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Home My WebLink About0459 BAY LANE �• .. aE Sr , w w ;� � i �o 4 . r,_ v Town of Barnstable *Permit#- Regulatory Se ` Fee 6 months from issue date BAMSTAEM truss Richard V.Scali Director q&e ! o 1659. Building Di=* * AY 19 ?017 Paul Roma,Building 200 Main Street,Hyannis,MA 29 1YA f?j/ f www.town.barnstable.ma.us �l ®LE Office: 508-862-4038 ABLE, 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY a�J Not Valid without Red X-Press I*rint Map/parcel Number l/ / Property Address -161 ��,4dv At Residential Value of Work$- Minimum ee of$35.00 for work under$6000.00 t ' Owner's Name&Address Contractor's Name Telephone Number Yloldg—10 Home Improvement Contractor Lice e#(if applicable) E1m�aiil: Construction Supervisor's License#(if applicable) 4�c� 7 7 ' ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance , Insurance Company Name Workman's Comp.Policy# ? v / , Copy of Insurance Compliance Certificate must accompany each permit. Permit Re est(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 Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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 require SIGNATURE: Z1) QAWPFILESTORMSIbuilding permit formslEXPRESS.doC 01/25/17 � V l2B�a�rcnaai��ueirlC�O��d1CLC4L[Cd6�',L � .. " v, uS�\'Office of Consumer Affairs&Business Regulation License or-'registration valid for individul use only - ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration 1257,99 Type: Office of Consumer Affairs and Business Regulation xpiration: 1/30/20&8 . Private Corporation 10 Park Plaza-Suite 5170 _ti >J Boston,MA 02116 C,J, RILEY BUILDER`INC CRAIG RILEY (; 10 B WIANNO AVE. OSTERVILLE,MA 02655 `� \ y✓ Undersecretary Not ali it out signet e Massachusetts-Department of Public Safety Board of Building Regulations"and Standards Construction Supervisor License: CS-066147 R - CRAIG J RILEY s PO BOX 382 Osterville MA 02955 . ✓.�.. `..,�'��` ` Expiration Commissioner - 02/05/2017 L BARMnsz.E, 639.�. Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ,n . Property"Owner Must Complete and Sign This Section If Using A:Builder ' !. 4 I^ ,as Owner of the"subject property hereby authorize W `to act on my behalf; in all matters relative to work au/otized.by this.building permit application for:. T� c Jo • (Ad ess of J b). . r Signa a 4 Owner Date Print Name If Property Owner is applying for permit,please.complete the�Homeowners License Exemption`Form'on.the reverse side. Q:IWPHILESTOR14Mbuilding permit formAsmokecarbondetectors.doc. Revised 050412 I DATE MM/DD ( /YY1'1') AC(ORv CERTIFICATE OF LIABILITY INSURANCE 05/18/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME:CONTACT Christine Davies. - - DOWLING &O'NEIL INSURANCE AGENCY A C.No.Ext; (508)775-1620 F^x A/C No E-MAIL - - ADDRESS: cdavies@doins.com 973 IYANNOUGH RD INSURERS AFFORDING COVERAGE . NAIC# HYANNIS �` MA 02601 INSURER A:'ACE AMERICAN INSURANCE CO 22667 INSURED • INSURER B: F ' C J RILEY BUILDER INC INS RERC: _ INSURER D i - PO BOX 382 INSURER E OSTERVILLE MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER: 155805 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 ADDL SUBR - POLICY EFF POLICY EXP TYPE OF INSURANCE - LTR POLICY NUMBER MMIDD/YYYY MMIDD LIMITS ' COMMERCIAL GENERALLIABILITY -�- - EACH OCCURRENCE $ - CLAIMS-MADE OCCUR- - DAMAGE TO RENTED - PREMISES Ea occurrence $ _ MED EXP(Any one person) $ N/A - - - PERSONAL&ADV INJURY $ - GEN'L AGGREGATE LIMIT APPLIES PER:. GENERAL AGGREGATE $ Po POLICY JET D�LOC PRODUCTS-COMP/OPAGG $ . OTHER: $ AUTOMOBILE LIABILITY ^a COMBINED SINGLE LIMIT ' $ ' • Ea accident ANY AUTO - - BODILY INJURY(Per person) $ - - ALL OWNED SCAUTOS HEDULED AUTOS N/A. BODILY INJURY(Par accident) $ NON-OWNED - - - PROPERTY DAMAGE $HIRED AUTO AUTOS Per accident $ UMBRELLA LIAB OCCUR _ EACH OCCURRENCE $ - .EXCESS LIABH CLAIMS-MADE N/A- - AGGREGATE $ DED RETENTION$. $ WORKERS COMPENSATION XTSPER STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N - E.L..EACH ACCIDENT s 500,000 A OFFICERIMEMBEREXCLUDED? - NIA NIA NIA 6S62LIKE89906917•. 05/05/2017 05/05/2018 (Mandatory in NH) - E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under - - DESCRIPTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $ 500,000 - N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) - Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the.insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. ' CERTIFICATE HOLDER CANCELLATION SHOULD ANY,OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hugh O'Neil ACCORDANCE WITH THE POLICY PROVISIONS. 459 Bay Lane AUTHORIZED REPRESENTATIVE Centerville MA 02632 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD II Client#:10798 2RILEYCJ DATE(MMIOD/YYYY) ACORDr. CERTIFICATE OF LIABILITY INSURANCE 7E mwDo17 ` THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies).must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - _ , . .. NAME: Dowling&0'Neil Insurance Ag P"°NE 508 FAX A/C No El): A/C No): 5087781218 973 lyannough Rd,PO Box 1990 E-MAIL Hyannis,MA 02601 ADDRESS: 508 775-1620 - INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM Insurance Company- 14788 INSURED INSURER B: C.J.Riley Builder,Inc.. INSURER C: P.0.BOX 382 Osterville,MA 02655 INSURER D 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .INSR TYPE ADDLSUBR - POLICY EFF POLICY EXP - .LIMITS LTR INSR.WVD POLICY NUMBER - MWDD/YYYY MM/DD/YYYY A GENERAL LIABILITY MP059664 5/02/2017 05/02/2018 EACH OCCURRENCE $1 000000, X COMMERCIAL GENERAL LIABILITY - - PREMISES Ea our ence. $500 OOO CLAIMS-MADE I—XI OCCUR MED EXP.(Any one person) $1 O 000 .. - PERSONAL&ADV INJURY $1,000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY - - COMBINED SINGLE LIMIT - Ea accident ANY AUTO - - BODILY INJURY(Per person) $. ALL OWNED SCHEDULED - -AUTOS AUTOS BODILY INJURY(Per accident) $ , NON-OWNED - PROPERTY DAMAGE $; - HIRED AUTOS AUTOS Per accident UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ ' DED RETENTION$ $ WORKERS COMPENSATION WC STATU- ATH- AND EMPLOYERS'LIABILITY �T ANY PROPRIETOR/PARTNER/EXECUTIVE 7 - E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? �' N/A - - (Mandatory in NH) ` - E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT -$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach,ACORD 101,Additional Remarks Schedule,it more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. . Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Hugh O'Neil SHOULD ABOVE DESCRIBED POLICIES B CANCELLED EXP RATION DATE THE EOF, NOTICE WILL BE BEFORE DEL VERED THE IN 459 Bay Lane ACCORDANCE WITH THE POLICY PROVISIONS. Centerville,MA 02632 - - - AUTHORIZED REPRESENTATIVE - ©1988-2010 ACORD CORPORATION.All rights reserved., ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S190819/M190818 LS1 L The CCoinrr'mo7rtvealdt of stdrusetts 1/ Depa rtz)wmttp of lni zslrid Ac q t�e�600 FPashirrgtort&treet Boston,CIA 02111 Warlmr'S3 Campens.afima Insum-nc8 Affidavit SedersiCanfractursMectdciansJi'lmmhers AppErant Iufct=tign PIeasqPxintLedUv ly (Busi he � �� ^ P Add>;ew. �ily�'Statel Phone' Are u an emploger?f -erl€fhe appropriate bom ' Type of project(regaire*-- I IamaemplaywWith ❑4_ I am a general contmckx andI ❑empl ew(full andfor part-time * 1�e hired.fha sub-ca�acfom 6. New cansfiurtioa 2❑ I am a sole psvpiietaF orpartner- Mted oath*attached sheet. 7- El Rerno&Hng These sub-co�ractors have s4�p and have no employees . g- ❑Demolition -wadmig employees audhare wotimWl �sty. a ;��.�� $ 4_ El B,uitding addition. INa camp-rnsn_�r a COMP- ❑ We are a corporatiamand its 1 n l+lerk:r�f repaiis orati ions regmzed] officers have eased their 1 L Plumbin r airs or additions. 3_❑ I ama homeoverrer doing all v�orl€- ❑ � � Myself[No gets'CcWP- of exemption per MM 1 ❑Rflafrepairs insurance reed j Y c.15Z§I(4�and we have no employees.[To worms' 1 -�]other-cow_itisoraace requireeL) •$ayapg&aa ei�atcheckssbas lam aIsaffiom thesecHaebe3ozvsb tiieaw�cers'mmpensafinupoTsyinfaams`ac� ffameoaraetswha submit tins dEdz%*UbErzt ng tbep IM&fi6'slf Vra&rani bum him Outflde cOnt.v�nmst.sdfbmit a newXMda!It indicatin Mcb- fContractn6i tehecYt&boxmustsltacbedansddXnnalsheetsIzwhsgtyenasaeofthesub-camuctomindststavdieflmornatthoseentitrti sbrM emplaye-Iftbe^T— -•—h—mnpIgea%they tp—ide their-dce 'comp•policy ez I tam art sesgFagar tlerrt;is prauieiirtg n�or�e-ts'catrrperesrdzan iRsrirarfca,�er m}s emplQ}�ees $elo�v fs�7tepal"i��a�jala spa information I ce company Name: it 3z 'poliey4lor^,pelf-ins Job T&-Address CO/Stateiz p: Attach a copy of the warners'comp atiQnpalicy-decla ration page((showing the poficy er and respiration date). Failure to secure coverage as req - under Section 25A of MGL a.15-7 can lead to the imposition of criminal.penalt%es of a fine up to$L50D.Oa andfor one-year impdsoumml�as well as civil penalties m the farm of a STOP WORK ORDERand a Free of up to$ZStl_Flfl a day against the violaim Be oddsed flist a copy of this statea>ent ntag be forwarded to fine Office of InvesEgations.of"the DIAL for ibsizaace'coverage y Ufa feest-sby eerii , ti �V,5�P'er ry attJes i ae-Ruettan prert�atRr1B 1. Phrase00" ®1 Dial use miry.. DO not WrRe in t lb ax€fi�trr 5e zorngfeteJ by taip or tol.n�rciat a Citf or TGWU- Per—ifIrl ease# L4suingAuior4(circle one): L Board of Health 3.BuffTmg Depar[m e.•e:at 3.f Rylrown Clerk 4.Electrical bnpector S.PhEmbi ng Insppecter 6.Other O'onbct Person: Phoney#- - -- — --- 6 laformation au' d lastructiOUS L&sswr effs GeuE as Jzm char 152 reQmies all�oy=m pz�ovidewaIkeas'c mP=sRflm flrfbeir employees. r* p {o ,an errpTayee is d efraed as"_.every pmas6n i m liLe smvice of another ntu1�anp mLt:art ofhir empress or finpliC4,oral or wrh=." Au�srployer is tiptoed as`pan in A pmjne�,assorietion,ccaparat[on or oiber Iegal e�y,or any two or more of the foregoing aJ •and $ie Legal x se�aiive ss of a deceased employer,or f z receiver or trastee:of an kffiV dmaL pastUXSb=P,association or other legal enfitY,=ploying mmPloyees- However{be of a dwr house having not more t�three aPadmeats mad who resides thereat,or the occupant of the- ovtaea IImg dwo ing house of Mod=who employs person e s to do mahtnm ,consskuc r;n„or repao-WoIc on such dwelling house or an the grotmds or bt aft app thm-do,shaIlnotbmanse of such employmentbe d=med to be an employee MGL chapter 152,§25C(6)also states that¢eye:ry sty or local l'LCenS mg agency shall wifhhold the issaance car renewal of a Ticease or permit to operate a bitc tress or to constmct buUffb3 s in the commonwealth for ally aPPIieantwho has xtotprodnced acceptable evidence of compliance with tIm ksurance_coverage regzrirect" Ad,�Onally.M(H.chaptcr 152,§25�states'Neitbcr thin _ nor any ofits poIitical snbdivisions shall eater ink any contract for the perform an te:ofpubhr.wotic mrtI acceptable evidence of complianm7idh file msoxMce.. re ads of-di chapfcabavel ee<nprescnbf dfo the mn tariing.atrfouty: AppIican-ts ' Please iul oil ork•the w 'competcsati on affidavit mmplete n b oxes y chmId g&o b �apply to your sitnatian and,if n ay,�PFy sub-contmtor(s)�e(s), address(es)and phone�ber(s)along wift ffimrcertffi�s)of insta-mzce. Lmmited Lial?ility Coinpeinas(LLC)cr L=fed Liabil4 Pmt=mbips(LI P)•with . e�Ioyees 0 . er than ib e members or partners,are not rimed to carry worT=e compe assafion mmce. sur If as LLC or LLP does hate employees,a.policy isreqnfi-ed. BeadvisedEnt this affdm#maybest1brailtedta thoDepaitnentof lndastial Accidents for confrmnfm of itLs ace coverage Also be stow to sign and date the affidavit The affidavit should b ereto:r ed to 1.e city or town that flip application for the permit or license is being requested not the D e--pazfinent of Irfinsttial Asp m-fs. Shouldym have ally questions regarding the law or ifyon are regtured to obtain a workers' rompeusafionpolicy,pleasecaatheDepartmentatthen=berlisted.below. Self-rosinedcompaniesshoulden, rtheir s e1f-n+-a ce license nmaber on Brie appropriate Imp. City or Town Officials t Please be sole tbat the aT.davit is comPlefe andprkEb!;dlegU3ly. The Depa tnrathas provided a space at the bott= of the affidavit:for youto fM ottt mthe event f3ie Office oflnvestigaflons has to coatactyouregard>ng$ie applicant. Please be sine to fM in fain pemLit/Iicense amber which wM be used as a referemr'e u=ber.In addition,an applicant f l a mast submit multiple pennwlicense applications in.aay given peat,need only submit one affidavit mdicatag current ¢ and ffider"lob a Q�s';1he applict should write-all locations in (cY or pohcymforutaflon C neces.-ary) .town)»A copy of thcaffidavitthathas bey officially Sbmn ed ormarked.byAe any ort�ownmay be provided to the applicant as grbofthat a valid affidavit is on file for frump p®ifs or Iiceusm Anew affidavit=ust be fMC:d ovt each year.-¢there a hDme`owner or citizen.is obiaiIIing a license or permit not relat_rs_i in any business or commercial y� Cie. a dog license or permit to bum leaves a -)said parson.is NOT to corupleb this affidavit The Office ofInvcsEigaiionswouldIilcetothank you in.advaam fur Your coOPCE'a on and should you have allygmcstions. please do not h esi to&5 m a mM The DeRmt nenf-s address,tt d4htme and fax f:arommmmSihE of , "• . , '` I}��m�of a1 Aotidenfs - . <<t =Ce QxTnVedkafiwm Berm&oilIi Tf,-L 617-' -4 Cid 4€6 or 1-9 IgA Fax#617-` 27 7749 Kevised424-07 - Tnng9PTI(Fa r ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �� Z Application # ze 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/ /3N.r LAty Vllage Cen ei`U ',�1-P Owner ko g`o ©n i e( Address Telephone Permit Request J 1 In.ee k Me%A k Wot-k% 1�151 1 I i�n9 /l ew Thin c rQr t z Fo(Z 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 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: ❑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 �t i r 2�e i`A r 7 Telephone Number S63? i Address 3 7(o OO i< % n5l&9 AA �' License # 64(/ 7 CPni&_f y,1<r MA Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE / FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED .; MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION F FRAME " INSULATION ti :r FIREPLACE 4 ELECTRICAL: ROUGH FINAL . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL . j FINAL BUILDING 9 I DATE CLOSED OUT ASSOCIATION PLAN NO. ¢T ' 'r The Commonwealth of Massachusetts Department`of Industrial Accidents ' Office of Investigations 600 Washington Street Boston, MA 02111 - www.mass.gov/dia Workers' Compensation Insurance Affidavit; Builders/Contractors/Electricians/Plumbers Applicant Information 'Please Print LeLYMV Name (Business/Organization/Individual): (y`��t 1F I T er,K t ' 0_U M l2' elymti -R\1 e Address: City/State/Zip: . Cenie,f v\\kP Phone #: 1710 3 Are you an employer? Check the appropriate box: Type of project(required): uired): 1.❑ I am a employer with 1 4. ❑ I am a general contractor and I 6. New construction employees(full andlo part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor o er- Misted 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' insurance:$ 9: ❑ Building addition comp.'[No workers' comp. insurance p. required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I arrra homeowner doing all•work officers have exercised their I LE] 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' l3.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob 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 criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage,verification. do hereby certify nder the ains andpenalties ofperjury that the information provid;71d//' veeis true and correct. Signature: Date: Phone#: Official use only. Do not write in this area, to be completed by'city or town offfciat City or Town: Permit/License# Issuing Authority(circle one): L.Board.'of Health 2. Building Department 3. City/Town Clerk.4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: -Phone#:...w: r - Information and Instructions. