTERVILLE , MA NOT To SCALE SHE ET 2 of 2 r ; 4 c sLL _.._ -�— L 1 Adsr--LA Ln..-.o.S.c Lsa.rma.nc a�.x�.►<[.n.r.cLOnomP.ac.t a,LL.MI.^.L u6to eomf *Sig coaww � .jj y a c4-..' F4• .. LL'.O- ' i FDUNWTON 0.AN. . O h.11wrn.ry yi.n[.M r.yeq .y PC.P..r.for tM u.q[M on1Y.Any o [Ily proMe�r �- c UMT 1 3 a s-rap aAfL i•s 4.%-1l L. L vv Ftli'MNGK , 2afi.Slf.L(NQiLAtlai�SFY.Q� '; O FIRE SOX ti Tt'RHITf.:2hHI1[1-D. - :FI Atstf UUMP _..__�+ ' FELT to ,I A"SCAT(M1W:) _ r Vs .bklT:.11ASft.'!t. f"'Ftv�rz-•�-.. KM [.A w4e:c taa.xr..�sn j F..OUNDATION.,llf -SECTION FIREPI-ACH UI<TNL �+l�TfcfeeeooPielcT.. r r-ALV.,POST 6140C A "PnT- CGf3G:6C:A6' - OFSQN f4. ...b"SAND FI l..l DECK R-AN..G'h,'-1:o) y t•FTp l•..i_MK:?ALl /Ml.Mwil-�p:.:.' 17a".-1.0' 9/29�98 sOs•a29.6191 .5:4" G.:.L<_AV.IflAQDL.OLI �sfbm latir>dooas:_' ".. signs -1-- ._ it�� s.,i; ,;• <;Yi' �, .' coftTight O ► YAll •. t R cR q - �' Lj ]:LC.'AtiUhlCilfc sfTA4�i" N � 1�8- OK:'►a.t Chi':t TS_ .....--- _.l_• `� 1 t all -----._-.fill^OAl1C1lOe 1D1.•CS _ 1 _ WArsRTABLE FIREPLACE DETAIL ' 4 Preliminary plant and layout& by DCD.are for the use Of their Customers Only.Any Other use Is striCtly Prohlbite MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 DATE: 1-11-1999 Bldg. Dept. Use CEILINGS: [ l 1. R-38 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-25 Comments/Location HVAC EQUIPMENT EFFICIENCY: [ ] 1. Furnace, 0.8 AFUE or higher Make and Model Number, THERMOSTATS: [ ] Adjustable thermostats required for' each HVAC system. AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] 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. HVAC EQUIPMENT SIZING: [ ] 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 . MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- .. - -- .. MASchect" COMPLIANCE REPORT Massachusetts Energy Code I Permit # MASch`&ck Software Version 2 . 0 I' I Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric -Resistance) DATE 1-5-1999 DATE OF PLANS : 1-4-99 TITLE: "LOT #5. ##61 ANTICO LANE PROJECT INFORMATION: COLONIAL J f COMPANY INFORMATION: OLD CENTRE HOMES . P .O. BOX 635 WAREHAM,MA. 02571 1-800-339-751.5 COMPLIANCE: PASSES Required UA = 380 Your Home = 355 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 886 38. 0 0 .0 27 WALLS : Wood Frame, 16 O.C . 2142 13 . 0 3 . 0 153 GLAZING: Windows or Doors 288 0. 400 115 DOORS ,r 52 0 . 350 18 FLOORS : Over Unconditioned Space a. 886 19 . 0 42 . HVAC EFFICIENCY: Furnace, 0 .8<• AFUE ' , COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent ' with the building plans, specifications, and other calculations submitted with "the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. 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 1250 of the design load as specified in sections 780CMR 10 a . 4 . G Builder/Designer Date/�5�7 MAScheck INSPECTION CHECKLIST Massachusetts -Energy Code MAScheck Software Version 2 . 0 LOT `#5 #61 ANTICO LANE DATE: 1-5-1999 } Bldg. l Dept. i Use I CEILINGS : C ) I 1 . R-38 I Comments/Location WALLS : [ l I 1 . Wood Frame, 16" O.C. , R-13 + 'R-3 Comments/Location I WINDOWS AND GLASS DOORS : [ ] I 1 . U-value: 0 . 40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes { ] No Comments/Location I , DOORS: 1 . U-value: 0 . 35 Comments/Location FLOORS : [ ] I 1 . Over Unconditioned Space, R-19 Comments/Location I HVAC EQUIPMENT EFFICIENCY: [ ] ( 1 . Furnace, 0 . 8' AFUE or higher Make and Model Number THERMOSTATS: [ ] I Adjustable thermostats required for each HVAC system. AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building' envelope that are sources�, of air leakage must be sealed. Recessed lights must be. type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0. 5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER [ ] I Required on the warm-in-winter side of all non-vented framed I ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] I Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be ' provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked- on the building plans or specifications..' DUCT INSULATION: ' C ) I Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8. 