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1258 CRAIGVILLE BEACH ROAD
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Y - I a c a ^ , � :a+ .fix• N Y , n c: , r- ry a '.. ... .. ., -.. .fir � � :` .- ., ,• �. _ . , i r Engineering Defre (3rd floor) Map Parcel ev'S�l a- ®yl Permit# House# /Z Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee f�� Conservation Office (4th floor)(8:30.- 9:30/1:00-2:00) Ot .` ' r 1 1 ArirR_lrialt,'n� d ?� ��° e► 19 RN$TA ` rSr .� 1 , TOWN OF BARNSTABLEE°"�"° �`� r 3 /� Building Permit 4p lication Pro*Setddress /,2 ST G,,ew 'ilj`lk ��%�C Village Owner -13/9N e1n14//!//e1!!C Address /oZs:F 0A/S!//�'. Telephone 3-05"J 720 — 3/a el _Permit Request CAM�/S/� �6Til�►�� i9A/Z �o�t/S'TmPU� 4 i9Csf First Floor 130 7 s and Floor //ky square feet Construction Type CaVCiPe7Z- 7jiy%/o1Z �a9/!?E' Estimated Project Cost $ _ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family M Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: I@ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing _ New_� Half: Existing New No. of Bedrooms: Existing 41New Total Room Count(not including baths): Existing Neves First Floor Room Count Heat Type and Fuel: X Gas ❑Oil ❑Electric ❑Other Central Air AR Yes ❑No Fireplaces: Existing / ' New �_ Existing wood/coal stove ❑Yes No Garage: ❑Detached(size) -� Other Detached Structures: ❑Pool(size) ❑Attached(size) Y �� ❑Barn(size) ❑None ❑Shed(size) L, ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes a No If yes, site plan review# Current Use Proposed Use � Builder Information Name Zerbe47VW;� ///9JAVr- 640P Telephone Number Address RO, &.k �/�l License# Cs' Oo/j/� /4&W41S,Me: ,0/,034 r,�6-, Home Improvement Contractor# /OHO Worker's Compensation# O ;31S—S994/d.`CI D16 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i`//4/nozl f>/Aw. SIGNATURE DATE BUILDI PERMIT DENIED FOR THE FOLLOWING REASON(S) C FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCELING Al ADDRESS VILLAGE r OWNER lv 1 DATE I# OF INSPECTION: i \•� f FOUNDATION Ct FRAME INSULATION �-✓� FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL•BUILDING A DATE CLOSED OUT 4J q� ASSOCIATION PLAN NO. .��INE r The Town of Barnstable • BARNSTABLE. ` Department of Health Safety and Environmental Services MASS 1639 �0 Building:Division „ 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice .t 4 Type of Inspection -Location. e,72�pAc f, T ermit Number Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: ra i 41 F Please call:, 508-790-6227 for e-inspection. 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ANCtASCKFWN4okEl.'q OR AWLI 6`! DWCj.sio. l0 �.' x,l_;....._'.,. QJEPfNEAD. �P�.IaE►L' . A.M.MICWWIL'wic Z .Lt_: ..::..1',:: ::-. :2`.-.6�x_C►,�6`- .N.IN��DL q.c.TS y 3TL.:: D46k L I fL4_O„ G° rtq" IrL -O i41 3' 1rL'_p„ Cs 9" At,StgtGTVE 1�EPDAooM 3,-8" 3'ON • - -Ex1St1N-C3._ReStGENGE _' ,�AGUL-LI TO>aEl � 51iOwEq .. . IL pwNERS BY O D 10"vAu� O -ZE11..1N O i Jo -- _ ' C�D _ I 5 _ o v © yAULTEG �9 — " 3�_go t t_In.lq Go .v 5'-l0 - T OPEN PaA\LAN C� -- _ C w L06 E r i -TS � IC I/.