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of.public work until acceptable evidence of compliance 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, if necessary, supply sub-contractor(s)name(s), address(es)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 number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the.city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,.telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600 Washington Street Boston, MA 02111 Teh #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 Y www.mass.gov/dia OP ID:CR '44 C- �n° CERTIFICATE 1 TIFICATE OF LIABILITY INSURANCE DATE(MMIDD,YYYY) 04/30111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS Ci=RTIFlCATE-DOES-NOT-AFFIRMATIVELY-OR-NEGAT4VEL-Y AMEND,-EXTEND-OR,-ALTER-THE-:OVERAGE 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 Pict confer rights to the .certificate holder in rieu of such endomeme s. PRODUCER 781-914-1000. Nam Thomas Gregory Assoclatas Inc. PHONE F 601 Edgewater Drive S235 781?a#6-2601 L No &MAI Wakefield,MA01880 ADDRESS: Chris Hawthorne PRODUCERMILLI-6 INSUREIM AFFORDING COVERAGE NAIL# INSURED William Fitzgerald dba INSURER A:PeerlesS Insurance Co. 24198 Mr.Plumb-Rite INSURER B:Peerless Indemnity 376 Nottingham Drive INSURERC: CenWr Alie,MA 02632 INSURER D 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS GENERAL r lean r Y EACH OCCURRENCE S 1,000,0001 DAWA X COMMERCIAL L GENER JABLITY CBP2240275 10116M0 1a16M1 omurrencel $ 100,00 CIAW MDE1:1 OCCUR NED EXP(ArW onePerson) $ 15,00 PERSONAL&AOVINJURY S 1,000,00 X NOAH-$1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG S 2,000,0 00 POLJCY PRO-21, LOC Ern Ben. s NON AUTOMOBILE IJABIUTY COMBINED nt) E LIMIT S ANY AUTO BODILY INJURY(Par person) $ ALL OWNED AUTOS BODILY INJURY(Per adident) $ SCHEDULED AUTOS PROPERTY DAMAGE S HIRED AUTOS (Persncident) S NON-OWNED AUTOS X UMBRELLA LJAB X OCCUR EACH OCCURRENCE S 1,000,00 ECCESSLIAB CLAMS-NADE 10M6110 10M6111 AGGREGATE S 1,�+� A CU8733556 - DEDUCTIBLE XRETENTION s 10,000 S TH- WORKERS COMPENSATION. WCSOWTAT ER AND EMPLOYERS JABILTTY 04108M 1 OM08/12 EL EACH ACCIDENT S 500,0 B ANY PROPRETORlPAR7 NER/EIECU IVE YIN N l A rc 8766668 OFFICERILLEMBER EXCLUDED?ILAandatory In NH) EL DISEASE-EA EMPLOYEES 500,00 Vy�deaonbe under EL DISEASE-POLICY LIMIT s 500,0 DES6RIFTION OF OPERATIONS Roar DFSCRIPTIDN OF OPERATIONS I LOCATIONS f VEFIICLFS(AMach ACORD 101 AddMorud Remarks Schwind%If mots space Is regrdrsd) CERTIFICATE HOLDER CANCELLATION BARNS-1 SHOULD ANY OF THE ABOVE DESCRIBFE POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. FAX: 508-862-4717 230 South Street AUTHORIZED REPRESENTrATIVE Hyannis,MA 02601 ®1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD COMMONWEALTH OF MASSACHUSETTS f;i AS A kL MASTER�,-U NI RE' S T R I CTED ES THE ABOVE LICENSgM G FITZGERA TINGHAM sR ? _ CENTERVILL'E MA 02632-2136 6417 10/28/12 972227 r • IKKEr • BARNSTABLE, 9� 16,39. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02661 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize dium h'tLl-tA to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addr ss of Job) <. dl A igna� e of Owner D to Print Name If Property Owner is,applying for permit,please complete the Homeowners License Exemption Form on'the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 Town of Barnstable- Of THE Jam, Regulatory Services Thomas F.Geiler,Director tiwtttvsT,�er.E, _ MAM Building Division .39 IAA Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage,an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or.farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit, (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations.,; The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection-procedures and requirements and that he/she will comply with=said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt lot fi Asse r s map and' m .. INSTALLED SYSTEM+ ~. SEPTIC3..... MUST 13E oF THE�5 LE 0 T PLIANC Sewage Permit number ............................... .......,.. ..(....... � H TITLE 5 �VtV47 yy�� y f j�'e� p g r NMENTg'i'L ` ODE�E6rt�'t BARNSTABLE. House number .. .1...................................... � l ,'A9 ? � i E6 9°° 6 9 0�9, �� l'p NO h ° f TOWN r®F BARNSTABLE BUILDING IFNSPECTOR 7 APPLICATION•FOR PERMIT TO ..'....s, ^!7/&..:; .....y.........................................................................:.. ��U�TYPE OF CONSTRUCTION .........G.�,/..ct.R.+s�.......'.:..�r.�.y.:T................................................................................ I .7................................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for permit according to the following information: Location ...zc,,./ .. � oYF l�! 0 . ......................... ............. .............................................................................. ,� lG /=f}/!9 J.... .......................:.................................................................................................. Proposed Use ../.�v.� .. ............. ZoningDistrict ..... ...............................................Fire District ....r..94, ..c........................................................ i Name of Owner '..14.......f5!K4 cc 5°c1dress ...�/..`1.... 1!9'^ .Jr......0 �T.cu/ .......... Nameof Builder ....................................................................Address ........................ ........................................................... Nameof Architect ..................................................................Address ..............,..,.................................................................. y Number of Rooms ................................................................Foundation R ........ .�n.G�e�.7, ......I................. a Exterior ...L!/c>....�................................................................Roofing .��,�./.��,.: .......................................................... Floors ..........................................................Interior f/ �e�`7zri�/e Heating i. i P-� P.:.. ..cJ ....w�! �C,....,........Pldmbing ... �� 4. .c:....... ... / , .. Fireplace .......c'�......................................................................Approximate Cost .....Q0 J../ .: Definitive Plan Approved by Planning Board ___, _ a -----------19_ Area ....... ...:.. ........... Diagram of Lot and Building with Dimensions Fee 1.7z... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 3 ��tQOD M f OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS [-hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .f................................... . ......... Construction Supervis(or's License ��.�� ..�............. SILVIA & SILVIA ASSOC. 1 ` No . 30 QA.. Permit for .....I...Story �t Single Famiiy Dwelling ..................................................... Location ......Lot...#G,...45.9...Bay..LaD.Q..... Centerville ............................................................................... Owner Silvia & Silvia Asp.Q ... ................... ..... ..............A ...... .Q,, Type of Construction ..Frame ............................... ............................................................................... I Plot ............................ Lot ................................ Permit Granted ......Decemb.er. ....18, 19 86 . .. ....... Date of Inspection ....................................19 v Date Compl ted r,,5l..z..f -TV D �3 �rG�L✓jGC �/�Z//�/ r ,, 4 Assessor's map and lot number .... ..!.......8 7..... .... ��---- gyp*TN E TOE Sewgge Permit number ................� .........L�2`7.!...(..N�...- ..... . ...... I I —40— 113 Z 39SESTIBLE, i House number 9 YAb& ......G.�................................. OO,o,i639: \e00 prV �1 TOWN OF BARNSTABLE- l; q� BUILDING INSPECTOR { APPLICATION FOR PERMIT TO c� TYPE OF CONSTRUCTION fie,! ✓.. 42.......... �T��G••••••• • •••• • • TO THE INSPECTOR OF BUILDINGS: The' undersigned hereby applies,for a permit according to the following information: Location = .............. .. . ....... .. ,... . ..:.................................. ................................... Proposed Use ........ - .'.f... .................................................... Zoning District .....! .:. .. ...............................................Fire District ..... .. .o..a..............................................::......... 'fir a Name of Owner .. . /t✓!. ?..4c..� /./vi.. .......Xs—h,c,kcAddress ...fin./..`.... 1�?...........7'...... f' Nameof Builder ....................................................................Address .......................:................................................. /j Name of Architect ............................... ................Address ....................... ................... .............................................................. Number of Rooms .. .........:..... Foundation r1.�1.t.��!f.. ...........oA.c;,cd_ rc-z...................:. Exterior ....................................................................:...............Roofing . ... ........................................................................ Floors ..��.:............E................................................................Interior ... ............................................'.......... p Heating z...:.. r .^,r,,,. r c Ff`'....::: '•'°r.. ....::..Plumbing �!:. .:.......��fi �.�. . Fireplace .......•_•x9......:......................... ......................................Approximate Cost ....: ?.<:2 ...elnnm.'a..:P ..... J > Definitive Plan Approved by Planning Board ___. _ ___________19_ Area ........ ..L.. ....................... Diagram of Lot and Building with Dimensions Fee �,.. �. SUBJECT TO APPROVAL OF BOARD OF HEALTH eft' a I c�,r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name�Zzl................................................... Construction,Supervisor's License . ,.. _ .... � � ___ I ASSOC, 30304 l 'Stoz �No --i�.....—. �ermit for --'---.. ----- Single Family Dwelling --------------------------' ' Location ....Lot...#.G.........45.9......Bay_Laue. . Centerville � -----./ ../ --.. ----------- ' Silvia & Silvia Assoc .Owner{�vvner ---------._----------..�.. Type of Construction Frame -------------- ' --------------------------' � Plot �� ---------� ----------' ' December 18 86 ^ ' Permit Granted ------------,—]g ^ � � Dote of Inspection ------------lA ^ | Doha Completed ------------'lV . � / . A�n � _~ - ^ . ^ ' PERMIT ' a'f� ••'. TOWN OF BARNSTABLE BUILDING DEPARTMENT »0T TOWN OFFICE BUILDING HYANNIS, MASS. 02601 �o rev r. MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #...... . .....3 -�� ......................................._......................k.. ........._................. issued to ....... � �? vj. ....Sy ............' 5��.....:'". `I... �` "i ..._ ....... ``� � . Please release the performance bond. Cf TM f)0 TOWN OF BARNSTABLE 30304 .Permit No. . BUILDING DEPARTMENT' I D I TOWN OFFICE BUILDING Cash ............. t679•��ff uv HYANNIS,MASS.02601 Bond ........x......... CERTIFICATE OF USE AND OCCUPANCY Issued to Silvia & Silvia Assoc. Address Lot #G, 459. Bay Lane Centerville, Masi. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND.THE BUILDING-SHALL,NOT BE.OCCUPIED 'UNTIL SIGNED BY THE BUILDING INSPECTOR UPON,SATISFACTORY COMPLI ANCE;WITH TOWN: REQUIREMENTS AND IN ACCORDANCE'WITH,SECTION. 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 7. March..31 19.. g2....... �.. Building'Insp'ector I r aT..,i�i 7 7'•' TK�i"<y . •7.7.s rT'l+y 1c 1y Rry - t-',•r' M ".p 9^rvy4'�+:�d "+' "'*' - C TOWN OF BARNSTABLE, MASSACH SETTS 4. ILD T y .. e FfIT aZt tg`. APPLICANT n ADDRESS__vls 46.A.V.6 s 0 SEI PERMIT TO DWAZ1,J,t!f LJ_L) STORY NUMBER OF- Ifd[► f (TYP OF'IMPROVEMENT) } NO.' • DWELL'.ING UN�TS 7rVi693 1PROPOSED EI h. a< Yi r - �y 7`' ZONING ATI(LOCATION) _LOt _Y f 4ydri - ` Tac'1111�' C`Ear1#ar�s111P -(NO ). T DISTRICT ISTR ETE ).' r .•.r - . ' I a r i t BETWEEN Iq AND -.(CROSS STREET) r .. ..:.-.. .. .. (CROSS ,S,IREEA) At SUBDIVISION LOT BLOCK LO.T' �.'•; ai° SIZE ! BUILDING IS TO BE FT. WIDE Bl( FT, LONG BY FT `I'N HEIGHT AND SHALL C'iJNFORM IN.CONSTRUCTION' t i Ii TO TYPE USE GROUP BASEMENT WALLS OR.FOUNDATION J .'(TYPE) I REMARKS 425 AREA OR VOLUME 1 g56 sC�• ft PERMIT (CUBIC/ • ESTIMATED COST 7,1�I /^�/n� /► p s,, t't `LV SQUARE FEfT) e �0 3 ,1 � yA-L•SOU4FEE..S s yi-+,...r • j: a. OWNEli Q;1 t�� z � f• —��v��'� i ' f t t ADDRESS BUILDING DE PT t. G'f O 11rt..a �` } �} •�6V ��G�1 - ' BY. �17,F �T r s L @ t i I: r; p.' .. :.r -:.; im P A_f t .. r e FROM,THE DEPARTMENT OF PUBLIC WORKS THE ISSUANCE,OF THI&-PERMIT'-DOES NO T'RELEASE i"Mt Ar'f L7CA'N'I"F'H VM.f re l{'Vrtil rrclrvs"- OF AN+Y APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR 'ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECT PERMITS ARE REQUIRED FORION HAS ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE.. - 3. FINAL INSPECTION BEFORE " OCCUPANCY. - - POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING IN PECTION APPROVALS ELECTRICAL INSPECTION APPROVALS. 3"=A?, 3 r EATING INSPECTION APPROVALS ENGINEERING DEPARTMENT t 3-3% .g2 OTHER 2 -BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BP TOR HAS APPROVED THE VARIODUS STAGES OF rp ORK IS NOT STARTED WITHIN SI/ MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. ERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. I DEPARTMENT OF HOMELAND SECURITY-FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B.NO.1660-0015 COMMUNITY ACKNOWLEDGMENT FORM Expires February28,2014 PAPERWORK BURDEN DISCLOSURE NOTICE Public reporting burden for this data collection is estimated to average 1.38 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources,gathering and maintaining the needed data,and completing and submitting the form. This collection is required to obtain or retain benefits. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing this burden to:Information Collections Management,Department of Homeland Security, Federal Emergency Management Agency,1800 South Bell Street,Arlington,VA 20598-3005,Paperwork Reduction Project(1660-0015). NOTE:Do not send your completed form to this address. This form must be completed for requests involving the existing or proposed placement of fill(complete Section A)OR to provide acknowledgment of this request to remove a property from the SFHA which was previously located within the regulatory floodway(complete Section B). This form must be completed and signed by the official responsible for floodplain management in the community. The six digit NFIP community number and the subject property address must appear in the spaces provided below. Incomplete submissions will result in processing delays.Please refer to the MT-1 instructions for additional information about this form. Community Number: SG& I Property Name or Address: �} �i't L�I4C ,C f'N CLFi-)'n=JZ_V tL Lu - I/1��d�jGt oi= �t�'tl t7/` G'3b A. REQUESTS INVOLVING THE PLACEMENT OF FILL Ie iv STE PZ As the community official responsible for floodplain management,I hereby acknowledge that we have received and reviewed this Letter of Map. Revision Based on Fill(LOMR-F)or Conditional LOMR-F request. Based upon the community's review,we find the completed or proposed project meets or is designed to meet all of the community floodplain management requirements,including the requirement that no fill be placed in the regulatory floodway,and that all necessary Federal,State,and local permits have been,or in the case of a Conditional LOMR-F,will be obtained. For Conditional LOMR-F requests,the applicant has or will document Endangered Species Act(ESA)compliance to FEMA prior to issuance of the Conditional LOMR-F determination.For LOMR-F requests,I acknowledge that compliance with Sections 9 and 10 of the ESA has been achieved independently of FEMA's process.Section 9 of the ESA prohibits anyone from"taking"or harming an endangered species. If an action might harm an endangered species,a permit is required from U.S.Fish and Wildlife Service or National Marine Fisheries Service under Section 10 of the ESA. For actions authorized,funded,or being carried out by Federal or State agencies,documentation from the agency showing its compliance with Section 7(a)(2)of the ESA will be submitted.In addition,we have determined that the land and any existing or proposed structures to be removed from the SFHA are or will be reasonably safe from flooding as defined in 44CFR 65.2(c),and that we have available upon request by DHS-FEMA,all analyses and documentation used to make this determination. For LOMR-F requests,we understand that this request is being forwarded to DHS- FEMA for a possible map revision. Community Comments: ' [LOMA. o unity Official's Name and Title: (Please Print or Type) Telephone No.: m f}UL �oB�1t> Ao1LD1N�- c�� MrSS- � `��OZ c��- � 40� ommunity Name: Community Official's Signature: (required) . Date: �f� 1 STIR(13Lc % PROPERTY LOCATED WITHIN THE REGULATORY FLOODWAY s the community official responsible for floodplain management,I hereby acknowledge that we have received and reviewed this request for a We understand that this request is being forwarded to DHS-FEMA to determine if this property has been inadvertently included in the regulatory floodway. We acknowledge that no fill on this property has been or will be placed within the designated regulatory floodway. We find that the completed or proposed project meets or is designed to meet all of the community floodplain management requirements. Community Comments: Community Official's Name and Title:'(Please Print or Type) Telephone No.: Community Name: Community Official's Signature(required): Date: DHS-FEMA Form 086-0-26B,FEB 11 Community Acknowledgment Form MT-1 Form 3 Page 1 of 1 a A.M.Wilson Associates Inc. December 2, 2016 Paul Roma, Building Commissioner Barnstable Building Division 200 Main Street Hyannis, MA 02601 RE: FEMA Community Acknowledgement Form 459 Bay Lane, Centerville (our file 2.1891.01) Dear Mr. Roma: My office is assisting Stephen J. Doyle &Associates in obtaining a Letter of Map Revision (LOMR) for the owner of 459 Bay Lane, Centerville, a property which has been developed since 1992 with a single-family dwelling. In order to complete the application to FEMA, it is necessary to obtain from you a completed Community Acknowledgment Form. To facilitate completion of that form, attached are copies of the site's Flood Elevation Certificate recently completed by Stephen J. Doyle, RLS, and the lot's permit history. We are happy to pick up the form when it is ready. Thank you for your assistance in this matter. Yours, A. M. WILSON ASSOCIATES, INC. i ) I Arlene M. ilson, PWS Principal Environmental Planner attachment 20 Rascally Rabbit Road 508 420-9792 Unit 3 FAX 508 420-9795 Marstons Mills,MA 02648 amwilsonassoc@amwilsonassociates.com Town of Barnstable Geographic Information System July 29, 2016 4,87057 187067 #503 #604 187082 #104 18f�7 #485 187064 #492 187077 22 187003006 187004 #467 #0 °. . 