0 . i DUCT CONSTRUCTION: I l 1 7111 r1+1r•f=r; r,-1- ..1 rn 1 .rl „i4-1, mn {-ir• gnri fihrniic- 1-,�f•kinrr tAnA system must provide a means for balancing air and water systems. I ` it 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. HVAC EQUIPMENT SIZING: [ ] I Rated output capacity of the. heating/cooling system is not greater than 1250 of the design load as specified I in sections 780CMR 1310 and J4. 4 . MISC REQUIREMENTS: [ ) I Refer to 780 CMR, Appendix for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chifted' fluids below 55 F, and circulating hot water systems . ----NOTES TO FIELD (Building Department Use Only)------------------------ --= ... The Commonwealth of Massachusetts ho =�-�� •` . Department of Industrial Accidents ::- _. 600 Washington Street --•- � Boston,Mass. 02111 — Workers' Compensation Insurance Affidavit name: O 1� l'gV� D�S`I\' =SS 9. D L �©� h a s . .. .l 0����0< ,I k . II -- \\ �` location: tn.DA � 5 b L 6h�('I city S� :e h�C%,�\`k vy*t phone# ST.Y -• ,3`�,-1 J,�S ❑ I am a homeowner performing all work myself. ty . ❑ I am an employer providing workers' compensation for my employees.working,on this job.: ::::::::.: ::::::::::::::::::::::: :: :: company name... :::::::::::.:. .....:.:: .............. ::::::...... ..... .. . ... ..:. .. . .::....-. address:..:..:.;.. >:<;::::.. .>:.:>:<;: ..I ;..::.....,:.::.,.:.-;:: ::<.::.;;;;.. .. ..... .......::..;:..:.;:::........ .....:............::..:::.;:::>:::..:......... :.::;: .. .:: .:;.,::,::..::....::.................:.::.... city:;.. ,: . .-- . .:..... ;;:,.;:.:;:phone#..: ;::: ::>;::>:: ::>:>:;::.; .......... .:.......:... .::::::..:.::•::::...:::.::.: . . .......... . . insuranceco.. :....: ..:::... o ::::..::::::::::::.::•::::::: ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contradba'.listed below who . ;,, have the following workers' compensation polices: '`;::`' .:::::...::::.:. ::.. :...:.:.:.::.:.::. ::.;;:}: com an n . .. .:,:......:.;.....:.:�..i..:"....�....:.:,i....I�:'.:�...-.,..".�, address:: :. �..... ... .:. .... .. ,::.: .::... .............. ... :::::.:::.:.:.:.:.:::.. ... :::. ......... ?E: H> ....:.,.::....: :................................................... ::..;......::::..:.::........ :::.................:••.:...:..,•::::::........... :.:;;•;:.;::.:;.:.; :................................:.:..::::::•:::::.:::•::::•::::•:•:::::%:.:.:::::::•:::::::::::.::..................................................................................................................:........................ .. x .::::::::.:>:<<:> ::;::.;::<:::>:>;::« «<::;:;:::::::<::::::,::>:::::::;;::::::;::;::«::<:::><>::::: :: ::::>;:.:> :<.:..:;. fy.... .....:.::................ 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Failure to seeare coverage as repaired under Section 25A of MGL 152 can lead to the impoaidon of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as weft as dvfi penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification 1. I do hereby c the pains and penalties of perjury that the information provided above is&w.and correct Signature Date ` 4 b � aL ct - Print name W__ �r0�t �ti ��b n (� OP SwJaWJhone# �f�0 •� �'( 5 S_ official use only do not write in this area to be completed by city or town official city or town: permit/license# . ❑Bunding Department ❑Licensing Board Immediate response is required Sdb ctmeWs Office ❑checkifimm respo q ❑ _ ❑Health Depafment contact person• phone#; ❑Other (raiwd 9195 P!!U .. :: ... DATE(MM/DD/YY)... ACORD� CERT1FICp►TE �F LIABILITY' INSURANCE cYM» 01/06/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE of Cape Cod, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 480 Route 6A, P O Box 838 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. E. Sandwich MA 02537 COMPANIES AFFORDING COVERAGE The Insurance Agency - - COMPANY Phone No. 508-888-2766 Fax No. A Legion Insurance Company INSURED _ COMPANY B J Scott Cimeno COMPANY Old Centre Realty Trust C P 0 Box 635 COMPANY Wareham MA 02571 D COVERAGES i 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. CO TYPE OF INSURANCE - POLICY NUMBER POLITE OLICYEFFEC IVE POLICY OLITE EXPIRAT ON LIMITS LTR GENERAL LIABILITY - GENERAL AGGREGATE $ - COMMERCIAL GENERAL LIABILITY - - PRODUCTS-COMP/OP AGG $ CLAIMS MADE ❑ OCCUR PERSONAL&ADV INJURY .