�—q!`MOVE E x 15Ttt.IC� gLo E � . W A I� Gt\L\N i I E tt_IN .4 O 0 m cn O _ Q O p t Room - o GREAT p m p -0 m MA�AGNUSY�3 STI.Tt�-mut�.C�tdf�-0006 � ALA.LOGALTONI.I CODES. Ilt'GOti►COAM AN C fi W ITN TI•I E SV� Y e e Tt.lOTM TFIfi aTI.RT O GOppO uCTON, 24 2 All OiMBAlOION SN�►U S �'^10R 'TO GCNEP� TTI COµS6�iI►Gt0 4 TEE ev'�! PROP0sao A00\"r N TO TuE 9 FOP!-.S1�IyN cam•O� T1.Ifi ggCONa F WOFS ARE�payLTEO..SEE P`A�-1 _6R�INNICK IDAW3UN PStSIDEI- aa �156 GAAtGY`L�E >SEAGu u6sT 4c "�I�°n���jEvS.t COa�'f'P►UGTIOu CEhtTieP`,vl" R ��.sS Ac1+u8ET �Nol AT SECpND FLOOR PLAN 5Eco►.,o F�oog P�a� 1 � c'�:O° OPSAWN aY p._M.M�CNNIEWKL DATE c q_q5 4-3 .9� Al. 4 W L 2- I u t ' � 3'Ia.u¢ LALL`f N OL\X-AN w� I I x 2,-G,k - 1911 op ropTnuG I I �I GUT 4'-C WIDE I � r 1 -• - OPEN tJG 1 N E%iST- �I FOu�.1DA IOµ. a'N I CH WALL. I W I o IOn COI.I P.S-M guOCK•uP EXIST1ely PIEAS W�FTy. r T f = Four-,n ATIor.I ' G14 -G ° G'-2 u 5° I I I w a oEm I - o � a NOTES _ {'ALL COti16TRuCTION Sr1ALL BE I�.i-CONFOgMA�CE ` %-ri,4 THg MA36ACM11�B-Rd STe.'rE LOCAL-TpWwa Go0E3, Irt,'_O" 12'-O 2;A�L-DtMQiTst0�:1�"SMVL,446 VCgqICIED DYT�{Q OWNg� jTu,gZTEEL BEAM �.aNQgAL CONrP1 AGTC� �rI�OR TO TaiH �.TAgT OR GON STSUGT dJ, 24'- O" .. S Au_FouwloAT owl Fool w+Gs 5�tsuu HE ROUv.IDeD oN Su IT^.IbLE uwDlaTugeao Sox,-Z. 4 `KALE �:A L FOuMOAT�Owl WALL% SukA.LL.lam IPPROOFEOo W�A 9iTUM1I.1- OI-S ®YTwQ MA�uFACTU�eq, pRopoSED A T OD110► T T.I TO N �.EX IJTIhI 1�"-C4i 1MNH`f TO BE OSMOLISHED. BRI Ur,WEr DewSow RE 510St.4CE IRSB GPIA�Gv.�uE gEAGri AOAC ' F O 1.1 t\l D AT 1 OU P L_ A t\-.1 GE�.ITEAv ,LEA MASSAc�tuSE�S SC ALE II ,'1= I' O" FOU�JOATION P'L A�. DPSA`N BY OVJ_G..NO ' A.M.MICHLsEv,�cZ A Wr I-A C at I-IQ j 0 16-rz I %G"O.C. 12 "A z win AI.T-"k I t�j VL: 10 -L 4- r p A-IT-s-It #10 or IL)A 4-SZ'u IDS t G"c C. in L)k to" 40t5 ze %G"Cc. YL COX -SI-Askn-kl'W 'A 10 )015'r3' a 75 T.3a I T. 4-\co�4CFW I St AB W-W-Ir. CONC%ETts vr0ouN0 A.mo-4 k_A rj Fk *4 1 US,Ib"- lro\.Jw=,mc'j oie. WALLS P,� VL.5 U= 0.02) 0 NJ B-IB AL-A., 'O%Dr C a Imir Coo GKOP ...r.XT - rm OWA.N G LA. pidd X LOG.-..�J.0 M F V5SME OL bp�kw W-.Ibf ov" u v THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I m C(:..-�-J-L DATA �DPERTY ADDRESS 1 253 CRAIGULLE BEACH R 10 LANOYOTH�-- a'-EATURES DESCRIPTION ADJUSTMENT FACT:-'--RS Land—By/D.1. Size Dimension CLASS LOC./YR.SPEC. P, P-1 !CD.i FF Depth/Acres ........... 8A7HS 1 -0 U x D= '2 N D 1 J o 6 15 I'll.T s x A D J U S T m S I'm C f -y L A N D—A DJ VIME Class Fw s Base Rat Adj.Rate A (i 1 D+ q, 0 130 1 G 0 5.3. 45 53.45 10 6 0 31 A 5 f) Rate Square Feet Repl.Cost SIC. Description MKT. INDEX: P. 5 V r�A S BAS 100 5 3 4 5 570 30467 L D! FAI �l U FWD 81 5 3. 5u 163 1423 1 I'S T L E --- Y -- -- ----- -- P i:-S 1 M, A D J "N J(] "A D TY I 1 C 2 s FWD I T 9 L XT 0-U-T I J *4 1 S 3 INTER.