187003004 B LEECH EAF/SLA/YD RD �y d 187003005 711 #465 'T -187073 •f, . 187076 r #10 187003008 #11 Z #461 187065 #464 ` 187002 .: 187076 .#373 187003003 #22 187003002 187001 #459 #361 Q .. 187066 187074 #_456 #38 186091 #446 _ 187003001 #0 186017 ,., #360 18 0085 #442 186016 188084 #390 186015002 ® #444 =' " 186015001 #430 18#65090 186018 #356 #420� 6 Feet DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:187 Parcel:003002 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 7W+ -100'may not meet established map accuracy standards. The parcel lines on this map Owner:ONEILL,HUGH G 8 KATHARINE F Total Assessed Value:$632600 - are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: - Acreage:0.44 acres Abutters '' boundaries and do not represent accurate relationships to physical features on the map Location:459 BAY LANE such as building locations. - Buffer �. r; I i Pnnt�this page; " • Owner Information -Map/Block/Lot: 187/ 003/002 - Use Code: 1010 Owner Map/Block/Lot GIS MAPS ONEILL, HUGH G & , 187 / 003/002 Owner Name as of KATHARINE F Property Address 1/1/15 459 BAY LANE 459 BAY LANE CENTERVILLE, MA. 02632 Co-Owner Name Village: Centerville Town Sewer At Address: No r GIS Zoning Value: RD-1 Assessed Values 2016 -Map/Block/Lot: 187/003/ 002 -Use Code: 1010 2016 Appraised Value 2016 Assessed Value ,. Past Comparisons Building Value: $ 260,900 $ 260,900 Year Total Assessed Value Extra Features: $ 63,600 $ 63,600 2015 - $ 599,700 2014 - $ 599,900 Outbuildings: - $ 8,400 $ 8,400 2013 - $ 600,100 2012 - $ 633,200 Land Value: $ 299,700 $ 299,700 2011 - $ 642,200 ^ 2010 - $ 647,100 2009 - $ 640,400 $ 632,600 2008 - $ 704,200 2016 Totals $ 632,600 2007 - $ 770,100 Residential Exemption Received= $90,000 • Tax Information 2016-Map/Block/Lot: 187/003/002 -Use Code: 1010 Taxes C.O.M.M. FD Tax $ (Residential) 1,005.83 Community Preservation Act $ 151.55 Tax Town Tax (Residential) $ 051.61 Fiscal Year 2016 TAX RATES HERE 6,208.99 1 • Sales History-Map/Block/Lot: 187/003/002 - Use Code: 1010 History: Owner: Sale Date Book/Page:' Sale Price: ONEILL, HUGH G &KATHARINE F 2011-02-25 25281/112 $595000 SMITH, STEWART& MARILYN TRS 1992-11-15 8327/329 $1 SMITH, STEWART N & MARILYN .. 1991-06-15 7560/208 $200000 SILVIA & SILVIA ASSOC INC 1985-01-15 4383/235 $348000 BROADBENT, ERICSSON B TR 1980-01-29 " ' . 3050/289 $0 • Photos 187/003/002 -Use Code: 1010 i • Sketches - Map/Block/Lot: 187/.003/002 -Use Code: 1010 44 i As Built Cards:Click card#to view: Card #1 - • Constructions Details-Map/Block/Lot: 187/0031 002 -Use Code: 1010 Building Details Land Building value $ 260,900 Bedrooms 3 Bedrooms USE CODE 1010 Replacement Cost $306,982 Bathrooms 3 Full-1 Half Lot Size (Acres) 0.44 Model Residential Total Rooms 7 Rooms Appraised Value $ 299,700 Style Cape Cod Heat Fuel Gas Assessed Value $ 299,700 Grade Average Plus Heat Type Hot Air Year Built 1991 AC Type Central Effective depreciation 15 ' Interior Floors CarpetHardwood Stories 1 .1/2 Stories Interior Walls Drywall Living Area sq/ft 2,904 Exterior Walls Wood Shingle Gross Area sq/ft 7,044 Roof Structure Gable/Hip Roof Cover Wood Shingle • Outbuldin s& Extra Features -Map/Block/Lot: 187/003/002 -Use Code: 1010 Code Description Units/SQ ft Appraised Value Assessed Value WDCK wood Decking w/railings -256 $ 3,300 $ 3,300 FPL2 Fireplace 1.5 stories 1 $ 4,700 $ 4,700 BMT Basement-Unfinished 1908 $ 385500 $ 38,500 _ a GEN Emergency 1 "y$ 5 100 5 100 Generator $. - , FPO Ext FP Opening 1 $ 1;500 $ 1,500 GAR Attached Garage. 572, $ 15,600 $ 15,600 FOP Open Porch-roof` 64 $ 3,300 $ 3,300 ceiling • Sketch Legend Property Sketch Legend y B21N Barn-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL. Solarium ` BMT Basement Area(Unfinished) FUS Second Story Living Area(Finished) SPE Pool Enclosure BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area (Finished) GXT- Garage Extension Front UST Utility Area(Unfinished) . FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Microsoft VBScript runtime error'800a01a8' R _ IE!:k 25251 P:R 1 12 �10608 C12-25—'...3011 & 01 2 17P QUITCLAIM DEED We, STEWART N. SMITH and MARILYN M. SMITH, Trustees under a Declaration of Trust entitled SMITH REALTY TRUST, dated August 10, 1992 and recorded at Book 8327, Page 330, for consideration paid in the amount of Five Hundred Ninety Five Thousand ($595,000.00) Dollars, hereby grant to Hugh G. O'Neill and Katharine F. O'Neill, husband and wife as tenants by the entirety, of 459 Bay Lane, Village of Centerville, Barnstable, MA 02632 MASSACHUUSETCIftISTATENTY EffikY WDEEDs Date: 02-25-2011 a 01:17Pm with Quitclaim Covenants ctl�: 690 Doer: iobr�s Fee: $2,034.90 Cons: $595r000.00 The land, on Bay Lane, in the Village of Centerville, in the Town and County of Barnstable, Massachusetts, and shown as Lot G on a plan entitled "Plan of Land in Barnstable, Mass. (Centerville) prepared for: Silvia & Silvia Associates; Inc.," drawn by Cape Cod Survey Consultants and recorded in Barnstable County Registry of Deeds in Plan Book 402, Page 78. See also Lot G, Book 477, Page 42. Said premises are conveyed subject to and with the benefit of all rights, restrictions, reservations, easements, appurtenances and rights of way of record, insofar as the same are still in force and applicable, including but not limited to such rights, restrictions, reservations, easements, appurtenances and rights of way described in "Protective Covenants,Restrictions Governing Beech Leaf Landing at Scudder Bay, an Open Space Development in Centerville, Massachusetts", dated May 12, 1986, and recorded at said Deeds at Book 5073, Page 200, as amended by instrument dated December 18, 1990 and recorded at said Deeds at Book 7388, Book 36, and instrument recorded on June 6, 1991 at Book 7560, Page 211. Said premises are conveyed subject to and with the benefit of all rights, restrictions, reservations, easements, appurtenances and rights of way of record, insofar as the same are still in force and applicable. The undersigned hereby certifies that they are the sole trustees of said trust, that there has been no amendment or, revocation of said trust except as of record, that no beneficiary is a minor, incompetent, a corporation selling all or substantially all of its assets located in Massachusetts, an estate subject to Unpaid estate taxes, and that all of said beneficiaries have directed the trustees to execute this instrument. For Title see Deed recorded at Book 8327, Page 329. r BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Return to: Roy A.Cramer, Esq. Date: 02-75-2011 01:17Qm C:t1Y• 690 Doc': 10603 Frieze Cramer Rosen&Huber LLP Fee: $1 7606.50 irons: $595Y000.00 60 Walnut Street Wellesley MA 02481 Bk 25281 Pg 113 #10608 Witness our hand s an d seals this • c�- day of J Yi 2011. STEWART N. SMITH, Trustee MARILYN M. SMITH, Trustee STATE OF FLORIDA 11- County of ��:1�.• On this day of January 2011 before me, the undersigned notary public, personally appeared Stewart N. Smith and Marilyn M. Smith, proved to me through satisfactory. evidence of identification, which were L:k c.<R,-s�,�'�, to be the person(s)whose name(s) is/are signed on the preceding or.attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose, Witness my hand and official seal. . ANTHONY 1.LARICCIA * * MY COMMSSION Y DO U4442 EXPIRES:August 27.201;, ��'�'0e Irded Th:u B.u�;.;;a;,:S�• l„ d -leg. > Notary Public My Commission Expires: ANTHONY L LARICCIA * * MY COMMISSION I OD 8844Q EXPIRES:August 27,2013 " ��oc��'°! Bonged llw Budget NolarY Semites BARNSTABLE REGISTRY OF DEEDS U.S.DEPARTMENT OF.HOMELANDSECURITY ELEVATION C.ERT.�F�CATE FEDERAL EMERGENCY MANAGEMENT AGENCY OMB NO..1660-0008 National Flood Insurance.Program ,ration Date:July 31,2015 Important: Read the;instructions on pages 1=9. hm SECTION'A—PROPERTY INFORMATION" FO NSURAK MPANYz Al. Building Owners Name Hugh 8 tCathanne O Neill ,$ ot`ic�i NumlSer- x A2. Building Street Address(including Apt„Und,°Suite,and/or Bldg..'N6.)or,P O' Route and,Box No._ 459 Bay Lane �.., City Centerville :,;�.'�.StateMA 21PCode'02632" t A3. Property Description:(Lot and Block Numbers,Tax Parcel Number;Legal D'escnption etc)' ` ` Barnstable"Assessors Map 187,Parcel,003-002,Deed,Reference-25281 112;Plan•Ref&6ei66=402 78 Lot'G ..= t A4. Building.,Use(e.g.,Residential Non-Residential,Adddion.Accessory etc) Residential j. AS... Latifude/Congkude:;Lat.41-38=3267< :Long.70-21-28.62= ''{ Horizontal Datum: ❑ NAD 1927 ® NAD 1983 A6; Attach at least 2 photographs.ofthe`bujkjing if the Certificate is'tieing-us to obtain flood insurance. AT Building Diagram Number :1A a .: A8. For a building with a crawlspace or enclosure(s): A9. For'a buildingwithan; ttached"garge;. $ t a}` Square-footage of crawlspace or encWure(s) 1984 sq.ft a) Square footage of.atta66,d garage 572 sq ft. b) Numberiof permanent flood`openings in the crawlspace b) Number of permanent flood'-openings'ih the attached garage: or enclosure(s)'.within 1.0,foot.above adjacent grade, 0' ,within 1 0(foot:above adjacent grade 0 I c) Total net area offlood openings in A8 b 00AW sq in c): Total net.area of flood.openings in A9,bl, 00.00 sq in d) Engineered flood openings?. ❑,`Yes; ® No d) ;Engineered flood.openings? El Yes: ® Na. SECTION El FLOOD INSURANCE,RATE MAP(FIRM)-.INFORMATION.::s 61..:NFIP Community Name-&Community,Number 82.County Name . B3::St. Barnstable 250001 Bamstable: MA B4.Map/Panel Number B5;Sufflx 66 FIRM Index Date B7JFIRM Panel 138 Flood B9 Base Flood Elevation(s)(Zone 563 J July 16,2014- Effective/Revised Date Zone(s) AO;use base flood_depth) a ,.July 16,2014 AE .- 12 B10. Indicate.the sourceof the Base Flood Elevation(BFE)data or base flood iepth,entered m Item Bg. e ❑ Fit,Profile ® FIRM ❑.Community Determined ❑ Other/Source: ' B11. Indicate`elevabon-datum used for BFE`in Item B9 ❑ NGVD 1929 ® NAND 1988 ❑ Other/Source B12. Is the building located m a,Coastal.Bamer Resources System(GBRS)area or Otherwise Protected Area(OPAj? ❑y Yes r® No i Qesignatign;Date: ❑; :CBRS ❑;:OPA SECTION C-BUILDING ELEVATION INFORMATION.(SURVEY REQUIRED) A.new Elevation Certificate will be requited when construction ofthe bwldi. Cl. Building elevations;are based on '❑ Construction Drawings ❑ Building Under Construction? ® Finished Construction # ._ 4 rig is complete. T C2. Elevations-Zones Al A30,,AE,AH,A(With;BFE) VE,V1 V30,V(with:BFE) AR,AR/A,AR/AE,AR/A1—A30,,AR/AH,AR/AO.'Complete items,C2c_a h f i below according to the building diagram specified in Item:A7.In Puerto'Rico only,.enter meters.. Benchmark•Utilized:GPSNET Verticalbatum NAVD88: ' Indicate el6Vatibn.da'tum'used f0f the eleVations`in.items a).through h)below ❑NGVD 192g ®NAVD 1988. Cl Other/Source: . Datum used-for building elevations must be the same as that used foe BFE. Check the measurement used. a)-Top of bottom floor(including basement,crawlspace,'or.enclosure floor) 14A6 ®feet ❑meters t b)Top of the;next higher floor: 23 05 ®feet [I meters c) Bottom of the lowest horizontal structural member(V.Zones only) et ❑,meters d):Attached garage(to ,of slab) 19 155 ®1 feet ❑meters e)Lowest elevation of machinery or'equiprn serncing fhe building 46: ®feet ❑meters (Describe type;of,equipment and location in Comments): f) Lowest adjacent(finished)grade next to building,(LA 121 ®feet ❑meters g)Highest adlacent(fnished)grade next to building(HAG) 21.7 ®feet ❑meters h);,Lowest adjacent rade at;lowest elevation-ofdeck orstairs,including structuralsupport. 12.2 .®feet [Imeters. SECTION.D—SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION' This certification is to be signed and"sealed by a land surveyor,engineer,or architect authorized,by law.to certify elevation. information.l ce►tify that the information on this Certificate represents my best efforts tointerpref the data available, t•. 1 understand that any false statement maybe punishable by fine.or imprisonment under 18 U.S.Code,Sect;on 100;1< 'a *� 't htlf�S ft ® Check tie're rf comments are provided,on back of form:. Were latitude,and longitude in Section A;provide, y.a ❑ Check tere ifattachments. licensed land-surveyor? ® Yes ❑ No Gertjfiees Na ne'Stephen Doyle License Numbei 37559 n `M, Cn ► -. _ ' . ♦ ' t�1Q.-37559♦. 1 Title;-Land Suiveyor, Company Name Stephen Doyle;&Associates C1,c �c7 4 a Address 42 Canterbury Lane City East Falmouth State MA ZIP.Code 02536 Signature' Q Date 08-17-16 ; Telephone 508 640-2534 FEMA Form 086-0-33(7/12) See reverse side for continuation. Replaces all previous editions:' �...,._.,�.....a-" ...,, ,.-�..,,-.•u.. .:.;;_.:.. ...:P..,...,.......:.. :.,;. ;�.�,.,w,r,�:;r_ ,^^.*e,,�,ry—,......-�,.-�•:a- .r...^,g:et�.r..ra+. •�. F,•,vwm«a..,.�.�. _ ... ... .. .. _ . ELEVATION CERTIFICATE,.page 2 x IMPORTANT:In these spaces,copy the corresponding informationfrom Section.A. FOR INSURA°NCE COMPANY USE Building Street Address(including Apt.,Unit,Suite,and/or Bldg,'No.)'orP O.Route and Box No. Policy Number- " 459 Bay Lane _ k _106 City Centerville State MA ZIPCode 02632CompanyNAtC;Numbe � ( SECTION D—SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION:.(CONTINUED) Copy both sides of this Elevation Certificate for(1)community.official,(2)insurance agenTlcompany,and(3):building owner.. !' Comments SEE ATTACHMENT Signature Date 08=17 16. _.. 3 SECTION.E—BUILDING ELEVATION INFORMATION(SURVEY?NOT, REQUIRED)FOR.ZONE AO AND ZONE A(WITHOUT BFE) r For Zones AO and A(without BFE),,.complete Items El.—E5.If the Certificate is intended to support a LOMA or LOMR-F request,.complete Sections A,B. Ind C:.For Itenis El 'E4;,use natural grade;_if available.Check the measurement used.in,Puerto Rico only;,enter meters:: ; a El. Provide elevation information for the following and check'the:appropriate boxes 16 show:whether the elevation is above or below the Highesf:adjacent grade(HAG)and the:lowestadjacent,grade(LAG). ; a)Top:of bottom floor(including.basement,crawlspace,or encosure)is: ❑feet ❑;meters ❑above or❑below the HAG. b)Top.of bottomfloor(including basement,crawlspace;'or enclosure)is : - ❑feet O'.meteit ❑above or❑ :below the LAG: E.2. For Building_Diagrams 6-9.with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8. 9 of Instructions),the next higherfloor (elevation C2 b in the.diagrams).of the bwldi is ❑feet' 0 meters ❑above or ❑below.the G. E3. Attached garage(top of slab).is ❑feet ❑meters .❑above or ❑below the HAG. ' " j. E4. Top of platform of machinery and/or equipment servicing the building is, ❑feet ❑meters ❑:'above or❑below the HAG. t E5. Zone AO only: If no.flood depth number is available,is the top of,the bottom floor elevated in accordance with the community's floodplain management ordinance?. ❑Yes .