$ OWNER'S&CONTRACTOR'S PROT - EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) .$ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - ANY AUTO ALL OWNED AUTOS ' BODILY INJURY - $ SCHEDULED AUTOS - (Per person) HIRED AUTOS - - - BODILY INJURY '$ NON-OWNED AUTOS - - - (Per accident) - PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO - - - OTHER THAN AUTO ONLY. EACH ACCIDENT $ AGGREGATE ,S EXCESS LIABILITY - EACH OCCURRENCE S UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM - $ WORKERS COMPENSATION AND WC STATU ER EMPLOYERS'LIABILITY - TORY LIMITS ER is EL EACH ACCIDENT $ 100000 THE PROPRIETOR/ A NCL° WC4-0289809 11/23/98 11/23/99 EL DISEASE-POLICY LIMIT $ SOOOOO PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100000 OTHER - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Carpentry/Building Operations ......... _.............._ __..... ......... _ _ .......... ..... ....... _. CERTIFICATE O HLDER CANCELLATION BARNT01 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL - Town of Barnstable 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Building Dept BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 367 Main Street Hyannis MA 02601 OF ANY KIND UPON THE MP NY,ITS AG NTS OR REPR . . _ AUTHORIZED REPRESENTATI E The Insurance ncy ACORD:25-S t1/95) ©ACORD CCIRPORATION 1988 A C T I V I T Y R E P O R T Date : 12/03/98 Time : 08 :45 : 50 For: MP A. Agcy, Brch, Dept A) Only: 1 B) Only: 1 D) All B . Which clients? All Clients C. Date selection 12/02/98 to 12/02/98 D. Marketing plan All marketing plans E. Activity category All activity categories F. Open/Closed Status All items G. Alphabet All clients H. Operator All operators I . Customer Service Rep All CSRs J. Producer All producers K. Company All companies L. Policy type All policy types M. Success Status Both N. Sort option Operator ID 0. Page break by sort No P. Output Summary detail Q. Extra criteria None Y ACOROTM GERTlFlGATE OF- AB#. TY( ISURANe f �1/04/1999 PRODUCER (508)888-2244 FAX THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ryden Insurance Agency Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 Route 6A HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR " ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Sandwich, MA 02563 j COMPANIES AFFORDING COVERAGE COMPANY Commerce Insurance Company Attn: Stephanie Rogers Ext 20 i ' A _ _ . .... .. . i_... Worc ester ...Insurance Company INSURED Sandwich Concrete Forms, Inc ` ; COMPANY P 0 Box 183E ..:.. I Sandwich, MA 02563 COMPANY C x COMPANY D COVERAGES r 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. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION' LOWS LTR GATE IWNODIM DATE W"DrYY) GENERAL LIABILITY . GENERAL AGGREGATE 3 6007000 X COMMERCIAL GENERAL LIABILITY .,..L .... n ,. ' , • : � � � PRODUCTS COMPICPAGG �3 `, 300,000 CLAIMS MADE X ,OCCUR ' PERSONAL 6 ADV INJURY S 300,OOO A K24387 08/18/1998 08/18/1999 . ! -' OWNERS L CONTRACTOR'S,PROT EACH OCCURRENCE S 300 000 I . . .......... a FIRE DAMAGE(Any ono fire) !S SO,..000 MED EXP(Any one Parton) S 5.000 AUTOMOBILE LIABILITY ` COMBINED SINGLEUMIT' S ANY AUTO W ALL OWNED AUTOS EDGILY INJURY X SCHEDULED AUTOS (Per poreon) 3 ——1 07/17/1999 00,000 HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accident) 300�000 ,,. PROPERTY DAMAGE S . 50 000 GARAGE LABILITY :+ , ,. "� AUTO ONLY•EA ACCIDENT ANY AUTO :..:.: OTHER THAN AUTO ONLY EACH ACCIDENT!S AGGREGATES EACESS UA<TY EACH OCCURRENCH S UMORQLA FORM .. ' . AGGREGATE 3 OTHER THAN UMBRELLA FORM WORKERS COMPEASATIONAND, '. ., ;, c*. - <: EMPLOYERS•LIABILITY r,. jDRY 041M. ER r 3 EACH ACCIDENT f 5 B WC812409. 