` uALTY 1 J 2 A 5 rLilU 5TR-dC T -,J w U --------------- D U Total Areas Aux 16-3 Base5,70 . P-E------ --- - E BUILDING LECTRI AL 0 - ILDING DIMENSIONS 10 F- T F---------�a SAS N20 E32 S05 W03 S10 W05 S05 20 3ASE UJADATIC A W 24 B AS FWD N20 E04 N12 E14 ---------- S12 W14 . W04 S20 FWD 5 --------------- L L AIN 0 PARCEL x--------- AREA VARIANCE STANDARD 0� Cape Cod Division C®L®N R ,�ll�-+11 L 127 White's Path, l� South Yarmouth,MA 02664 c A S C 0 M P A N Y 508-394-9851 Fax 508-394-2564 I August 30, 1996 Ledgewood Manor Corporation ATTN: David Thomas P. O. Box 671 W. Barnstable, MA 02668 re: 1258 rear Craigville Beach Road Centerville, MA account number: 54-11-7088 To Whom It May Concern: This letter is to confirm that the natural gas service to the above referenced property has been cut and capped outside of the work area, 25' from the previous meter location. This work was.completed by us on August 29, 1996. If you have any questions, I can be contacted at the number listed above, extension 7503. Sincerely, Bonnie Figueroa Distribution Department 7 Actc)R-ss '12 5 LS CRAIGVILLE BEACH R 10 LAND/0THER FEATURES DESCRIPTION ADJUSTMENT —S.Size—6,-e n s�o n Land By,Dale LOC./YR.SPEC. --. - rCD.i FF-Depth/Acres ------...... ....... --------- ---- 10 18LOG.SIT 1 x .611 =10c 6ATHS 1 -1 U X X ATI .," TTIC U S I R E P L A C E U x Cl A D T m Z LAND LAN D-A Di 'I NC 01ME -v I; t 97300 CUO�n,Isst T,01alnns 6.,e Rate Adj.Rate Lc Nn, _ I i c+ oli c. lio lic) 65. 00 71 -50 1 Cj 7 5 G, Description Rate eet INDEX Square F Repl.Cost 8AS 1JO 71 .50 7 3 a 55770 3 j FEP 65 46.48 90 4133 i 4--.mom ST Y L 1S3 100 71 .50 96 6864 8 0 -3 f]__:,_,_",.,., 15B 100 71 .50 118 8437 ji FMP J_ 5 5.50 255 1403 .2 1 1 L I A I P'�7 a20 60 42.90 780 33462 z J, 13i. ENT-E- 5-X-* - -, -3 1—2 S, BASE i FLDj T Rrtl C T Aw 10 10 FLT-Ji7-CD '-R D L Aux 34 5 Base 994 18FEP 110 3-F_T Y?--E---- -J-0 E Total Areas BUILDING DIMENSIONS L "T SAS W05 FE P S10 E09 N10 W09 F 0 UN_9A T'lVfq J 0,. A SAS S13 1S8 S06 W16 N06 E16 -------------- - SAS W 25 N29 lSjB S12 W04 N17 FMP 14 E 1 73_�ff 0 R 73-5-A A T L W15 S17 E 15 N17 1SB E14 S05 6 . 6 L A M Wig}. . . 8AS E30 Sll 1SB PARCEL 9 6----* AREA VARIANCE - STANDARD � wn of Barnstable' . The To • � al Services • � Department of Health Safety and Environment sass . Building Division A 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 For office use only , Permit no. Date AFFIDAVIT. HOME DWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION wires that the "reconstruction, alterations, renovation, repair, modernization, MGL c. 142A requires re-existing conversion, improvement, removal, demolition, or butcon not morethan four o dwelling units or to owner occupied building containing at least one but no structures which are adjacent to such residence or building be done by registered contractors, with s requirements. certain exceptions,along with other �oL�Ti4Yt �' G7--mG� Type of Wo rk• lz� 60&6 Est.Cost Address of Work: Owner's Name Date of Permit App hcation• 4� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWN PERMIT OR DEALING WITH UNREGISTERED OWNERS PULLING THEIR SOME IMPROVEMENT WORK DO NOT HAVE CONTRACTORS FOR APPLICABLE UNDER MGL c.142A ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner.ZZ)a D �40-1 Registration No. Contractor Name Date OR. Owner's Name flare . : . ic• C11WHIORRIC01111 Of fizaaaciluseas Department o,jbtdusVial Accidents Ila =1� 0!llceoll�es�l�aas . 