❑ No: ❑ Unknown"The local official must certify`this information tin Section G., SECTION.F=PROPERTY'OWNER(OR OWNER'S REPRESENTATIVE):CERTIFICATION t _ The property owner,orowner;s;authorized representative who`completes Sections A,B',;and E for A;(without:ai FEMA-issued or community-issued BFE) } l or Zone AO must,sign.here..The statementsi Sections A,B,.and E are correct to the best,of my<knowledge. j Property Owner's or Owner's Authorized Representative's Name Address City State. ZIP Code _ t Signature Date Telephone. F Comments , F . .,:;. . :"_. ❑Check'.here if attachrments. SECTION G' COMMUNITY`INFORMAT ION*(OPTIONAL)`„ S The local official who is authorized bylaw or ordinance.to administer the community!s floodplain management ordinance can complete Sections A,'B,C.(or E),and G` of this.Elevation Certificate.Complete.the applicable ifem(s)and sign below.Check the'measurement used in items G8-G10.In Puerto Rico only,enter meters. f G1..❑ The information;in Section t was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify'elevation information: (Indicate the source and date of the elevation datain the Comments area:below.:) G2.❑ A"community,official completed Sedtion E'for:a building located in Zone:A(without a FEMA is sued`or community-issued BFE)or Zone-AO: G3.❑ The following`information:(ltems G"10)is provided for'commumty'floodplain;management purposes. I I G4.,Permit Number G5: Date Permit'Issued. 06, Date Cert sate Of,Compliance/Occupancy Issued j G7. This permit has.been issued for: ❑`New Construction ❑Substantial Improvement j G8. Elevation of'as-built lowest'floor(including basement)of the building ❑feet ❑meters Datum G9. BFE or(in Zone AO)depth of flooding-at'the building site' ❑feet ❑meters Datum i G•10.Community siesignflood elevation: ❑feet ❑meters. Datum Local Offic!ars,Name . ' Title + Community Name' Telephone Signature Date Comments ❑Check here'if attachments. FEMA Form 086-0-33(7/12) Replaces all previous editions. ELEVATION CERTIFICATE,page3 Building Photographs: See Instructions for Item;A6. IMPORTANT::In theses aces,co p p py the corres onding'information from Section.A. ; OR tNSURANCE`COMPANY tiSE Building Street Address(including Apt,:Unit,Suite,.and/or Bldg.No.)'or P.O.Route anal Box No.( PSI tJumber." :x #459 Bay Lane , City: Centerville State,MA ZIP Code W632: "'o D Coik&nber If using ttie Elevation.Certificate to obtain NFIP flo6d'.6surance affix,at least Z building photographs below according to the instructions , for Item A6. Identify all photographs.with date taken "front View and Rear`A iew and, if:required, "Right Side View"and "Left.Side I view: When applicable, photographs must-show the foundation with representative examples of.the flood openings or.vents, as indicated in Section A8. If submitting'more,photographs than will fit on this page use the Continuation:'Page: Front.VieW l t Photo:Date: 08 09-16 r I ° } ry r r. r. e f F w i FEMA Form 086-0-33(7/12) Replaces all previous editions: } ELEVATION CERTIFICATE, page 4 - Building Photographs ,. Continuation Page IMPORTANT: In these spaces,copy the corresponding information from.Section.A, t 0R(NSURANGE COMPANY USE y. #Building Street 459 Bay Laneaddress(including Apt.,Unit,.Suite:and/or Bldg.No.)odP O.Route,,and.Box No. PokxCy N`iim�y " A CityAK Centerville State MA * ZIP Code 02632 Co NA �umber� � gz VIM If submitting more photographs than will fit on the preced1ng:page affix the additional photographs below. Identify all photographs; with:.date taken; "Front View" and ",Rear View" and if required,. "Right Sidia,View" and "Left Side View," When applicable,, photographs.must show the foundation with representative examples of the flood openings or vents as'indicated in Section A8. i i t. Rear View Photo Date: 08-09-16 r i ?sa•Af,.�3 ', _ ` Mpl Y1 Yd W+# r 4i�F tj11��S�ES � k� k5 N`...a' •� - d , A 4 'R F FEMA Form,086-0-33(7/12) - Replaces all'.previous,editions Elevation Certificate"Comments"Attachment Property Location: #459 Bay Lane;Centerville, MA The residential'dwelling located at#459 Bay;lane is a wood framed structure cor tructed on full' poured concrete basement walls,having a walk-out`to the rear ofahe basement area (southwest).The standard residential'utilities:arelocated in the basement at.or above elevation 14:46' NAVD88; , G _. , excepting the'small area:below the rn-house:residential elevator shaft that extends 12" below`the i. basement,floor to!elevation 13.46' NAVD88i. The mapped"AE"flood,line.meanders the.southside of this structure where it is_evident that-fill was placed at the time of construction appro*nately:199f The,reported LAG el on(12 2')was: recorded at the:south west corner of the structure atop said filled area: ' I Date M.17-16 ' i StephenDoyle'RLS .- ,TEP1E i 1, n 4 I cFL ,s1 y ZONE AE ; ' SG C. SCALE MAP Y E 1" = 500' rus Q= �,�� y P own• f' t 500 1000 FEET •, � PANEL 0563J `s FIRM a FLOOD INSURANCE RATE MAP • t, �* Sc�rxdde-r Bay' BARNSTABLE COUNTY, ' +L`IMIT OF MODERATE �' MASSACHUSETTS ;¢' VVF�VEACTION ° (ALLJURISDICTIONS) PANEL 563 OF 875 `r (SEE MAP INDEX FOR FIRM PANEL LAYOUT) CONTAINS a COMMUNITY NUMBER PANEL SUFF1A BAf S'A 1,TOWN :5I om]l .1 Y NE A ° I Q7 • ZONE E `® -NOTE- (EL 13 (EL 12 I THIS INCLUDES SYSTEM 80fS1MRISHn{THEE Afi TAtRIFR RESOU® BAWER RE SYSTEM ESTABLISHED UNDER?HE GOAS'A. ENABLING RESOURCES AC'OF 1983 ANO�OR 5UtlSE0UENf ENASLYVG lEO1sLAnOv Notice to User, The Map Number shown below should be used when placing map orders, the Community Number shown above should be used on Insurance applications for the subject I� I NGA E a community. LANE j MAP NUMBER .b. ® I 25001CO563J tic EFFECTIVE DATE F' ,4 r ie �'� LIMIT OF MODERATE `��r�tl`` JULY 16,2014 � AVEA►TION Federal F.mrrgrnc) Nfunagenlrm Agency This is an official copy of a portion of the above referenced flood map It was e>rtrarted using F-MIT On-Line This map does not reflect changes amendments which may have been made subsequent to the date on the Q E _ title dock For the lot est product information about National Flood Insurance �1 +P Program flood maps check the FEMA Flood Map Store at w msc terra goy Legend -- N: p" y i { 1, 4. ,•o s CU - 4 9B Y �: o- .a Map printed on: 11/2/2016 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adcyueelc for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property houndaries and do not represent 367 Main Street,Hyannis,MA 026oi 0 333 667 nn on-the-ground soney.It may be generalized,may not accurate relationships to physical ohiects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: t inch= 333 feet Q cartographic errors or omissions. gis@town.harnstable.ma.11c Print Page Page 1 of 4 R f n Print this.page •. Owner Information-Map/Block/Lot 187/003/002-Use Code: 1,010 Owner t MaplBloclJLot ,GIS MAPS, f 0NEILLHi1GH G & 187/003/`002 Owner Name as of KATHARINKY Property Address, 111115 459 BAY LANE 45.9_BAY LANE t ! CENTERVILLE,MA,'02632 . Village Centerville: Co=Owner Name - t Town Sewer At Address:No i GIS Zoning, Value RD-I - 1' -J R Assessed Values 2016=Mali lock/Lot 187/003 002-.Use Code :1016 " _ f c 2016 Appraised Value. 20l'.6 Assessed Value last Com�ar..isanS: Building $260,900. $260,900 Year Total Assessed; Value: - Value,, Extra 63,600:I s $ 63600 2015°- $�99,700 Features: 2014.-`$ 59.9900 } ' 1013 -$ 600,100 Outbuilding_s:' ' 2611 -$ 642 200- Land,Value• $299;700 $ 299,700 '" 4 2009 $640,400 ;. 2016 Totals` $ 632,600 S 632,600 2007-<$ 770;100- Residential Exemption:Received=$90,000. Tax Information`2016.-�Map/Block/Lot: 187 t 003/602-Use Code.'1010 Taxes C OM.M.;FD Tax $ (Residential). 1, 0.05.83 Community Preservation !Fiscal Year 2016TAX RATES fIE:RE: Act Tax' $ l 1.55 Town Tax(Residential) z http://www.t6wnofbamstable.tis/Assessing/printl.6.asp`yap=0&searchparcel=187063002 1 i/2/2016 Print Page Page 2 of 4 6,208.99 • Sales History'-Map/Block/Lot: 187!003/001-Use Code: 101:0 } History: Owner: Safe Date Book%Page: Sale Price; ONEILL,HUGH G&KATHARINE+F ` 201'1 02 25" 252.81/112 $595.000 SMITH, STEWART 2&:MARILYN TR$ 69 11-1.5 8327/329 $1 SMITH, STEWART N'&`MARILYN ' . 1991 06115 ` 7566/208 $200000 SILVIA&,.SILVIA ASSOC INC 1985-01:-15 4383/235; $3480.0.0 1: BROADBENT,ERICSSON B TR 1980-01-29 3050/289 $6 ' Photos 187/0031 0,02 Use Code:4010 f' 40 4,. r • Sketches ,MapBlo. kWLot '187%003 002 Use Code: 1'010 t. l As Built Cards:Click card#to-view: Card#l _ d • Constructions Details-;Map/Blocklot 187/0031 002;-Use.Code: 1.01.0 Building Details Land http://www;townofbarnstable.us/Assessing/printl6.asp?ap 0&searchparM. 187003002 II/2/2016 Print Page ? Page.'3 of 4 Building value $260,900 Bedrooms 3 Bedrooms USE CODE: 1010 i Lot Size Replacement Cost $3.06,982 '. ' Bathrooms 3 F 11-1 Half 0'.44 u (Acres) F Appraised :. Model Residential Total Rooms 7 Rooms, Value. 299,700 -Assessed $ Style Gape,Cod; Heat Fuel Value 299,700 S 'Grade Average Heat Type . Hot Air l' Plus ,Year Built •199:1 AC Type Central i Effective,, Interior 15: CarpetHardwood depreciation Floors - l''` Interior /2 ' l Stories 1 1 Stories. Drywall.- us Exterior' Living•Area.sq/ft, 2,904 Wood`Shingle 9 Walls ; Roof f Gross Area sq/ft 7,044 Gable/Hip, Structure Cov er ver- Wood-Shingle F 1. .. 1 F ; i Outbuildings'&.Extra'Features-Map/Block/Lot: 187/.003/002 - Use.Code: 1010. Code; Description. ' Units/SQ ft Appraised Value. Assessed Value. Wood Decking WDCK _56 $:3,300 $4 00 w/railings:: Fireplace 1.5 - 1 FPL2 .. 4. 1 S 4,Z00 - $4 700` stones 1 Basement 1 BMT 1908 9,50.0 $38;5.00 a Unfinished GEN. Emergency 5,100 $.5:,100; .J y .Generator FPO Ext FP'Qpenng 1 $ 1,500 $ 1,500' GAR Attached Garage 572 $:15,600' $ 1,5;600 Open Porch-roof- FOP 64 &3,300 $ 3 300 l t :ceiling;, 1 • Sketch Legend' Property Sketch Legend; B2N Bam-any 2nd story area. .fPC Open,Porch.Concrete F.loo� REF_ Reference Only BAS First.Floor,Living,Area FTS Third Story.-Living Area SOL Solarium E (Finished) 4 http://www:toAvno,fbamn table.us/Assessing/Dtintl6.asp?ap.=0&searchr)arcel=l'87003002' 11/2/2016 Print Page Page 4 of 4 t BMT Basement Area ' FUS Second Story Living'Area SpE 'Pool Enclosure:. (Unfinished_) (Finished) BRN Barn GAR Garage TQS:. Three Quarters Story (Finished) CAN Canopy GAZ Gazebo UAT Attic Area(Unfinished) CLP Loading P_Ilatform GRN,,, Greenhouse. UHS Half Story.(Unfinished) FAT Attic Area(Finished) Garage Extension Front_:. UST Utility Area(Unfinished) FCP Carport KEN Kennel UTQ Three Quarters`Story (Unfinished) FEP Enclosed Porch MZ1 Mezanme;:Unfinished,° ., U,UA Unfirnslied Utility Attic. FHS Half Story(Finished) PRG Pergola UUS FuWUpper 2nd Story ±: (Unfinished) FOP Open or Screened in. . PRT Portico WDI< 1Nood Deck Porch PTO Patio \ C' Microsoft VBScript runtime error'8000168' Object required:'' /Assessing/print16.asp,line 151 . I F l • i s http://.www:townofba-ri stable.uslAssessing/printl6.asp?ap=0&searchparceI=497003002 ' 11/2/2016 �. Bk 252 1 P 2 02-25=2 11. ,. .41 QUITCLAIM,DEED ' We,STEWART N. SMITH-and MARILYN M. SMITTH Trustees under.a.Declaration of Trust entitled`SMITH REALTY TRUST; dated August 10, 1982'and recorded at Book $327, Pago,330, for consideration pa , rn,the amount of;Five Hundred Ninety Five Thousand{$595,Oa4,04) Dollars;.hereby grant to Hugtt:d.O'Neill and Kaitharine R ' O'Neill,,husband and wife;as,tenants by the:entirety,of 459 Bay Lane, Ullage.of ' Centerville, Barnstable,'MA a2632 rrAssRcrTs T gg ff 7 BARNSTABLE C(Ttf TITUM' 'NEEDS ` 'f Date: 02-25-2Uf1 a01:17�et_. CtiIt: 'A" oew: 14b08. . with QUJtCIs m Covenants'_ Fpe; $2�U34.9t Ccs�5 ;454S+OU0.Q0 } The land, on:Bay Lane,;in the Village of Centerville; in the Town;arid,Countyof:° 8arnstable, Massachusetts, and;shown as Lot 0.on.a plan entitled``Plan of'Land in . . Barnstable, Mass..(Centervilie)prepared for,,Silvia& Silvia Associates, Inc. 'FA by Cape Cod Survey Con"suitants and recorded rn`Barnstable County.Registry of Deeds,in Alan.Book 402, Page 78.. See also Lot G,.Book Ot Page 42 Said premises are conveyed subject to an"d,Wth the benefit . 41 rights, restnc#ions; reservations,;easements,.appurtenances and rights.of way of record, insofar as.he same are still:in force-and,applicable,including but not limited to.such;!rights; restrictions,reservations,easements,:appurtenanaes and rights.of way described in 1. Protective-Covenants, Restrictions Governirig Beech!Leaf Landing of Scudder.Bray, an Open Space'Development rn Centerville, Massachusetts'; dated May 12, 19$6,and: 1 recorded at said,Deeds at:Book,5073,Page'200, as amended by instrument dated' December 18, 1990 and:recorded at said Deeds at Book`7888,,Book 36;and instrument recorded on,:tune 6, 1,991` at Book 7560, Page 211. Saidpremises'are conveyed subject to and with the benefit of:ail rights, restrictions; reservations easements,;appurtenances,and"rights of way.of;record,insofar as the, :same are stilt in force ands applicable. i The undersigned hereby, certifies that,they are the sole trustees of sand trust, that there { h has been no amendment or revocation of said trust except as of record, that no' beneficiary is a minor; incompetent, a`corporation' selling all or sufJstantiaily .ail of its assets located in.Massachusetts; an estate subject to unpaid estate:;taxes and that all r of said beneficiaries have directed the trustees to execute this instrument i i For Title see Deed-recorded atHBoo k 8327, Page 329 6ARNSTABLE' COUNTY EXCISE TAi. .. BARNSTABLE COUNTY.REGISTRY OF DEEPS` ad 02-25 2011 8 Of;f7nd tteturri to Roy,A Cramer,Esq C r lr b9O Q$c;T .I1160S.- Frie e,Cramer (6k'n`&Huber LLP Fee•; 5ia:b+3,6.S�1 Cons. . j45:.DO�1,.Ot 60 walrtut'Street' { a . Wellesley MA 024$ Bk. .2528.1 Pg 113 #10608 Witness our hands.and:seals this . _:day:of J 'Yt { STEWART N. SMITH, Trustee, MARILYWk SMITH,Tivstee' - 4 STATE OF',FLORIDA s County ofAxfi` 4n this day of',January 2011 before me, the:undersigned notary publics personally appeared Stewart'N'.. Smith and Marilyn M.Smith, proved to me-through satisfactory i evidence of'identlfication, which were t �' to be.the�' ' ' _yr �� persons)whose name(s) islare signed on the preceding;or attached document,`And acknowledged;to me that helshe'signed ,Voluntarily for its stated'.purpose, I Witness my hand and`'.official seal. i ANT1iQW L LAIV A � aYCOMUISS1r3tt�M DD�ata2 * EXPIRES:August 2T 2013 . n to Notary Public �'.� n •„ Y, ��. MY ic6mmission Expires: .4 r t ANTHOW'L Lp IMIA ° . _ ,- ;,� tdY COMti6SS>ON t OS1884e42 _ ; # EXPIRES:August v-2011 . d�t+3paFL�°' Badedlleu Bulpet ticmry EeM1ttes 1 BARNSTABL,E REGISTRY OF ENDS I aPrNP - '9C q 0 w law <i WT,°.'MW r - Jam: H 3[ .. ^Lro—ruD RE'S7'R14TE0 AREA Ml'al! r• •� ffx - i''P.�xer V n Q� armsrPu calm 7P1. � - - - mal a naT_:e.'aSk naa-»oa'M WOO LT 8 tefW'YaP .—_r.;a773E aF VE�fiTom vmime A 55949: '�.au zo' c�ii,P _ uocwcaeR+late .a aaoi' a.e4.ar: r rrA ' ~brh'i'#S1r •+qa• I'v:45x+Wa.-a .—:IaOCIGaaV.N1UT.i,iP}f! .&Y7S'.b"W e$AY•.. J .+a'Nw'�ew �r . nz�xr�s� .4.ao' L'OT t4 'sLsrvY>;.rea f r� a r,4420-t .tw' * a.�y� q L PT ra :f .sesro»tt xom � �• a � RESTRICTED AREA 'A2;. R A TaA A.IWAP aaa kYas.s'E Pig. :.Nll�Q aY D. r ` 1 F�7 4.c Ai' g".. - kk. y g I talPPY Y 12aH a„P r a rsu nk- § �'" a :n /� .nc:mP.ea uo a•cw �+ cr .e- i t` � G�V � V'• b PCQ'6 G93.K C.W4. 9" ?a•Tyat: .. per, .t• .. , r�.. itf a Q 2..k2r4�._,�g. LOT'6 r y yy axc svx r:r., ! , ulx G:t'#N.YMYq'.A,C tl . ..8 ��... ,�,. 2�_ � ,wb"N' "(r _: parr. szew� �' - • r\`y N.` AND)N F "A'�- w SAT SCUDDE BAY DJ LOT: AN U1 ,x e ` Marx' R FD •� p' _ri •�:i .. rurN,.a,;. : ' .ss - :SIO/WA B SWL' IA ASSMIINC. QAvE a l tcCilS LF i .F'Y ML C'walAe Na 4 ttla ION IAUti'+•fID t+k i.3 '.�. .. 4 . Mx':':it9f5l 1 C,irc7 CN`IFuYL N 9 W Y•,': _ _ .s OACh HPAtE}'.i w�.;• E.VILU.M%51 i er..p.X ilb b Iti ' u:9 S aYCN,S'iE4 KlR G�'34 gf - W~ • / f41Nu aMIFaM1Yb'W ✓N `N NA! AiI :'i1.YAa.P1; , ac,. 5•Pilx 99y�s {��4T YSYY 5r.!B` ._- • S PERMIT HISTORY £ LOT G 459 BAY LANE, CENTERVILLE ' *04/22/85 Local Order of Conditions #85-7 *07/23/86 Local Order of Conditions (#85-7) 11/21/86 Disposal Works Installation Permit (#86-1240 replaced #85-427) ' *12/18/86 Building Permit (#30304) *12/30/87 Local Order of Conditions Extension *09/28/88 Septic System Certificate of Compliance 07/23/89 Local Order of Conditions Extension *07/11/90 Local Order of Conditions Extension *02/07/92 . Elevator' Permit (#206800) *03/31/92 Certificate of Occupancy *11/03/92 State Wetlands Partial Certificate of Compliance (SE3-1245) For Lot G *12/18/92 Local Order of Conditions Partial Certificate of Compliance *copyenclosed ' I FILE NO. 85-7 f �f TN E Tp ' ......