06 1Z 1998 : 06 12 1999 e, " 00,000 THE PROPRIETOR/ INCL EL DISEASE POLICY LIMIT 3 500,000 • PARTNER6/EXEGUTIVE ; �,:,• t OMCeRS ARE. EXCL' EL DISEASE-EA EMPLOYEE 3 500,000 OTHER DBBCRIPTION OF OPERATIONSILOCJITION6r4FAICLESJSPECIAL ITEMS ' co CERTIFICATE NO PER r 'F !� 17 , l:v. :VIV\CT�ON:..SI..W...,.� 1.. ... ..... .,_.. ,._ ....... ,. i<• a' .,� - BHOULO ANY OP THE ABOVE OHSCRIBED POLJC3E3 BH GANCSLI BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILLENDEAVOR TO MAIL a '' 10 DAYS WRITTEN NOIIC15TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, $Gott Ci menO` BUT FAILURE TO MALL SUCH NOTICE SNALL IMPOSE NO OBLI"T10N OR LIABILITY P.O. BOX 635 OF ANY KIND UPON THE COMPANY.ITS AGENTS OR REPRESENTATNEB e Wareham', MA 02571 AUTMORG�DREPRESENTATIVE C David Val ovaC ACORD 25 .(1196) CORDCORPORA110N;19 i :: : AY{ r■ rp♦rDATE(MMIDE)NY) C R { ■ `� :.i}}iii::.::.i::i:^i:R::;:6y:: ii5i;i•:ii:ii:}::J;..;niy::n.:::::::.::�:::::::n�::::::::.�::::::M:::ii:.:::.4:>:i:�:iii:v:iii:vvv:;;.;:n.;::::ji.:$::.:::::: 0 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ins . Agency Of Cape Cod, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE g Y P HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 838 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Sandwich, MA 02537 _ .„ T - _ COMPANIES AFFORDING COVERAGE . COMPANY` Trust Assurance Company INSURED COMPANY Greg P. Jones DBA Jone Excavation - e P. 0. BOX 635 COMPANY „ Wareham, MA 02571 C COMPANY D ...>isri»€ 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 ITHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONLTR LIMITS DATE(MM/DD/YY) DATE(MM/DD/VY) GENERAL LIABILITY GENERAL AGGREGATE $ 300,000 A COMMERCIAL GENERAL LIABILITY TBI 9/21/98 9/21/99 PRODUCTS-COMP/OPAGG $ 300,000 CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ 300,000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300,000 FIRE DAMAGE(Any one fire) $ 50,000 MED EXP(Any one person) $ rj 000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) HIRED AUTOS `-_ BODILY INJURY $ NON-OWNED AUTOS (Per accident) f PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY TORV LIMIT R ::> EL EACH ACCIDENT $ THE PROPRIETOR/ INCL PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT $ OFFICERS ARE: EXCL EL DISEASE:EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATfONSNEHICLES/SPECIALITEMS Excavat ion Contractor H#�E.3 ..... ......................................................... Town Of Yarmouth SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Yarmouth, MA 02664 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Attn: Inspectors Office -1_0_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIO OR LIABILITY OF ANY KIND UPON T C MPANY, TS AG TS ESENTATIVES. AUTHORIZED REPRESENTATIVE y]ill DAVID J. DEC I EAR R 199 FO M ATION TTE R OF IN R '" THIS CERTIFICATE IS ISS AS A.MA aOOUCETt (508)238-0056 FAX (508)230-8367 I rs a Insurance Agency ONLY AND CONFERS No RIGHTS UPON THE CERTIFICATE 9 Y Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 85 Washington St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. o rth Easton Village Shoppes COMPANIES AFFORDING COVERAGE ........ ..................... . orth Easton, MA 02356 1 COMPANY Assurance Company of America ttn: I_i nda Ext: 211 A .......... .. .. iSURED ! COMPANY P & W Construction, Inc. 13 50 Elm Street ......................... . ................ ........ . ........ North Easton, MA 02356 COMPANY C i COMPANY D a M... 'J• .L i 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. .... ......._...................... .................................... . . .... .............. ..... ... ....... .......................... 'O TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE .POLICY EXPIRATION LIMITS 7R DATE(MMOONY) ; DATE(MMIDDIYY) GENERAL LIABILITY '. GENERAL AGGREGATE :$ Z,GOO.OOO ... ..............................:......... COMMERCIAL GENERAL LIABILITY ? PRODUCTS-COMP/OP AGG S. 2,000,000 ........ .............................:..... CLAIMS MADE X OCCUR PERSONAL fl ADV INJURY :$ 1 000,000 q SCP 32752702 03/12/1998 03/12/1999 .............................................,................ OWNER'S rs CONTRACTOR'S PROT: EACH OCCURRENCE $ 1 I GOO,OOO ,................... ..........................:.. FIRE DAMAGE(Any ono 1110) ;$ 50,000 .... :......................................... ...... ................. MED EXP(Any one Pomon) 3 5,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMB 8 ANYAUTO i ..................... . . ...................., ........... ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS ( ................ .......... r person) MIRED AUTOS BODILY INJURY- NON.OWNED AUTOS - - i (Per Bcci.....eanU................ .......... .. .. ... PROPERTY DAMAGE i S AUTO ONLY•EA ACCIDENT :4 8 GARAGE LIABILITY ... .... . - - i . . ANY AUTO OTHER THAN AUTO ONLY EACH ACODENT;$ ............. AGGREGATE;$ EACH OCCURRENCE EXCESS LIABILITY E UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM WC STATU WORKERS COMPENSATION AND 'TORV LIMBS? ; ER q` );; :i ... TR EMPLOYERS'LIABILITY EL EACH ACCIDENT $ SOD,OOO q 1C9 95834108 03/12/1998 03/12/1999 .............................................. ........ THE PROPRIETOR/ INCL i : EL DISEASE•POLICY LIMIT :S 500,000 PARTNERSIEXECUTIVE OFFICERS ARE. EXCL i : EL DISEASE-EA EMPLOYEE':S 500,000 OTHER i DESCRIPTION OF OPERATIONS)LOCATIONSIVEHICLe=PECIAL ITEMS L Le SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Old Center Realty BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. BOX 635 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRrAENTATIVES, Wareham, MA 02571 P RESENTATIVE 3. t•J (�p4 i:l•. TnTr)I P fin 't;•.,., r....>.,.,.- .'�",. ;�?...r.,.r.: R�N" ,•'.7�7'...+IF;,. �r,�S■ Y:°' xyai 'lid.: N 'D ,,w :;4 .� .,.�.. .�' J:"N'' 'i'. ?;ki�'�.�,k� PRODUCER :; 0 ' 3 THIS CERT1Fi 01 4/9 9 1 CATE IS ISSUED AS A` MATTER OF INFORMATION ALMEIDA & CARLSON INS ONLY AND CONFERS NO RIGHTS UPON THE: CERTIFICATe HOLDER. THIS CERTIFICATE DOES NOT AMEND, CXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 345 COURT ST BOX 3255 COMPANIES AFFORDING COVERAGE PLYMOUTH MA 0 2 3 61 COMPANY A GRANITE STATE INS CO INSURED COMPANY MARK SHANAHAN DBA B MARK SHANAHAN DRYWALL COMPANY BOX 1126 C PLYMOUTH MA 02362 GOMPMY •r,0;i<o:4»:�:e!><;iqn'r.:�ti�iri�[�:°i'"t:iv,.'c.''::Y:;�:•»:':'i'ac'i�•s:��'��art;<:y:••:y:r.�::tMrt:":::::. �»:�:>.���. ..,�:or:•r>. ..4.L.6 6. ...b.S..,L,7,i..1.R f... f,L,R ff?;':iif....> •.S..,t if.l R f.j)A.V;Y...:::..:.\:':S:S:::.o:;t';6X'rvv., hh �so+:7;i,'ti!•➢•RR. i!,4,i;w>.>.�. x:.. <. {:<JW;<•r;.;i.?.I!.?�;i,iyi;Y.•fi 3.. .,,7,vIL,i..i>s.R. R... :.4:fi'y.,;+ixZa' i;,:X,�,«r)i•:•��.i.:. 'S;<Sa^'•;;.� :r1 � (�j��..f... •.>::o.o.o:: ::4:v,4;oi:9'rf Gaf'i•9 R.t,>;>n:t,Y.:f.�f........1.... o.,o g;;V;P:a�>:7a:Yk,/:.t;::3.:i.� w.. .)..o»t6;t.i ¢.S,tl� A. ����tl;OrS;t°o .a..�:........::!.T.!S..<rl..,.w4:e:6K?:•7GYi..$......6.�"t.�,:6.tl�S,:;v,;��;7;,Y..............:.::..,.:�R..<.o.a:)...a:onJ�V,!•>.J.!:!•Y.,,1,>,::f,:S,..2•.. ai:(x:xF.t.�.�ier::.:....o....::q.:Z.i:o:;a,4.:9 Y!rt 7t,.:�o:o::.,....a.i29:i':L:0:4::p;R.Ma�;�t•..�;i<..;Si"7L:::'o�ro�s•zf:0,•�:!�t. {)).'),C..7.1...i..!/.�...1:.A>.RV.4>1f.0.b,i,4....1r�(^.,f).4..v.K�R�x�%•%•�rY.O`4.L.'3.':x;!;f,.�tlt<....�.t�:�J:J>;•rJ:Vr:7r0��. 