6111111 irrMagion Street Boston.Masi 92111 Workers' Compensation Insurance•AMdavit or— •A Icanf"formation• - Please PRiNT`t J y� ,�„ I"rnion• �, nhnrrc# ❑ I am a homeowner performing all work:myself. ❑ 1 an a sole proprietor and have no one working in any capacity ❑ .I ath an employer providing workers' compensation for my employees working on this lob. comnnnt•nnnre• addrem! rih•• "hone#• insornnee ce "olio# my 1 am a sole proprietor eneral contra cto or homeowner(eircie ogre)and have hired the contractors listed below who the following workers' compen o icrs• IN• LEA 6� c�� comnam nanre• �y�" .02 �" • S68 �.(/. ,U/�//'c�cS✓���' ///// �a2' ��� ' "hone#• ��� - incurnnc �n /g�c�� /�/�UXC� �Li!s ro • miter# OCR- 6s�c�p �r• �,,,-�.;:�•. �.. wt�n4.,.•.sawr•Q'r+"w�"�•'es"'fn"�iFs a ""t74Fss��� �, - m r address: t eim: a 57� nhone#! On'-turn c" �fkS`��72/� CASUAL .. "offer Wt- 6 1 o��'���� Abash additlonai'aheet i[tieca !%%; ,%+Y:-•./wi-s,.-•f+�.Jae'r�n!nP- _''""'"'�--=`� _ ��.._ failure to secure coverage as required under SWioa 3A of 51GL 152 can tend to the iaspaa'don of crimiod peaddea of a floe up to 61.500.00 and one rears'imprisonment as wed as civil penddes in the form of a STOP NVORK ORDER and a tine ofMDOAD a day apion me. f understand that coin.-Of this statement may be forwarded to the ollise of lnvesdaations of the D1A for eoreraDe veritteadwL I do iierrbt• under th xdpenoltles ofpaluIT that the infomsmdon pnvrided obm is Mw and cmvzvL 1gn2111tt; ate Print name ✓�U/� /1�071'I�9cS Fdno only do not write in Ibis area to be emupicted by city or tow°omeial ptrmitAtemae ll nl;uildin0 Department 011s Board mmediate response is requiredOtiealtb Department phone fton: — _�� • °•Informntion and Instructions • • .•, � wires all employers to provide workers' cnmpcnsatian for Massachusetts General Uws chapter 152 section_5 requires p P employees: As quoted from the"law".an empint+ee is defined as every person in the service of a other undcranl contract of him express or implied.oral or written. •� I An emplmver is defined as an individual. partnership,association.corporation or other ::l a cntit y, or any two or the foregoing enpaged 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. Howeve rnvner of a dwelling house having not more than three apartments and who resides therein.or the occupant of the dwelling!rouse of another who employs persons to do maintenance,construction or repair work on such dwellint t thereto shall not because of such employment be deemed to be an empl or on the mounds