� ,tom • � rua s6Jq. \�09 �p NO k, ' Order of Conditions ' TOWN OF BARNSTABLE WETLANDS PROTECTION BY-LAW, Ch. 3, Article XXVII FROM: BARNSTABLE CONSERVATION COMMISSION { Beech Leaf Island.Inc. & To Silvia and Silvia Associates Inc. ' Silvia and Silvia Associates, Inc. ' (Name of Applicant)• (Name of property owner) 619 Main Street Address Centerville, MA 02632 Address Same ' This Order is issued'and delivered as follows: by hand delivery to applicant or representative on (date) ' X by certified mail. return receipt requested on April 22, 198-5 (date) This project is located at Bay Lane (Lot G Beech Leaf Landing at Scudder Bay) , Centerville ' Barnstable Assessor's Map # 187 Lot 3 The property is recorded at the Registry of Deeds in Barnstable ' Book 4383 page 235, 240, 242 Certificate (if registered) '. March 11, 1985 March 19, 1985 Notice of Intent dated Date of Hearing This Order is issued on April 22, 1985 1 Findings The Barnstable Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has ' held a public hearing on the project:Based on the information available to the Barnstable Conservation Com- mission at this time,the Barnstable Conservation Commission has determined that the area on which the proposed work is to be done is significant to the following interests under Article 27 of the Town of Barnstable by-law: ° , ❑ Public water supply K Storm damage prevention XX Erosion Control ❑"Private water supply Prevention of pollution K- -. , Wildlife _ :9 Ground water supply C Land containing shellfish C. Recreational Flood control ❑ Fisheries ❑ Aesthetic I , Therefore, the Barnstable Conservation Committee hereby finds that the following conditions are necessary, in accordance with the Performance Standards set forth in the regulations, to protect those interests checked above. The Barnstable Conservation Committee orders that all work shall be performed in accordance with said conditions' and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. GENERAL CONDITIONS f ' 1. Failure to comply with all conditions stated herein.and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. This Order does not grant any property rights or any exclusive privileges. it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state-or local statutes, ordinances, by-laws or regulations. 'k 4. The work authorized hereunder shall be completed within three years from_the date of this Order unless either of the following apply- f (a) the work is a maintenance dredging project as provided for in the Act; or I (b) the time for completion has been extended to a specified date more than three years, but less than five years,from the date of issuance and both that date and the special circumstances warranting the extended time period are set forth in this Order. i .5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon ' application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill, containing no trash,refuse,rubbish or debris, I including but not limited to lumber,bricks,plaster,wire,lath,paper,cardboard,pipe,tires,ashes,refrigerators, motor vehicles or parts of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periods from this Order have elapsed or. if such an appeal has been filed, until all proceedings before the Department have been completed. ' 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land T . Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done.In the case of registered land. the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed ' work is to be done. The recording information shall be submitted to the Barnstable Conservation Commission on the form at the end of this Order prior to commencement of the work. N/A 9. A sign shall be displayed at the site not less than two square feet or more than three square feet in size bear- ing the words, "Massachusetts Department of Environmental Quality Engineering. File Number N/A 10. Where the Department of Environmental Quality Engineering is requested to make a determination and to issue a Superseding Order,the Conservation Commission shall be a party to all agency proceedings and hear- ings before the Department. 11.' Immediately following completion, the project shall be certified to be as per.these conditions and plans, in ' writing, to the Barnstable Conservation Commission by the project engineer who shall be registered'in the state of Mass. 12. Upon certification by the project •enci near , the applicant shall forthwith request, in writing, ' that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. 13. Prior to any work being done at the site, all legal advertising bills incurred by the petitioner in relation to the Wetlands Hearing held on this project shall be paid. 14. ' The Barnstable Conservation Commission or Conservation Officer shall be notified no more than two weeks nor less than two days prior to the commencement of work, and have the authority to issue - an Enforcement Order-if the terms or intent of this Order are not complied with."' ' 15. It is the applicant"i responsibility to provide all contractors with a copy of this Order and to ensure that all workers are informed of the conditions of this Order before they begin work at the site. 16. The work shall conform to the following plans and special conditions:. PLANS: Title Dated Signed and Stamped by: On File with:. Lot A m Commission Preliminary Site Plane March 11, 1985 C. -Frank Whiting, R.L.S. Barnstable Conservation Sewage Disposal System Jan. 24, 1985 Stephen Wilson,-P.E. Profile Key Sheet Design March ll, '1985 C. Frank Whiting, R.L.S. " Special Conditions (Use additional paper if necessary) , ' 1. There shall be no stockpiling of fill or excavated material between the house and the wetland. 2. Prior to the start of work at the site, a double row of staked hay bales shall be placed at the work limit/lot line, on both the, southerly lot line (up to the intersection with Lot F) , and on the northerly lot line (up to the intersection with Lot E) . These hay bales shall be maintained throughout construction. 3. An undisturbed buffer of natural'vegetation shall be maintained at least 35 feet from the edge of the wetland. Any areas disturbed 'within the buffer shall be replanted with indigenous shrubbery spaced three to four feet on center (ink- berry, bayberry, clethra, high bush blueberry, etc.) . 4. An undisturbed buffer of natural vegetation shall be maintained at least 20 feet from the top of the bank. Any areas disturbed within this buffer shall be ' replanted with indigenous shrubbery spaced three -to'four feet on center (ink- berry, bayberry, clethra, . highbush blueberry, etc.)'. 5. The driveway for the residence shall be constructed of gravel or other pervious ' material. : - 6. Dry wells shall be'installed to handle roof runoff. 7. All disturbed areas shall be revegetated immediately following completion of work at the site. No a_ea shall' be left uevegetated or i:nmulched for more than 60 days. ' 8. The site shall be,inspected by the Conservation Commission in June 1966. Prior to June 1, 1986, the project engineer shall. stake out the limit of the vegetated buffers as 'required by Special Conditions 3 and 4 above. Any areas that have ' not been re-established with indigenous vegetation within these areas shall be replanted with indigenous shrubbery prior to September 15, 1986. 9: This approval is contingent upon Board of Health approval of the proposed on-site sewage disposal system. 10. There shall be no lawn allowed on this lot. '' ...................................................................................................................................................................................... (Leave Space Blank) '! Barnstable Issued By Conservation Commission j Signal, This Order must be signed by a majority of the Conservation Commission. ' On this 22nd day of April 19 85 -, before me personally appeared Gilbert Newton , to me known to be the person described in and who executed the foregoing instrument and acknowledged that helshe executed the same as his/her free act and deed. November 28, 1991 o Pub My commission expires ' The applicant,the owner.any person aggrieved by this Order.any owner of land abutting the land upon which the proposed work is to be done or any ten residents of the city or town in which such land is located are hereby notified of their right to request the Department of Environmental Quality Engineering to issue a Superseding Order,providing the request is ' made by certified mail or hand delivery to the Department within ten days from the date of issuance of this Order.A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and the applicant. Detach on Dotted Line and Submit to the Issuer of this Order Prior to Commencement of Work. To Barnstable Conservation Commission(Issuing Authority) PLEASE BE ADVISED THAT THE ORDER OF CONDITIONS FOR THE PROJECT AT FILE NUMBER , HAS BEEN RECORDED AT THE ' REGISTRY OF s ON (DATE( If recorded land, the instrument number which identifies this transaction is - ' If registered land. the document number which identifies this transaction is _. . Signed ' Applicant M BOOK5281PIGE ±Oi :::. ctTwrrow MN- 85-7 ., Yam^' ausrraas ., SILVIA AND SILVIA tN Applicant ASSOCIATES, \ Xj t ; iNCORFORATED -,. order of Conditions < r r j. TOWN OF BARNSTABLE WETLANDS PROTECTION BY-LAW,Ch.3,Article XXVII � w: f lid 3Ju• FROM:BARNSTABLE CONSERVATION COMMISSION To SILVIA AND SILVIA ASSOCIATES. INCORPORATFn ` •' (Name of AppBeanU (Name of property ormer) ' { Address 619 Main Street, Centerville, MA Add 1 This Order is issued and delivered as follows: Jul 23, 1986 Idatel 1 by hand delivery to applicant or representative on y by certified mail.return receipt requested on Idatel • l ^C Bav Lane Cente W C R 1 •11 ! #. This project is located at rville A (LOT t v _n9- Page 1 1 i l87 Lot 1 (Portion) ter ,�y Barnstable Assessor's Map N � Deeds. Barnstable � r ' The property is recorded at the Registry of � ..; Book 4181 Pace 215• Rook S071- Page 12L; Rook S071. Pages 19A � Certificate(if registered) ' intent dated ,'March 11, 1985 Dace of Hearing March 19 '1985'` +' Notice of This Order is issued on July 23, 1986 ` as i`I;1 t Findings The Barnstable Conservation Commission has reviewed the above-referenced Notice of Intent and plans and has , '.F. held a public hearing on the project Based on the information available to the Barnstable Conservation Cum- mission at this time.the Bamstable Conservation Commission has determined that the area on which the proposed li u:_>.•'• work is to be done is siRnifictant to the following interests in accordance with the Presumptions of Significance `Fs eat forth in the regulations for each Area Subject to Protection Under (check as apprnpriatei: 14 i ARTICLE:7 ONLY j� l - t 'Public water supply 11 Storm damage prevention Q Erosion Control ; 1 �I Private water supply @ Prevention of pollution :1 Wildlife i it ' Ground water supply C: Land containing shellfish u Recreational Flood control u Fisheries Aesthetic t till: - r - r :,f : . � I r r - - 1 f v l; aooK5281 F.GE M { Therefore..the Barnstable Conservation Committee hereby finds that the fallowing conditions ere necessary,In accordance with the Performance Standards set forth in the regulations to protect those Interests checked above. The Barnstable Conservation Committee orders that all work shall be performed in accordance with stud cooditism and with the Notice of Intent referenced above.To the extent that the following conditions modify or differ from i the plane•specifications or other proposals submitted with the Notice of Intent, the conditions shell control +� GLIERAL CONDITIONS 1. Failure to with an conditions stated herein,and with all related statute$and other comely regulatory meastues, shall be deemed cause to revoke or modify this Order. 2. This Order does not tan property rights or an exclusive privileges: y injdry great Y P PertY rib Y P gn:It does not authorize an .1 prop rivece property or Lives of Privets rights to-P >• r� I 3. This Order don not relieve the.permittee or any other person of the necessity of complying with all other I ' I applicable federal.state or local statutes,ordinances,by-laws or regulations 4. The work authorized hereunder shall be completed within three yawn from the date of this Order udess either of the following apply.. - ' 1 ter! the work is a maintenance dredging project u provided for in the Act:or 1 < - xK: I fbl the time for completion has boen extended to a specified date more than three yeah,but less than five yea from the date of issuance and both that date and the special circumstances warranting the extended r, time period are set forth in this Osier. I S. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 8. Any fill used in connection with this project shall-be clean fill.containing no trash.refuse.rubbish or debris. ti J IJJ' including but not limited to lumber.bricks plaster.wire.lath,paper.cardboard•pipe.tires-ashes,refrigerators. I M motor vehicles or parts of any of the foregoing. . !' 7. No work shall be undertaken until all administradve appeal periods from this Order have elapsed , h t Jj 1 8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land.is located,within the chain of title of the affected property.In the case of recorded land.the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done.In the case of registered land.the Final I'i Order shall also be noted on the Land Court Cemincace of Title of the owner of the lava upon which the proposed ti i; rII work is to be done.The recording information shall be submitted to the Barnstable Cohn onservation Commission v on the form at the end of this Order prior to commencement of the work. I ;' 9. A sign shall be duolaved at the site not less than two square feet or more than three square feet in size bear- ing the words.-Massac:-tusetts Department of Environmental Quality Engineering. J File Number 85-7 I I ! 10. Where the Department of Environmental Quality Engineering is.requested to make a determination and to i issue a Superseding Order,the Conservation Comrnission shall be a party to all agency proceedings and hear k I! Y ings before the Department. j i ' 11. Immediately following completion.the project shall be-certified to be as per these conditions and plans n i writin¢,to the Barnstable Conservation Commission by the project Fnaineer who shall be registered in the state of`lass. !-. Upon certification by the project Engineer the applicant shall forthwith request,in writing, that a Certificate of Compliance be issued scating that the work has been satisfactorily completed � i' 13. Prior to any work being done at the site.all legal advertising bills incurred by the petitioner in relation to i . i the Wetlands Hearing held on this project shall be paid. 14. This Order is issued under Article X-XVIIof the Town of Barnstable Bv-Laws 'he Barnstable Conservation ConuMsion or Conservation Officer shall be notified no more than two weeks nor less than two dgvs prior cc the commencement of work,and have the authority to issue an Enforcement Order if the terms or intent of this Order are not complied with. 15. It is the applicant's responsibility to provide all contractor with a copy of this Order and to ensurethat all workers are iniormed of the conditions of this Order before they begirt work at the site. - , .. .. ... ... .. .... _—•----- ... is• B=5281 P1GE 103 16 The Mork shell conform to the(08owing plans and specie)Condition: - i PLANS: Dated Signed and Stamped by: Cm File with: •. Title .. t Lot G 3 pre rySitePI= March11, 1985 C. Frank Whiting, R.L.S. Barnstable CariservationCotmdsaiott i i— { ��e.Disposal Syscem Jan. 24. 1985 Stephen Wilson, P.E. r+' ----------------- fi Profile " Key Sheet Design March 11, 1985 C. Frank Whiting, R.L.S. is xi+ ditional epee p if necessary) .- Lot G Special conditions(Use ad 1, There shall avnted material between the be no stockpiling of fill or exc house and the wetland. { 2. Prior to the start of work at the site, a double row of staked hay bales f shall be placed at the work limit/lot line, on both the southerly lot line ;ef ! (up to the intersection with Lot F), and on the westerly lot: line as shown i on the project plans. These hay bales shall,be maintained throughout <•.;•. construction. - ,.! be ;fir i maintained at least 3. An undisturbed buffer of natural vegetation shall di ! 