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. CO TYPE OF INSURANCEvOUCY NUMBER POLICY EFFECTIVE POLICY EXPIRAnON LTA DATE(MMIDD/YY) DATE(MM)DONY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE IS COMMERCIAL GENERAL LIABILITY PRODUCTS•COMMOP AGGI 8 CLAIMS MADE r OCCUR PERSONAL A ADV INJURY 8 OWNER'S L CONTRACTOR'S PROT EACH OCCURRENCE 8 FIRE DAMAGE(Any one ere) d MED EXP(Any one person) 8 AUTOMOBS.E LIAaIUTY ANY AUTO s COMBINED SINGLE LIMIT 4 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY A (Per paraon) HIRED AUT06 BODILY INJURY S NON-OWNED AUTOS (Par aooidont) PROPERTY DAMAGE $ GARAGE LIA88JTY ;v AUTO ONLY•EA ACCIDENT 6 ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT 9 AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE 8 UMBRELLA FORM AGGREGATE $ OTHER TWIN UMBRELLA FORM e womms commmAT►oN AND WC 3 5 4 8 519 y7/0 8 9 8 7 0 8/9 9 X T ITs eR EMPLOYERS'LIABILITY EL EACH ACCIDENT 100, 000 PARTNER S/EXEC U V� ` THE PROPRIETOR/TI INCL EL DIBEAB[3POLICY LIMIT b 500 , 000 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE 6 1 0 O 000 OTHER DESCRIPTION OF OPERA'O"/LOCATIONB/VEHICLE.9r8PECML ITEMS USUAL BUSINESS AS DRYWALL ,1t • Q��n tv: �,;ii:;t5t;4 .> <t �Y K :^f:ish;t;v:y:w:;,:v,.CY.•>.;f;V'i:.;7;:y:?:<:x•):`:>:' '��tA� ;<:Y,4:o: Y f'R��6 4 6 6 F 4 4 .>,t.,t<,Y.r.'Y°f:1::.:... :,2>,f,.>•n�,t>.K..r� �i'ri:V'tl::f:):e:q;4:0?{r?3<>?:;;>2:;.:;r:Jf� '>`i:3.0:0:x5':wr{';tps o 0 .t:�.:..:,r.��T'-�SS.o J.<:K ;�..,....>,R n�r:+:+i r.f.f.:;:.,.n�..o..�s..;:v�. ...,�Y "iC r%'•�. 'f. ..:...Orr.9:. �4.1�t0/�• o.ex5grf�:� +.+:>,n:!�>'.f.,.: :'<:Z?rr.,... ...a.o a oa .,Z,{ : ,.xJ;�t: SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BH CANCELLED BEFORE THE OLD CENTRE HOMES EXPIRATION DATE THERROP, THE WSUINO COMPANY WILL ENDEAVOR TO MAIL • 1 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TN6 LEFT, P .O. BOX 635 BUT FAILURE TO MAIL 6UCN NOTICE SHALL IMPOSE NO OBLIGATION OR LLAO&M WAREHAM MA 02571 OF ANY KDID UPON THE COMPANY RB AGENTS OR REPRESENTATTVNS. AUTHORt= REPR88EI0ITATNE Doreen Sullivan DS C ...,..,..,�.+���rr��((nnyy���� .. .,.r......t.o.4.Q�a.t<.4,r'%•)��.4.4.F:1.;.... ;.)):).v,.'!:�:`:r,<:>:t•' �.::5:>.�� ' ;:: :.'��:{F't:i:;{:...?:4;4,��•.�....: •�.'y.; ..:�.:9,n >: LV.4::.+ .... ,�:;..,;..� .. � )x)>,>>>>;,?f N....:.......0 r. ,.<:<>•;>•::.,.t..t�(::j:i,i.:):Za. Ja` t ) ;r�.�;.t;v f�: V.L,'i;:g• ?E: `:°: ., j' Tn ': lP"rI , - �irlcl�rHr1 ro H('TT11-17H PQOTQ+,)QnC 7T 'CT GCCT It,O )Try � .emu,-u,i�•n-tit iiy� r-�VCiv�i h�1-aUt r1L AVOI\�� 1 {"' s ` r ?> ■■` DATE(MMIODfYY) • ••� �c'�..• . � 01/05/1999 PRODUCER (508)761-7371 FAX (508)761-4817 7ALTER RTIFICATE 18 ISSUED AS A MATTER OF INFORMATION arry 1. Boardman Agency Inc. D CONFERS NO RIGHTS UPON THE CERTIFICATE 679 Washington Street .THIS CERTIFICATE DOES NOT AMEND,EXTEND OR HE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 3269 COMPANIES AFFORDING COVERAGE South Attleboro, MA 02703-0925 caMPnNr Vermont Mutual Insurance Co Attn: Carole McMorrow,CPIW Ext: 12 A .................................................................................................................. ......:......................... ........................................................................................:.................... ._ INSURED COMPANY Viens Masonry 150 Collins St. .... ................. .................................................................................................................. So, Attleboro, MA 02703 Co CANY ...................................................: i COMPANY D .2:c::.: .'F•<�:;::isi::i>ire:,iii:::>:i::::.::<.,::!:t::;%::::::c:::::,i� 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. .................................. . . CO TYPE OF INSURANCE POLICY NUMpER. POLICY EFFECTIVE ::POLICY EXPIRATION; LIMITS LTR. GATE(MM/DDIYY) DATE(MMIDD/YY) GENERAL LIABILITY GENERAL AGGREGATE S 600,000 X :. .............................I.............;......... ................. COMMERCIAL GENERAL LIABILITY PRODUCTS•COMP/OP AGG :$ 600,000 CLAIMS MADE X OCCUq ' PERSONAL 8 ADV INJURY :S A `' ` BP17009478 : 04/17/1998 04/l7/2001 >.....:....................................................... 30Q 000 OWNER'S 6 CONTRACTOR'S PROT: EACH OCCURRENCE $ 300 OOO ............. .......: ..............•,.•.•.......•...•.•.........•........ FIRE DAMAGE(Any one fin) 8 50,000 .......................................... i MED EXP(Any one person) S S 000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT E .............................................................................. ..... ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Pot Demon) HIRED AUTOS .............. ............... ... i - _ BODILY INJURY 3 NON-OWNED AUTOS (Per(Acdden!) .....•.....•..... PROPERTY DAMAOE S GARAGE LIABILITY i AUTO ONLY.EA ACCIDENT ;E ANY AUTO OTHER THAN AUTO ONLY: ?` . .................................................... EACH ACCIDENT:E AGGREGATE:5 EXCESS LIABILITY EACH OCCURRENCE Y UMBRELLA FORM I AGGREGATE E OTHER THAN UMBRELLA FORM Y WORKERS COMPENSATION AND VC s::%.<s:l:x%,a1i•s 'i'r>i::a:>: EMPLOYERS'LIABILITY i ......;.TORY IIMITS,! ioTH- ........ ER ?„i`<; ?.``5:`.;'.:°a:• ;?:°sa;:: EL EACH ACCIDENT E THEPROPRIETOR/ ............................. ................................... PARTNER&TXCUTIVE INCL E EL DISEASE-POLICY LIMIT E . .. OFFICERS ARE: EXCL EL DISEASE•EA EMPLOYEE:8 OTHER DESCRIPTION OF OPERATIONSILOCATION&VEHICLESISPFC1AL ITEMS lob site: Various Project Locations ��+�.y� tEiS �R`tr•� s;�ty�:?:f;'.' �;{::,.,lf;f•:2�`'L`•`:�7:ti< "'I::`ia.�I'•:`:::'i::ti:''�.,...x%',:a,>.C[ .f•. ..:.....;.�:.....:.•.. 1.�:. .... o .::::.� ..:...:. : >, ,,, 'a:...,..:.... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUINO COMPANY WILL ENDEAVOR TO MAIL 10 DAYS KITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT. Old Centre Homes BUT FAILU O MAIL SUCH NOTICE SMALL IMPOSE NO OBLIOATION OR LIABILITY NO reast Drive OF ANY I UPON THE COMPANY,ITS GENTS OR REPRESENTATIVES. Sagamore, MA AUTHOR EPRES NTATIVE .gym .... AC RD CERTIFICATE OF LIABILITY INSURANC PID TP DATE(MM/DD/VY) IN-1 11/20/98 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Drake,Swan & Crocker Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Agency, 'Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 14 Lot's Hollow Rd. ,PO Box 429 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orleans MA 02653-0429 Phone• 508-255-3212 INSURERS AFFORDING COVERAGE INSURED INSURER A: American Economy Ins. Co. INSURER B: Massachusetts Bay Insurance M.A.P. Insulation Co. , Inc. INSURERC: New Hampshire Insurance Co. P O Box 1309 INSURER D: Sagamore Beach MA 02562 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. fS TYPE OF INSURANCE POLICY NUMBER DATE W POLICY EFFIEIDDDATPOLIEYMWDDLIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY 02CC32643570 01/03/98 01/03/99 FIRE DAMAGE(Any one fire) $50,000 CLAIMS MADE OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY JET LOC AUTOMOBILE LIABIUfTY COMBINED SINGLE LIMIT $ 1000000 B ANY AUTO ADN534489601 05/01/98 05/01/99 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ �[ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS LIABILITY WC5886162 11/01/98 11/01/99 E.L.EACH ACCIDENT $ 100000 F.L.DISEASE-EAF_MPLOYE $ 100000 E.L.DISEASE-POLICY LIMIT s500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Insulation and gutter installation. CERTIFICATE HOLDER N ADDITIONAL INSURED;INSURER LETTER: CANCELLATION OLDCENl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Old Center Realty IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR P.O. Box 635 REPRESENTATIVES. Wareham, MA 02571 AUTHORIZED BXVE ACORD 25-S(7/97) ACORD CORPORATION 1991 f • - �Jlte COo)n,9920.77�(�P,IL�C/7 0�� �(.Cl:filiYrll c6ll.'✓�1 1 - DEPARTMENT OF PUBLIC SAFETY i CONSTRUCTION SUPERVISOR LICENSE Number: '. Expires: Restricted To: 00 J SCOTT CINENO 11 NOREAST OR BUIIAROS BAY, MA 02532 °FINE tp�_ . •'l,°� The Town of Barnstable • snxxsrnsz.E. • 9� �0� Department of Health Safety and Environmental Services 1 Mn+" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-90-6230 Building Commissioner kJ7_1 CO December 15, 1999 � L�� Re: Release of bonds To Whom it May Concern: Enclosed please find bonds posted against damage to a roadway during construction. Our.return of these bonds indicate that certificates of occupancy have been issued for the properties and that the Town of Barnstable has no further interest in the bonds. If you have any questions regarding this,please give me a call at 508-862-4038. Sincerely, Kathy Maloney Office Assistant