or building appurtenan MGL chapter r52 section 25 also states that every state.or local licensing agency shall withhold the issuance o renewal of a license or permit to operate a business or to construct buildings in the Commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally.neither the commonwealth nor any_of its political subdivisions shall enter into any contract for the performance of public wort: until acceptable evidence of compliance with the insurance requirements of this chap: been presented to the contracting authority. � is .w� _ .. ... .: :.,,•��=•:�.:: .�.-..� - �',• p+bTi.-f=n: :' '�: •�L�•!r:'!•.1�;�^�:r"���'..•�~`�'ti��_• �.+!�7i:.ty ►+�.w�w?::-•�.•.:�. ,'l. 'Applicantss the workers' compensation affidavit completely, by checking the box that applies to your situation a Please fill supplying company names.address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents far 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 requ to obtain a workers' compensation policy,please call the Department at the number listed below. ui.::=�..�r.:..:_ Lai.: ••' �':r:.:--"�::.�,;,;�;s ',i... ... . City or Towns Please be sum that the affidavit is complete and printed legibly. The Department has.provided a space at the the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returr. the Department by mail or FAX.unless other arrangements have been made. 1"he Office of Investigations would like to thank you in advance for you cooperation and should you have any ques please do not hesitate to give us a call ... •.. .. ,r•�ii -..._ .. ate•`::IY..«i�i�:w1:.+�Irw+a.w��i..�•~;�vi.r �` •~ � +Y •.telephone and fax number. - The Department's address. p The Commonwealth Of Massachusetts Department of Industrial Accidents _ V Office of Imsduadons _.. . .air. 600 Washington Street _ Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 a= 406,409 or 375 --- ��� lXJ J �. _y^A �� -� n ,�- �_ YGCJ �� �� �: _ _ � � � ; E � Commonwealth Electric Company 2421 Cranberry Highway Wreham, Massachusetts CONEOCK12, & . Telephone (508)291 0950 2571 484 Willow St. Hyannis, MA 02601 August 27, 1996 Town of Barnstable Wire Inspector , South Street Hyannis, MA 02601 Re: Disconnection and removal of Electric Service, Dear Sir: This letter is notification to you that the electric service has been disconnected and the meter and cable removed to the premises of Joan Brunnick, 4 Horseshoe Lane, Centerville. Very truly yours, C , Linda Roderick Chief Customer Service Representative Ref: WR #118802 . BLDG. COST. r.. .!s Bsmt.Rec. Room V S.. ,>n.w.., y - conc. .-b Bsmt.Garage St. Shower Ext. 1 PORCH. DATE +e'alls•„:, `. PURCH. PRICE.;:. Brick Walls. Attic Fl.&Stairs y��' Toilet Room - Roof. - .RENT - k ono Wails Fin.Attic - r Two Fixt. Bath - Floors +' INTERIOR FINISH Lavatory Extra Bsmt. F I 1 2 3 Sink F , U Water Clo. Extra i 112 s/a Plaster Attic — RIOR WALLS Knotty Pine Water Only •�.