35 feet from the edge of the wetland. Any areas. disturbed within the buffer �f ,yr digenous shrubbery spaced shall be replanted with in three to four feet on center (inkberry, bayberry, clethra, high bush blueberry, etc.). I ' �'�+`•� '_ 4. An undisturbed buffer of natural vegetation shall be maintained at least 20 feet from the to of the bank. Any areas disturbed within this buffer - :'. �y +z_ shall be replanted with indigenous shrubbery spaced three to four feet on := center (inkberry, bayberry, clethra, highbush blueberry, etc.). 5. The driveway for the residence shall be constructed of gravel or other pervious material. ! installed to handle roof runo 6. Dry wells shall beff. 7. All disturbed areae.shall,be revegetated immediately following completion ^a r of work at the site, No area shall be left unvegeta[ed ortanstiched for ..w more than 60 days. °! 8.' This approval is contingent upon Board of Health approval of the proposed C Till l on-site sewage disposal system. ll .;. 9, Architectural site plane for the lot shall be filed with the Conservation Commission prior to the construction of the proposed building foundation, r of buildin I: These plans shall show the location and dimensions 8 footprints, (Leave Space Blank).............................................................................................. 1 r g � t t O is A. y•` � g - I BOO 5281 pta 104 Special Conditions - Lot G (con t.) W h i j Vot, I ! including decks and retaining walls, if any, revisions to grading plans z as appropriate, and shall show compliance with special conditions 1 through 8 above. 'i P 10. Landscape design lane for the Lot shall be filed'with the Conservation P B .I Commission prior to installation of landscape materials. These plans ' .. J !.'. shall show location of planting beds, landscape walls, patios, and similar ' I features as appropriate, and the location and square footage of sodded lawn areas requiring fertilizer and seeded grass areas requiring no '=M fertilizer for long term maintenance purposes. The total sodded and seeded grass areas for all of the development lots in this subdivision ! g,: a known as Beech Leaf Landing at Scudder Bay shall never exceed 35,000 f square feet, to be located as shown on the aforementioned landscape Wa Ire design plans. For the purposes of this Order, a "LAWN" shall mean an area of herbaceous vegetation maintained by frequent mowing. 11. Plan modifications are allowed so long as they do not infringe upon { minimum wetland resource setbacks.required elsewhere in this Order, h.II or as established by other applicable By-laws, Regulations or project i i; permits. �. " I Ji!jvyt t: .x I a[ _J 800K52©IF-GE 105 .;• �: is Conservati Co lion Barnstable Issued By Signaturdsl This Order must be signed by a majority of the Conservation Commission , 1986 before me 23rd day of Jul On this Lindsey B. Counsell to me known to be the L personally appeared that hefshe executed the same person described in and who executed the foregoing instrument and ecitnowledged as hisiher free act and deed. ".: `9•'. �:� My commission expires it y' Public r.. , oury '.'- '• son aggrieved by this Order.any owner of land abutting the land upon which the propoeed :'Cho applicant,tlia owner,any Per work is to b.dans a any can residents of the city or town in which such land is located are hereby notified h their right - to request tin pepartmenc of Environmental Quality Engineering to issue a Superseding Order.providing the request is a fro.the data of '}! onuido f the bnquat r�aV u the sarosdtiar be deliverytt bye etertffiad mail or hand delivDepatineilL Within tonery to the ConaervsuonDeCornndeeion and the applicant. n�I;UR�EI�SEP 386 i= It =�`. � � ��'j�•�is 1. � fit' 41 Now.gG FFa_....___.____ THE COMMONWEALTH OF MASSACHUSETTS as-1142-7 BOARD OF HEALTH ........................................ Applirtttiutt fur Dbiptwal Nurka Tuuutrurtiuu Prriitit t Application is hereby made for a Permit to Construct :(X) or Repair ( ) an Individual Sewage Disposal System at: ............... t,..__........_..__...._......_.....;.............................:... ......,.............. v r,t ��3....._........................... . ..... I—Ii--Addeo,, r L.n N., Inc.:....mil IC................... ...................../✓.L..Y..... ....!t..._._....__........................_.__._..... 0—er AdJs W ..................................................e.1................/................... ...................Cn.�rlf_�i!/.1�C.................................................... 1.,Wlel Add—. - ' Type of Building t Size l,ot..13,416......Sq. feet ' a Dwelling—No. of Bedrooms...... .......................Expansion Attic (no) Garbage Grinder (X,) ' a Other—Type of Buiidiug ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QOther fixtures ..............................................................................................................................................:....... W Design Flow...................................a`,..gallons per jwnson her day. Total daily flow.........................3' Q. ......gallons. a Septic Tank—liquid capaeity1A)M..gallons Diameter... Depth.a nil.*.. W Disposal Trench—No.....4.............Width..3.Ff:.........k-tan ......•l'otal.lenching area.....3.15.....sq.ft. ' Seepage Pit No..................... Di_meter........._.......... Depth below inlet....................Total leaching area..................sq.It. Z Other Distribution box (K) Dosing tank (?, IQbmr Ghn..%Iae,-) aPercolation Test Results Performed by.rr,�u...�r:�P. .tr..4x�L..Lent..t!/..! !!. ?'. Date.../..l.-L`'`r4........... .1 Test Pit No. 1.—Z........minutes per inch Depth of Test Pit. q. Depth to ground ualer.......... r►A6CJa� W Test Fit No. 2....!!:7......minutes per inch Delith of Pest �,. Depth to ground tvaler.. 4, H.01 Afa ......................................1/i.. ..._.................. . p ,n ,1d : Snits N H s, Description of S ._ a 1�► / s 3 a....................... . . 1 "'� oo ..rlrac�cNJ.Srato!.i11rtS<rf.ry rat.,/"/40..L 4..-1.�. /irt¢....aerarl0................................ d tin x T..P....�..,...Q.-✓ r.1.J.ocxR...Ln�Rt.r.r�.......jo.....fCilu?iL,.».. . ,c-0..-rnuce.cD..wl-.rat.Cf....................... ' V Nature of Repairs or Alterations—Answer when applicnble.......................................................................`a+ Agreement: ` The undersigned agrees to install the afnredescribed Individual Sewage Dispnsal System in I nrrlance with in/a ' the provisions of TITLE 5 of the State Sanitary Chile---The undersigned further agrees not to place the system in/i-/'!-f% operation until a Certificate of Compliance has been issued by the board of health. Signed......:.............................................................................. .......................... ' Application Approved By..........:....................................................................................... 1�.!.. .1..;�.:: .... Application Disapproved for the folloruing reasons:.........................................................................................:u..t._............. ........................................................i ..............................................................................................................................................._. ua. PermitNo.................................................._. Issued..................nu..........................._.. s THE COMMONWEALTH OF MASSACHUSETTS a - ' BOARD OF HEALTH ..........................................OF.............................................. ..................................... Tertifirutr of (Ruutpliutirr THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by......_.._............................................................................................................._.............._......_... o.a,u.. ' at......................................._............................................................................................-............................................................... has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the ' application for Disposal Works Construction Permit No......................................... elated. ....................._..................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE......................................__..................................._ Inspector...............................:.................................................... ' THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH .OF...................... No......................... F eE........................ OWpL al U1lurlw Tutintrurtiuit V utit Pennissionis hereby granted....................................................................................•..... ................................................. to Construct ( ) or Repair ( ) an Individual Sewnge Disposal System atNo............................._._......................................................................................................................................................... SI—I as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... DATE..........._.................................................................. FORM 1254 H01389 &WARREN. INC.. PUBLISHERS TOWN OF BARNSTABLE, MASSACHUSETTS b U I L U I N tm t IL R IVI I , ' UATE—D e e.Eilil��3 -�--`9 C I'EF2MIT APPLICANT 1_ ?"01` E�'S• V:t `je ADDRESS - •r ' T. .,.it F ^E: • t' R 4RSE) PERMIT TO r" 1 NUMBER OF IL lilt Lld �� ink(1-► STORY L !1Ft7 a7___�_ N'.t�j j ,r Tl L � � i II NUMBIING UNITS ItO GQ31 ' (TYPE OF IMPROVEMENT) N0. )PROPOSED SE) AT (LOCATION) 1.1)t (It_ 5!a Bay Law.' F P ZONING CT_ itT)_1 IN0,1 (STREET) DISTRli BETWEEN AND ' (CROSS STREET) • (CROSS STREETI SUBDIVISION LOT LOT BLOCK SIZE , ' BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP +.BASEMENT WALLS OR FOUNDATION y (TYPE) ') REMARKS: I of d AREA OR VOLUME _ 1 �riV +.rf 1 ESTIMATED COST y$ _Gnn PERFEE DO �% DO( ICUBIC/SOUARE FEET) -,% - OWNER -- g!4..44 q �t d �3.t:�—�L1•i'i'(,1E ■ .,� 'I ADDRESS_r _ BUILDING DEPT. r' l "\•,� f+ i.: ice! ' BY , i FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NUT RELt ASt IHt AHWLILANI I-HUM Int LUNUII IUn� OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN + ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS.- MADE. WHERE A CERTIFICATE OF OCCUPANCY -IS RE- MECHANICAL INSTALLATIONS. 'I 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERSIREAOY TO LATH). FINAL INSPECTION HAS BEEN MADE. °3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET I BUILDING INSPECTION APPROVALS PLUMBING IN PECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 1-0/410p 2— ,r EATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 1 OTHER BOARD OF HEALTH WORK SHALL NOT PROCEED UNTIL THE INSPEC PERMIT '+v!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE ! TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN Sl:' MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. 'I t I BooKE090 PAGE 197 Q 4 32 ' File #85-7 OEM me"a (To oe o wAftd a oaoat Barnstable C ,e7y A00 Silvia 6_Silvia-- sac,Inc Extension Permit ' ToWN of'BAIsI sw.BLE sY-LAWS ARTI= 27 i Barnstable Conservation Coormi ssion r—�Audwity Silvia 6 Silvia Assoc:, Inc. 619 [lain Street, Osterville, MA. 02655 T I � '� (Nart+sl (Address) The Order of Candwaru(or Extension Pwmd)issued on July 23, 1986 � ) ,,• ?ilvia Silvia Assoc., Inc. (name(toruvoncat Lot #G Beech Leaf Ln., _n t ervu la , . i raddreas►is Mrsby'ea2ufded for a Perbd of am year(a)trpm tf» dw it e,:pirsa ' TheEvaasbnPenrAtwil-ci an July 23, 1990 ram( This d=xn nt M)d tw rsearded in aeeardarm with C ww*Co xMM 8 of ra Order of Candtbm"L 44 1 T[ 4 9 ' s BOOKMPIGE 198 1 � t Barnstable Con+arvatiaa C�issioa f i i ± i ' ' ,ttrn+Exter>.sion Pe nvt must De Sgned by amaiordy at when WAAd by Me 11 memters. December tg 87 before me 1 30th eav i i On Nickerson to melmawntobeM r�r t' at7b 5 us an L. ent and a —,edged �?�elshe aiceotstsd 1 I pa�nbed in and wtw execst>!d tha fanepoin4 ^ 2u �. same as hhismhet tree actand deed. October 28, 1994 My cammMlan toy Oq 1 I 1 r W = r• r / - S �W � p p �' ` � •REGORGED i j s I 1 f 1 { I i I i 1 AD D THE COMMONWEALTH OF MASSACHUSETT��Za�AMOVALOF Appt1E tsars commiobtAR D OF H EA LT FbARNSTABU CONSERVATION t blf COaa°r'r _ (� s COMMISSION garaa F.........�/t�.v..rAesc tr....._..............._.........._...._. � ate trtttluu for Dhipinial Warkl; (Randrurtlutt Permit ! Application is hereby made for a Permit to Construct (X).or Repair ( .) an Individual Sewage Disposal System fat: .................... ............._...._... o rG......__...... .._.....»__......_____... •LaeaUsn-Add n or Lot Na Ii7.tl�l,.�.__jsilutz _.lk sct�.......�inr................_.. .................._. R.Y.....4!vi�..__........_..... —•••- Address a ` caner ., 1............____•. Installer.......... ........._..................... ....................�n.':N..fY!:{!.1.l�G.................................................. Address Type of Building � Size LoL..1.6,426........Sq. feet - U Dwelling—No. of Bedrooms......! r-.S.........................Expansion Attic (1•6) Garbage Grinder (K) r "1 Other—Type of Building ........................... No. of persons............... Showers ( ) — Cafeteria ( ) ad Other fixtures ..................................................................................................................................................... Design Flow...................................5..S.gallons per person per day. Total daily flow.........................3 C)......gallOns. . .. v —.llepth.S.-B Septic Tank—Liquid capacitylADO..gallons Length.I.QIr.6R. lidth....:.�. .... ..... x Disposal Trench—No.....1............Width..,344- ........Total Length.3S..f A......Total leaching arm....3.15.....sq.ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet....................Total leaching area.................sq.ft. Z Other Distribution box (X) Dosing tank (XKfbRtp Ck-unlDer•) sPercolation Test Results Performed by..r.�.� 4r4 �. urw4 ..�e2F..✓.I !il.br.. Date...L.L'L$ 8 ............ "11 Test Pit No. 1....Z......:.ininutes per inch Depth of Test Pit...13-V......... Depth to ground water......... k. Test Pit No. 2.... ......minutes per inch Depth of Test Pit...16............. Depth to ground water.... �..... 1.OF.lyaf _..___. a_ " o STENE N 0 ...................... CJ ' . 1lYescrttion of So,I. Uasoi. .J.. .! fopSG a,y a wtt:sor, w �.P..'z..' r9' .@0°..ITlleeptya..Srt..aQ...mcxe.ef?..w,. Iety{Q....................... ... p�7oz•te p �... s r• txj Nature of Repairs or Alterations—Answer molten applicable..........................:..........................:................ ............................................................................................................................................................................ Agreement: ' . • '' The undersigned agrees to install the aforcdeseribed Individual Sewage Disposal System in actordance with,&,y/e, t the provisions of TITLE 5 of the State Sanitary Code—'rbe undersigned further agrees not to place the system in 0641111111,0 operation until a Certificate of Compliance has been issued by tile board of health. .. .......................... \ D e ' Application Approved By......... .`. ��.........` ................_.................... .�. Date I Application Disapproved for the following reasons:....................................................................................... ....._.._ _.......................................__.........................................._..........._...........................................:.................................Date......:.___ �(s I_»�.......».......___ Issued......................................_.»...._.....». 1 Permit No...._'-:....4 ...... `� . Date J ` THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /\ Trrfifirate of Tilutplitture THIS IS T CERTI Y,That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) ............... ..t— 4. ... .. ,n eta uer ......_._.........................._..._....._.... ..........._...»_»_.._ at.....:....... ............ ...._ .!-!...................._............................................................................................... has been installed in accordance with ne provisions of TIT W. .5 of The State Sanitary' Code ps described in the application inr Disposni Works Construction f erinit No.............:..1.........:.:..:.1.....'. desteti.......±.i.1..',..L.......:?............... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................... .... .:....0. ..:..........._._............... Inspector............� ..................................................... r THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t f .. r. CF:.......................c.:..:...! �................... ............................ No ....i..L.........�1 i ..................... .. FEE........ ...»........... 111urita ( onutrurtiutt Permit ._..... ... - . . ....... Permission is hereby granted................ to Construct ( ) or Repair ( ) an Individual Sewage Disposal System t atNo.................._...._._._:..._'�...._. .......1::.. ...........:............_...._......................:..............._..............................................__... sneer as shown on the application for Di Ws.. Works Construction Permit No......................Date d.......t..:...:.. .. ..' r........... ...... :DATE..........................._.......... ............_ FORM 1253 HOBBS B WARREN, INC.. PUBLISHERS BAXTER & NYE, INC. Professional Land Surveyors and Civil Engineers 812 Main Street • Osterville, Massachusetts 02655 • Tel. (508) 428-9131 WILLIAM C.NYE, P.L.S. - President' RICHARD A. BAXTER, P.L.S.-Vice President PETER SULLIVAN, P.E. Vice President Engineering' ' December 21 1.990, Silvia and Silvia 367 Main Street Hyannis , . MA 02601 RE: Septic System Lot G, Bay+ Lane Dear Ronnie and Floyd : ' Just a brief note on the status of Lot G. The septic system has been installed and inspected with the exception of the pump and its associated hardware. I realize that this is ' obvious since Lot G has only ,a foundation on it . Once the pump is installed , then I can do a final ' inspection and inform the Board . Just let me know when you -are ready. Any questions please call .. Very truly yours , ' Baxter & Nye, 'Inc ._ Y Peter Sulli.van , P. E. ` Vice-President-Engineering PS/fmj MEMBERS OF CAPE COD SOCIETY OF PROFESSIONAL ENGINEERS AND LAND SURVEYORS I AMERICAN CONGRESS ON SURVEYING AND MAPPING ' MASSACHUSETTS ASSOCIATION OF LAND SURVEYORS AND CIVIL ENGINEERS ` 152 BOOK'72�7 P�GE i File #85-7 { P�oF•tNa To` DE?Fie No. I a ♦0 (To be proviaW Dy C_) City Town Barnstable '{ i 3A3ISTAM i �O .1 9 Aooucant • Silvia & Silvia Assoc. Inc.i639 \�o EQ YAY k' . Extension Permit TOWN OF BARNSTABLE BY-LAW, ARTICLE XXVII From: B rnst hle o cervat-i nn r nmmi scion Issuing AutnOrtiy I 619 Main St. To: Ci l vi a P. Q1 1-Tri a D—sce- rnr - Osterville MA 02655 (Name) (Address) The Extension Permit)issued on July 23, 1989 (date) t0 (name)for work at T.nt, 4G Beech Leaf Lndcr.' , Centerville (address) is hereby extended for a period of two year(s)from;he date it expires. This Extension Permit wiil expire on (date) This document shall be recorded in accorcance with General Condition S of the Order of Conditions. 6 s ' :..........:......... ....` ......... ............................................................... leave Soace 3;anK1 ' 7.1 ' E'fec;ive 1111,M9 1 ' ,5OOK7247 NGE 153 issued by Barnstable Conservation Commission r IA", Signature(s) , 1. .. i When issued by the Conservation Commission this Extension Permit must be signed by a majority of its '! members. .. On this lath day of July 19 90 beft ��„_ •�,;, personally appeared Mark H. Robinson to me kncLvht be't(re. person described in and who executed the foregoing instrument and acknowledged that_tie/Site epcuted the s e as 's/her f ee act and deed. v Nov. 28, 1991,!� -.�r••• tary Gbi c My commission expires RECORDED-AUG z 90 Detach on dotted line and submit to the Barna4,ah1 a Conaervati_on Co»>Masionprior to commencement of work. • • ' "•�(•Y.'IlYY•YYYV... ...... • ...• a••.••...•• ..... ' •••.•..•........•.......•..•..•.• 1 7.1 ' Ejfec:ive 11/'0/89 i • GtJ ob.(. 1 �)1b 30�l�lti •.f ��i{i�atl •. oftcssurl�3tsefts DEPARTMENT OF PUBLIC SAFETY I ELEVATOR DIVIS _— Ir ONE ASHBURTON PLACE,BOSTON 0 P210p8 Elevator No. 2 Located at 2 =(,(f /Z CERTIFICATE FOR USE OF ELEVATOR, Chapter 143,General Laws,as amended. Capocity Pounds ' Speed 3?feetPer• Min'. • Date issued Inspector 2 P u . drier of i , ' ExPires 1 Ye4w from above date Q Q In Case of Accident Notify the Chief of Y Inspections at Once e�TM�>o TOWN OF BARNSTABLE 30304 I • Permit No................. :BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash •••••••••••••••• HYANNIS•MASS.02601 ,. '�,13ond ........X.„•••.•.• �C ' + CERTIFICATE OF USE AND OCCUPANCY I Issued to Silvia & Silvia Assoc. i t Address Lot #G, . 459 Bay Lane- Centerville, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL.NOT BE OCCUPIED UNTIL ' SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 14 March 31i.. 19 92 !/ Building Inspector t 3 I F • I E00K.89-56 FACE 152 690�?-; + 310 CMR 10.99 f OEP File No. SE 3-1245 Farm 8 (To be proviaed by OEP) + city'Town Barnstable 1 Commonwealth i ly i Si 1 via Asso — Aoo+�cant S a & - of Massachusetts Inc . PARTIAL Cer- ificate of Compliance Massachusetts Wetlands Protection Act, G.L. c. 131 , §40 1 [J From Department of Environmental Protection Issuina Authority N 911 Main Street Osterville .MA T To A•M• Wilson Associates (Address) 02655 .' 1 (Name) Q © �: November 1992 in 6- Date of Issuance - 1 =' Silvia & Silvia lssc l," OrderDepartment Inc ' ""�"" This Certifiicate is issued for work regulated by an 95 f Conditions issued to ION dated May 3 , and issued by the It is her eby certified that the work regulated by the above-referenced Order of Conditions has 11 been satisfactcniy completed- ork 2. It is hereby certified that only the following portions of meleted: (If thle Certificate of Compliance enced Order of Conditions have been tis'what portions are included.) 1 does not include the entire project. specify home, driveway, The construction Of tl►utilities f and ldrainage ,on Lot G. i grading, landscaping, I the above-referenced Order of Conditions was It is hereby cerified tt.at the work regulated by . r.i Na future 3. Act May be commenced without filing a new Notice of Intent never commenced.The Order of Condition Yhas lapsed and is therefore no+once. �� - ' work subject to regulation. the 1 and receivi^g a new Order of Conditions. ................................................. el r! 4: r. ' 001(8aJ'� FAA 153 4, p; This certificate shall be recorded in the Registry of Deeds or the Land Court for the district in date) which the land is located.The Order was originally recorded on 094 at the Registry of Deeds, _Barnstable , Book 4522 ,Page The following conditions of the Order shall continue: (Set forth any conditions contained in the 5. Final Order, such as maintenance or monitoring,which are to continue for a longer period.) 3 grid 4 of the Superceding Order Special Conditions: 1, , 3, 1985 . i -of Conditions issued`by the. DEQE on May �` • . Issued by De a/Irtment of E v Signatures) Wetlands Section Chief . Eli abeth• A. Kouloheras, . _ r q ` F N n o �' r' i n this Certificate must be signed by a majority otris members. When issued by the Conservation Commis ion third dayof Novembe 19 A�,_� aefoje•me 4 Kouloheras jto rnQ�no to be th On this e ' personalty appeared Eabe th A• #rho e�iw6.tted �t Q� "person described in.and who executed the foregoing instrument and ac}cnowl ' the same as his/her free act and deed. o r T My commission expires Nota Y Public ULU LA NOV 109Z _ Detach on dotted'ij^° and submit to the — - - u issuing A t>lority fir!• N p 1. tv JOB ' - A. M. WILSON ASSOCIATES, INC. SHEET NO. OF 911 Main Street OSTERVILLE, MASSACHUSETTS 02655-2015 CALCut-ATEoev DATE (508) 428-1450 . ' ! FAX (508) 420-1856 . " CHECKED BY DATE SCALE ........ ......... ....... ......... _....._...... ._.. ......................:........................_...:...............................:.._.................... - •_ _..............................._ ........ ... ..... ...... ... .. . ......... ................... �...._........................................... - E ....... ...... ..... ... .. ....... ........ .__. .............. ............................ ...._♦ ........ - ....... .. .. ....... ........ ..._.._.. ...... ....__ - - �: .__.... .__.... ....... -_. _................ ......_.. -............... _...._.�__..:_ .:..... ......................... .:.:... - - I ...... ......... ..._..... ... - _ ..... - .. ....................... _.... ....... -........_... } ..... ...... ....._ ...... ............_... ....._........................ ........... ....... -_.__. ..... 1 .:. ..........................._....1 :.: _. ........... _..... .._ at tr+e Caroficate of Comdianca toa the txorec:at: t C t�zcc Lt e'r Piease De edv+se4— VA.L >ze_t f♦J T. c s r J�.�-fSK,'�� _c• f SE I?y 5 tas beer+19= ed at the Reg'atry 't. Fie Numoer i 'ano tus peen notes"m t^e c:aln of nne of rite artec:ea orooerty`an 4 It,eccrcea lano.me Ins.—Jment numeef wntc-,identltleS MIS L3n5aCt10n 15 miter wnlca Ieertniie- ,Ls r�nsacacn is its re :erec tans e^�• - ' Signature K/DH/1m SE 1-124-5 cc Barnstable Conservation •Commi ssionQ.� - - r - i - - ! ...... .......... .... .... .... ... ........ .......................:.... ...._............................. .......... ... .. ......... - - 1 .. ..._.. .. 4 ....... ...... ............ .......:. ....... ........... :.......... 4� • .........r. . ..... .... ....1 ........ .... ... ...:'. ..... i 3 .. .............. .... ..:....................... F. ... ....... § d ':t ,t 1 a T , � r r ........ ........................................ - ' PNOWLT'jO1•I l�ql-NneO1'�IIPl17ppl��iNG.Gf0I0N.MiII Olnt.7o Olax�lIONE 7OLLfAfE tA0671S�67E0 FILE Oe e OEOE File No. ART-0014 pi THC tp (To be proviaso by OEOE) BARNSTABLE City Town ---------------- Apolicant— STT, 1TA & SILVIA ASSOC . riot 1 C0�0 039 P A R T I A L Certificate Of'Compliance TOWN OF BARNSTABLE ORDINANCES, ARTICLH 70CVII From Barnstable. Conservation Commission Issuing Authority 619 Main Street To Silvia & Silvia Assoc . Inr. . Centerville ,' MP. 02632 (Name) (Address) Date of Issuance December 18 1992 r. pf Silvia & S i l v i a 'A s s o c . I n c This Certificate is issued for work regulated by an Order Centerville , MA A r " 22 , 19g5 Conditions issued to 51 Main Street dated P and issued by the Barnstable Conservation Commission 1. ❑ It is hereby certified that the work regulated by the above referenced Order of Conditions has been satisfactorily completed. 2. Z It is hereby certified that only the following portions of the work regulated t b the above-refer- enced Y Order of Conditions have been satisfactorily completed: (If the Certificate of Compliance does not include the entire project. specify what portions are included.) ' The construction of the 'single-family home driveway , grading , landscaping , uti3.3 '.:.ies and drainage on Lot G ' (G (85-7) 3. p It is hereby certified that the work regulated by the above referenced Order of Conditions was never,commenced. The Order of Con,d+!ions has lapsed and is therefore no longer.valid, .Jo future work subject to regulation under the Act may be commenced without filing a new Notice of Intent and receiving a new Order of Conditions. ................. .......... .....:..... ...... .........I.............. ................. (leaveSpace Blank) . ' 81 Ellective 11/10/89 ' 4. This certificate shall be recorded in the Registry of Deeds or the Land Court for the district in which the land is located. The Order was originally recorded on .Ta n _ t 98 8 (date) at the Registry of Deeds Book Page ' Instr . #00431 5. = The following conditions of the Order shall continue: (Set forth any conditions contained in the Final Order, such as maintenance or monitoring, which are to continue for a longer period.) Issued by Barnstable COnseryation COmmicainn t; Signature(s) When issued by the Conservation Commision this Certificate must be signed by a majority of is members. On this 18th' day of December 92 19 before me personalty appeared H e n r v Barbour to me known to be the Person described in and who executed the foregoing instrument and acknowledged that he!she executed the sa as hi :her free act and deed. �. November 6 1998 tary P t My commission expires ' Detach on dotted line and submit io the Barnstable Conservation Commission ....................................... ...F..................................................... .......... . ....................................................................................... To Barnstahle rouser vat-ion ommi aai nn issuing Authority ' Please be advised that the Certificate of Comoiiance for the project at L o t #G Beech Leaf Landing,, Centerville , ART-0014 MA e Fite Number has been recorded at the Registry of 1) PAa i n Rarns ahl ' and has been noted in the Chain of title of the affected orocerty on 19 --- — _ �11 recorded land the instrument number which�tlentifip5 this,transac.ttoQis It registered land,the document number wh,Ch identifies this transaction is Signature Applicant ' 8.2 PERMIT HISTORY r I STATE SUPERCEDING WETLANDS ORDER (SE3-1245) - ; ! *05/03/85 Superceding Order of Conditions Issued 1 , *02/19/88 Extension 'Superceding Order of Conditions ' *04/29/91 Extension Superceding Order of Conditions *05/04/94 Extension' rSuperceding Order of Conditions *copy enclosed , I ' Form 5 DEQE File No. SE 3- 24 (To be provided by DEQE) Barnstable Commonwealth City/Town of Massachusetts Silvia & Silvia Assoc. Applicant SUPERSEDING µ Order of Conditions Massachusetts Wetlands Protection Act G.L. c. 131 , §40 From Department of Environmental Quality Engineering 1 ' To Silvia and Silvia Associates, Inc. Ericson Broadbent, Trustee (Name of Applicant) (Name of property owner) I 619 Main St. , Centerville, MA Address 02632 Address c/o Silvia and Silvia - This Order is issued and delivered as follows: ' by hand delivery to applicant or re resentative on P (date) z by certified mail, return rebeipt requested on - 5-3-85 (date) 1 This project is located at Lot #3 Bay Lane The property is recorded at the Registry of Barnstable - 3050 289 Book Page Certificate(if registered) Dec. 21, 1984 ' The Notice of Intent for this project was filed on (date) Jan. 2,1985, continued. to Jan. �6, �985 The public hearing was closed on date ' Findings The DEQE has reviewed the`above-referenced Notice of Intent and plans and has held a'public hearing on the project. Based on the information available to the DEOE at this time, the DEOE has determined that ' the area on which the proposed work is to be done is significant to the following interests in accordance with i • the Presumptions of Significance set forth in the regulations for each Area Subject to Protection Under the Act(check as appropriate): ❑ Public water supply Ck Storm damage prevention ❑ Private water supply L-R Prevention of pollution ❑ Ground water supply ❑ Land containing shellfish ' G Flood control O Fisheries 5-1 ' I Therefore, the DEQE hereby finds that the following conditions are t necessary, in accordance with the Performance Standards set forth in the regulations, to protect those inter- ests checked above. The DEQE orders that all work shall be performed in accordance with said conditions and with the Notice of Intent referenced above. To the extent that the fol- lowing conditions modify or differ from the plans, specifications or other proposals submitted with the Notice of Intent, the conditions shall control. - ' I General Conditions 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory meas- ures, shall be deemed cause to revoke or modify this Order. 2. This Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state or local statutes, ordinances, by-laws or regulations. 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: (a) the work is a maintenance dredging project as provided for in the Act; or ' (b) the time for completion has been extended to a specified date more than three years, but less than, five years, from the date of,issuance and both that date and the special circumstances warranting the extended time period.are set forth in this Order. ' S. This Order may,be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. ' 6. Any fill used in connection with this project shall be clean fill, containing no trash, refuse, rubbish or de- bris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires,ashes, ' refrigerators, motor vehicles or parts of any of the foregoing. 