Q960715A Y TOWN OF BARNST E OF OCC P NOY IC TE . .CERTiF A A PARCEL "ID 000 000 131 r GEOBASE ID ADDRESS 61 ANTICO LANE PHONE CENTERVILLE ZIP - LOT 5 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 41087 DESCRIPTION SINGLE FAMILY DWELLING (BLD PER 35809) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services i TOTAL FEES: THE BOND $.00 CONSTRUCTION COSTS $.04 _ Q� 753 MISC. NOT CODED ELSEWHERE ` B , MASS. ; 163 Ep BUI I BY DATE ISSUED 09/15/1999 EXPIRATION DATE r y � � �y f s a�• x �� 3f�'�� S }_ ` ..yy �-4 {��.T,. I.vS.J�aNr`�"-...4�+�'�vs1w •#1 7G�. :♦ � y � • y4 ' y !r �r�s' 1 f � 'k �1•� 's' ,IF,yam... -�II. .!Y �' "1.!--w .. Y R' :�.,{$„]• .10 PAR&j 61, AN'I.ICO LANE PHONE. CENICERVI'LLE ZIP L,Cfi 5 BLOCK 140'r SIZE DDA IYEVEI` PMEN' I PERMIT 35809 DESCRIPTION NEW 3 B HOME SE�`PT#99 -1.0 7 BUILD TITL . NEW R'E481 DENT 1AL BLDG PMT Department of Health Safety CO..NTRA,C 1 bR$- j; _SC€T T CIMENC ARCHITECTS:: and Environmental Services TOTAL t Eti.w kr r r t �t� C0,0S1yRUCTION C)STS , $95,040.00 � No" 1t3 SINGL:R FAM I�Qt�.,l�; DETACHED I PRIVA,3:'S 'Ix ?` 1w'`�.�'M�� ; • �1639� Fp Mpl � BUILDING MVISION BYy. DATE 1.S-SUED 01/11/1.9C9 EXPIRATION MATE 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 MAY BE 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 t.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 (READY TO LATH). `? PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH— ANICAL INSTALLATIONS. 3.INSULATION. t OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. . 4.FINAL INSPECTION BEFORE OCCUPANCY. 1 BUILDING INSPECTION APPROVALS PLUMBINP INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS " 2 2 / 2 xJrs� 3 1 E ING I SPECTION'001 VAL _ ENGINEERING DEPARTMEN I t `AK® �G� 2 BO RD OF HEALT' J O ER: SITE PLAN REVIEW APPROVAL ARK S ALL NOT .ROCEED UNTIL PE IT WILL BECOME NULL AND VOID IF CON INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK.IS.NOT STARTED WITHIN SIX CARD CAN BE.ARRANGED FOR BY VARIOUS STAGES OF CONSTRU.0 MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- a TION. NOTED ABOVE. 7 n 7 -,,....+.•tw:�;..�.-.-"',..-w,_.6. i^.. .• _' ,-- -..- , .3.,,,••s..,,•vK,..:r!.,..rl..;_Y;�+�.;;.Fr..c:,.i,� i" ."_ x;.t;':+:.,..,*,4;};'!4e; `oFtHEiti 4 The Town of Barnstable o* BA MAS,gBLE.e. ` Department of Health Safety and Environmental Services MA550 t639' �0 prFO Mn+' Building Division . 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection L "' Location � ` �r•� � ` e v Permit Number 3 S (?3 ' Owner � �� Builder SC. One,notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Pa G, v Please call: 508-8862-4038 for re-inspection. Inspected by Date e r f , ..,.w.�,�., .�,-,.,.._Mrr,;`�,r�fi:ti-....-..�"1". _....:...........p:••.•..wr.....,nl.,,.�,.",,',.,...-.�..,•_'.,,,,.,.-X"'i.`-•c�a.,d -.i,-...«„+»v+'rn�[;..cyan...,y�P�.t•,.+.�-,.,=..g`r..,�,�.".+,.."^r:-rr:r..1'.t,L`...rwvr...•.✓..tirr-+-. M�� pF�NEip�� The Town of Barnstable BARNSTABLE, • Department of Health Safety and Environmental Services MASS. i639. �0 °rFo►may1, Building Division 367 Main Street, Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection `i' r vim✓ Location ��l � -�'1...1�� �..�'e Permit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Ct Y'OA,4 k— PW) V) (::Do— JLJ(D A 1�6 r uv P_C F Please call: 508-862-4038 for re-inspection. Inspected byZ Date MAScheck COMPLIANCE REPORT 3S.-�� �. Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-11-1999 DATE OF PLANS: 1 YC CD TITLE: C-�'^ ✓� COMPLIANCE: PASSES Required UA = 302 Your Home = 300 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 816 38.0 0.0 24 WALLS: Wood Frame, 16" O.C. 1568 13.0 3.0 112 GLAZING: Windows or Doors 288 0.400 115 DOORS 52 0.350 18 FLOORS: Over Unconditioned Space 816 25.0 31 HVAC EFFICIENCY: Furnace, 0.8 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. 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. Builder/Designer Date 5 f, rml ?;Y 'L �I' .. 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