7. No work shall be undertaken until all administrative appeal periodsfirom this Order have elapsed or, if such an appeal has been filed, until all proceedings before the Department have been completed. t8. No work shall be undertaken until the Final Order has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which ' the proposed work is to be done. The recording information shall be submitted to the DEQE on the format the end,of this Order prior to commencement of the work. 9. A sign shall be displayed'at the site not less than two square feet or more than three square feet in size ' bearing the words, "Massachusetts Department of Environmental Quality Engineering, File Number SE 3-1245 ' 10. Where the Department of Environmental Quality Engineering is requested to make a determination and to issue a Superseding Order,.the Conservation Commission shall be a party to all agency proceedings and hearings before the Department. ' 11. Upon completion of the work described herein, the applicant shall forthwith request in writing that a Certificate of Compliance be issued stating that the work has been satisfactorily completed. ' 12. The work shall conform to the following plans and special conditions: 5-2 Plans: Title Dated Signed and Stamped by: On File with: PRELIMINARY SITE PLAN in BARNSTABLE March 11,1985 C. Frank Whiting DEQE MASS. (CENTERVILLE) ji I - . 1 Special Conditions(use additional paper if necessary) 1. All construction activities shall be prohibited within twenty (20) feet landward of the top of the coastal bank. This condition does not apply to the construction of walkways and seating areas. 2. Walkways identified on the plan may be 'brushed and maintained -to a width 'I not to exceed ten (10) feet.- Lumber used in the construction of seating areas must be treated with a non-leaching preservative, if any preservatives are to be used. ' 3. All roof runoff shall be channeled into dry wells. A]l driveways shall be surfaced with gravel, shell, or other pervious material. ' 4. No vegetation in the wetland areas shall be brushed, thinned, or otherwise altered. No ,herbicides shall be used during the construction. 5. The hay bale siltation barriers identified on the-plan shall be emplaced ' before the grading begins. They shall be" maintained in good condition until the area is stabilized. - ' 6. A post-construction as-built plan, stamped by a Professional Engineer or Registered Land .Surveyor, shall be submitted to DEQE and the Barnstable Conservation Commission within ninety (90) days of the completion of work. ' This plan shall accurately depict the distances to wetlands resources. t :.............. . ................ . . (Leave Space Blank) S-36 ' Issued by the Department of nvironmental Quality.Engineering. Signature o ert agan uty Regiona nvironmaentaiEngineer ' On this 3�� day.of - 19 $5 before me personally appeared Rnhprt P Fagan to me known to be the person described in and who executed the foregoing instrument and acknowledged that he/she executed the same as his/her free act and deed. Notary Public My commission expires I The applicant,the owner,any person aggrieved by this Superseding Order,any owner of land abutting the land upon which the pro- posed work is to be done or any ten persons pursuant to G.L.c.30A,§1 OA,are hereby notified of their right to request an adjudicatory hearing pursuant to G.L.30A,§10,providing the request is made by certified mail or hand delivery to the Department within ten days from the date of issuance of the Superseding Order,and is addressed to: Docket Clerk,Office of General Counsel,Department of I Environmental Quality Engineering,One Winter Street Boston A 9 .M 02108.A cop of there request shall at the same time be sent b Y q Y certified mail or hand delivery to the conservation commission, the applicant,and any other party. A Notice of Claim for an Adjudicatory Hearing shall comply with the Department's Rules for Adjudicatory Proceedings,310 CMR 1.01(6).and shall contain the following information: ' (a) the DEQE Wetlands File Number,name of the applicant and address of the project; (b) the complete name,address and telephone number of the party filing the request,and,if represented by counsel,the name and t address of the attorney; (c) the names and addresses of all other parties,if known; ` t' (d) a clear and concise statement of(1)the facts which are grounds for the proceeding,(2)the objections to this Superseding Order. including specifically the manner in which it is alleged to be inconsistent with the Department's Wetlands Regulations(310 CMR 10.00)and does not contribute to the protection of the interests identified in the Act,and(3)the relief sought through the adju- '' dicatory hearing,including specifically the changes desired in the Superseding Order; (e) a statement that a copy of the request has been sent to the applicant,the conservation commission and each other party or rep- resentative of such party,if known. Failure to submit all necessary information may result in a dismissal by the Department of the Notice of Claim for an Adjudicatory Hearing. 1 Detach on dotted line and submit to the prior to'commencement of work. .......... ................................................................ ..................... ......... ................................................... To Issuing Authority Please be advised that the Order of Conditions for the project at 'i File Number has been recorded at the Registry of and has been noted in the chain of title of the affected property in accordance with General Condition 8 on 19 If recorded land, the instrument number which identifies this transaction is If registered land• the document number which identifies this transaction is f ' Signature Applicant 5-48 ! To —3P,R>l STc��C r CtJ�+ SE �,JA77 uA] C 6 Ou- Issuing Authonty Please be advi ed that the Order of Conditions tWthe project at Fite Number has been recorded at the Registry of A� �� and I has been noted in the chain of title of the affected property in accordance with General Condition 8 on �— , 19 FS It recorded land, the instrument number which identifies this transaction is� If registered land. the document number which identifies this transaction is l signature C S a1 e ! �i � ppliGartt . 5-48 U �O�F,tc SQe�f Sccizl�JrS/- F}ssutl. 7,1(2 M A Y 9 Ia85 r 1 ,y � - •.. j U�.F11 Nu2lg a3eag anea-11 " Form 7 - ' DEDE File No. ,�SS 3 1245 ' (To be provided by OEQE) ? 'BARNSTABLE Commonwealth City/Town = of Massachusetts Applicant FEB 4 19a8 Silvia 'b Silvia Assoc. 2 V' i Extension Permit Massachusetts Wetlands Protection Act G.L. c. 131 , §40 ' From: Department of Environmental 0ta i y Engineering Issuing Authority To: Silvia & Silvia Assn'ciates T„c 619 Main Street Centerville MA 02632 ' (Name) (Address) 't The Order of Conditions(or Extension Permit)issued on May 3 '1985 (date) to Silvia & Silvia (name)for work at Lot #3, Bay Lane (address) is hereby extended for a period of one year(a)from the date it expires. ' This Extension Permit will expire on May 3, 1989 (date) This document shall be recorded in accordance with General Condition 8 of.the Order of Conditions. ...............................................................................................................................................{................................ (Leave Space Blank) . I ' 7-1 f Issued by Department of Environmental Quality Engineering 1 Signature(s) lKabert agan,� eputy Reglonai. nvironmen a ngineer 1 . 1 When issued by the Conservation Commission this Extension Permit must be signed by a majority of its members. 1 On this day of -1 'Aral 19 .� before me . personally appeared Robert P. Fagan , to me known to be the 1 person described in and who executed the foregoing instrument and acknowledged that he/she executed the sqrpe as his/her free act and deed. YX Notary Public My commission expires F/GG/jt 1 cc: Conservation ,Commission 1 , 1 " 1 Detach on dotted line and submit to the prior to commencement of work. ....... To Issuing Authority 1 Please be advised that the Extension Permit to the Order of Conditions for the project at File Number ,has been recorded at the Registry of and 1 has been noted in the chain of title of the affected property in accordance with General Condition 8 of the original order of conditions on t 9 If recorded land,the instrument number which identifies this transaction is ' If registered land,the document number which identifies this transaction is Signature Applicant 1 7-2 . 1 1 BD�K 69b 6PAGE 1 9 . 60103 Form 7 DEP Fite No. SE 3—12 4 5 (To be provided by DEP) Commonwealth ��r�r''"`�'`� • City/Town—BARNSTABLE of Massachusetts appucar,c Silvia & Silvia Assoc Extension Permit -Massachusetts Wetlands Protection Act - G.L. c. 131, §40 Department of Environmental Protection (pursuant to .Stat. 1989, c. 240, s.101, ". . .the Department of Environmental Quality ��gineeri7& shaAl.l be � th �asrirr e*it�i p�-nte^ram^*+ wng uthority From: nc*.+ �� o no.,�T+-„opt ^f To Silvia & Silvia Assoc .-, , Inc :' 619 Main'- Street , Centerville , M.A 02632 (Name) (Address) d The Order of Conditions(or Extension Permit) issued on May 3 , 1989 (date) ' to Silvia & Silvia Assoc . Inc . (name)for work at Lot T3 , Bay Lane (address) is hereby extended for a period of year(s)from the date it expires. e ' ' May 3 1991 to This Extension Permit will expire on � (date) ' This document shall be recorded in accordance with General Condition 8 of the Order of Conditions. 1 ' t + ........................................................................... ............. .. ., ....... .... ................ ......................... ................ r. H Aavo Rnara Fllanbl 1 1 GOOK 6 9 6 6 PiGE 90 Issued by Devartment of Enviromental Protection E1' zabeth A. Kouloheras , r Chief Wetlands -Sect aon_. ......_ .._.. _ i j .. When issued by the Conservation Commission this Extension Permit must be signed by a majority of its ' members. On this /; day of ��i�irX y^P g 6 j before me 7 personally appeared F l i ?aheth A Kouloheras to me known to be the ;person described in and who executed the foregoing instrument and acknowledged that he/she executed .toe same as his;her free act and deed. EIJI ......Public My commission expires <� IC DF.3/J t cc '•Conservation Commission ;1, Ln is � •.�c F Detach on dotted line and submit to tha �_S_ De-P' ECGtiED guy' z? 7 prior to commencement of work. "4, :I: i 23624 310 CMR 10.99 BOOK�7:)�� fr�E 2.5�3 ' i Form T DEP File No. (To be provided by DEP) City:Town RARNSTABLE Ate,_- CgMmonwealth oIMassachusetts Avalicant Silvia & Silvia Assoc . '� - Extension `Permit Massachusetts Wetlands Protection Act G.L. c. 131 ,140 De artment of Environmental Protection Issuing Authority From: Silvia & Silvia Assoc Inc , 619 Main -Street CentervilleL---=MA. 02.632 To: (Address) (Name) May .3 , '19 91 (date)- The Order of Conditions(or Extension Permit)issued on Lot #3 to Silvia & Silvia Assoc Inc (name)forworkat Bay Lane (address)is hereby extended for a period of 3 Year(s)from the date it expires. This Extension Permit will expire on May 3 19 9 4 (date) This document shall be recorded in accordance with General Condition 8 of the Order of Conditions. cf 25 J A.issued b yDe tmten f r v iior1 l en tal Prote ction ion Q' , � . v� Signature(s) We t lan s Sec iop,� Elizabeth A. Kouloheras , Chief, tD �70 r n f or i�D nco P' t� vil N� 1 When issued by the Conservation Commission this Extension Permit must be signed by a majority of its members.' a of 19L_ [—_—.before me V r �� -day '� • On this � !� personally appeared K uloheras , to.me known to be the person described In and who executed the foregoing instrument and acknowledged that he/she executed same as his/her tree act and deed. - y� My commission expires otary Public D`tiUN MAY Z 9 9 1 � �------y r. r, r qu __ -DEP..File No. SE 3-1245 .... ' Form T (To be provided by DEP) 4 City/Town BARNSTABLE - ' 1 Applicant Silvia Silvia ASSOC., Inc. Cameortiea[t1: . 1 Of Massadlusetts -E)fT'EIiSIOM PN3t11IT_____ MA.SSACHUSlErrS WETLANDS PROTECrIOM ACT G.L. c. 131, %0 From: Deyartment of Environmental Protection — -�-� 'Issuing Authority 4 ti _.f. •'ems- .:� + . .. .. To: A.M. Wilson Associates, INC. 911 Main Street Osterville, Massachusetts 02655 (Address) ' .The Order of Conditions(or Extension,Permit) .Issued*on Mril 29.199b (date) to Silvia b Silvia Associates. 'Ine.'-'(nacre) for work at Lot S 3 Bay Lane (address) is hereby extended• for a•period of three M `years(s) fran the date it expires. <c - _�.r. ;•• .:�' ,, This Extension a on Ma •3 1997 date Ext an Permit wit ire t l This document shall be recorded in accordance with General Condition 8 of the Order of Conditions. F ............... .. ...a.. ... ... .. ... .. ,' (Leave Space Blank) Issued by Deoartnment of Environrmentai Protection Signatures) ..... Etiz th A. Kouloheras, Chief, Wettands Section ' When issued by the Conservation-Commission"-this Extension Permit must be-signed by a majority of its members. -___..____._..._.__. --____--- _-•• _ •__=•---.__ ._.. _. - --..-_.___ .__ .. _. .. ._..__ On this 4th day of MY 19 94 _ . . before me personally appeared Elizabeth A. Kouloheras to me known to be the _ person described in and who executed the foregoing instrument and acknowledged -^ that he/she executed the same as his/her free act and deed. f ' r' �?g ' N x ry PM0c My comma, sion expires t ' Detach an dotted line and submit to the Depertmmmmsmt of Envim-onmaentat Protetion prior to eaameeaent of woft. .............................................................................. To Department of Ervironmerital Protection Issuing Authority Ptease be advised that the Extension Permit to the Order of Conditions for the project at Lot * 3 Bay Lane Fite Number SE 3 - 1245 has been recorded at the Registry of Deeds. Barnstable County and ' has been noted in the chain of title of the affected property in accordance with General Condition 8 of the original order of conditions on 19 If recorded land, the instrument number which identifies this transaction is ! If registered land, the document number which identifies this Transaction is' Signature A lleant. . S I� A. M. WILSON ASSOCIATES, INC. cos ' 911 Main Street SHEET No. OF OSTERVILLE, MASSACHUSETTS 02655.2015 (508) 428-1450 CALCULATED BY DATE FAX (508) 420-1856 CHECKED BY DATE a SCALE 3 i To D f 1 rt meet of Envirormenta l Prot ..:...:. actionPlease be __. ...................... .............._..._............_...---.._:_.._...... advised that the Extension Permit' File R r SEto the Order Issuing Authority has been has been recorded at the project at Lot # 3 not in the chain the Reg- 9a Lane of title of the ry °f deeds Barnstable ' original order of c°nditi 11111111�'J. . affected property in actor Cotait ons on dance and If recordland, the with General Condition 8 Of the recorded instrument 19 If registered land, the document r which identifies this transaction is ' member which identifies this Transaction is Signature Applicants q __V/ EF:1 i3F:}E—�j1i)E 3.,—Ij�} c, �: 1 #201321' `EARt�a�;TA ELE C it NT`r' FEi;ISTR,� f OF CiEEEi� � ...._.__......... ... �_._ ___......... _................._..........__.__.. _ — ._._._.._.__..._.. .. ._� _........ --. _. .............:.............. .......... ............ .... ..............._....._....................._.................................................................._ . . ........................................ ..__ ......_....._._......................_....................._......._.._.— — ............____.._............................:.........__ .........:.......... — : —— ...._........ :._ ___ REGISTER RECEIPT # : 1995 9743 BARNSTABLE COUNTY. REGISTRY OF DEEDS RG170R jRINTED j : THU 4/27/95 15 :.26 :57 � . BATCH: ' 7799 USTOMER: .. N/A PAGE: 1 IOOK-PAGE : 9645 102 RECORDING FEE: 10.00 NSTRUMENT # : 20021 POSTAGE: .32 ECORDING DATE: THU 1995-04-27 3 :21 MARGINAL REF FEE: .00 DORESS : BAY LANE COPY FEE: .00 CONSIDERATION: .00 COUNTY EXCISE: .00 OTAL AMOUNT DUE : 10.32 STATE EXCISE: .00 0AIO BY : CHECK 6847 ---------------- TEE/GTOR GROUP : 001 OWN : BARN BARNSTABLE ,NSTRUMENT: _O ORDER RANTOR: GRANTEE : ESCRIPTION: 3 BAY LN MARGINAL REF BOOK-PAGE: ' RANTORS: .. A M WILSON ASSOCIATES INC (&O} SILVIA & SILVIA ASSOCIATES INC (&0) MASSACHUSETTS COMMONWEALTH OF (DEP &0) f.RANTEES. NONE RECORDED ' ETURN ADDRESS :---A M WILSON ASSOC INC------------------------------------------ 911 MAIN STREET OSTERVILLE MA 02655. ------------------------------------------------------------------------------- i 1 I M. D F� A a N t 819-74 4 45 -, _ M ' n P ' � C��1 G� PuoT' ,� N ' so, � Est W/A i �,1u✓t A A 446ei tATES NcoaPoun.. 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