�!e-Siding —� Plywood NoPlumbing Bsmt. Fin. " Plasterboard - Lnt. Fin. Fl6e ngias ` Sv �/ TILING. B,k. Fl.G F P Bath _ Heat . 3�2 ace Brk.On Int. Layout Bath Ft.&Wains. Auto P.I.Unit 1 - Veneer Int. Cond. Bath Ff. &Walls . Fireplace r. Brq,0n. -HEATING Toilet Rm. FI. Plumbing Com; P.o t Air ! Toilet Rm.71. &Wains. - -- ----- r— ---- Tiling j i Toilet Rm. FI. &Walls 1 � _ Ins. ! Hot Water —..I__— St --- ,� '' Air Cenu. Tub Area _.—...". ...:___.—. . �. Floor Furn. _._. _. i ill ot i a O, PUTATIONS I Pipalass Furn. 1 _6-1/9 S.F. - I . Oil 1 S c!:- t - S.F. • I _ --------- ,. !! 3—_......__._—____—__ .� _.__ - '- :t Lj_L fit!` 4 213 , _ 61 1$ 1�2�3jAf iei � asIaO h9E7ASUREv or,,,,,, Pier Found ! ! Floor 7-1 s _ Fireplace c „k i 1 - 1 Ydzl!Fcend. t ! j a- ! 10, Door - !.. .. F LOOr .. c_? '' I --...LISTED tD _ ; Sg!a.Sdg. 1 } 31 r'•,tURoofing s -I — No Elect -TIN — D61e.Sdg. f hsngle Root =- t— DATE hang_malls I 3 i g Iusnhin3 i 4 ROOMS Cement Bik. E°' ic 1 j yYC's,• Lxf s,.Tile -Bsmt. 1st�/� TOT-.L Brick + Int. Finish -.:PRICED gle I 2nd 3rd FA<-i OR 1 — ° -J I REPLACEMENT - - - - 1f/r7�` OCCUPANCY'''. ,' CONSTRUCTION SIZE - - AREA CLASS. AGE REMOD. COND, REPL. VAL. Phy.Dep. . PHYS. VALUE unct.Dep. ACTUAL VAL. 2 4 $ FIE 77 .,�.R,z;�.,?..,�Y.w.' a..,•5• :`s.,,3, a t,r-:..•i .� .. ,..�.�`. .:.- .. ...A. • ..t .a�• 4. a" r� .+ny;: �v x ..a. �. tee_: .na Y "� T `�. t� ,.� ;," a..TOTAL,•„w..•: .He:..'t. s b i -.✓,f sa r .. a4'.r_. "3VR..':'. ...\. �Ki�F"L*+*t7'...:t">S `"5.._::�.. ✓'�," r! h, �. ..✓. :: .. a. ..-. ,, 4 �d." .:W '^'. .. ..a ..:.. x:.i•,+. ,c a.,.,,.. .:. w ..,:.. ,�, �',,. .'�....... a.... .,.'t- `�.;° '•a'8,;. �3 i.-.:,..5 -:ir��'s .:�:. rt ::5,`^�� �:�,`q'. -'' 4 --»,. ,-,a. l.. .r .. ,rr , `F .....,.r :..�... ... � .,a�x �, -....:. i -. :.a :�,•� k #"�". .,.,- '".}'_::.::. ar,-'�`-. 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" .. ..tf 3.1,..,. S.. .....,,� . ',_<„m: -r ?Sw r r h,. s.,.. s +� .;� as a.-,yrm-ka,.::. ',. .u, -. . >.... -_ ,. ..,...� .. .,.•+3.5# ,.. .. r .- .. .-, � .... - - ..._�.r, � .w.a..s... k. ,, :� �+ ....... f.a�� ,R:i,;:�c,?� re- ,«�, a .`•vr:�:..f �'r ,.;�..-. �^•:-. _... -aa."-.:. ...,..:•}�^.:.. - .:�"... , ....c ,s.<.,_ ., is„,.P.'.'-: , .:. ttrt,:.x;.;* ..��,-_.-.,F y.<x.�..:r 1-. � w.ns.. t v t `A "`�' ,i C-T-.. �. .. ,t ,+� ��'�'w ,♦r �+�, '.:`-- �';.I ...- :..: ."." y:* t3 3*Y¢,}J ��:x ::'vt`k- F - � G.. =RESIDE PRO PERTY ROPERTY r L.OT-No. f £ a - - } •SIRE .T 1 T , STREET ` t'' s _ SUMMARY, > Cra { ille2 Beach Ro CernterviIle DIS R C x ' ; LAND BLDGS.. ,� d.r OWNER , rn w ,� C 0 . _ ..,, - TOTAL LAND RECORD OF TRANSFER DATE 8K PG I.R.S.' REMARKS:" BLDGS. TOTAL —101 --k LAN D BLDGS. TOTAL - -� ._ 7 ! — — ` LAND ._. — IMF a _ i �d _ i ��Ci �0 7'1�l e l [ __Cil` �[.'� BLDGS. TOTAL --{ LAND BLDGS. - i ; ' TOTAL - __...---- LAND --— -- — -- — BLDGS. TOTAL -- m LAN - U�a BL - I TOTAL I LAND ' �Sst !.<.�, _., f r...•, � TF � BLDGS. _-.... TOTALItY B n LA.D BLDGS. ' .�.,<<... r FrJ C.d i :(�' t .._ _ .._ TOTAL L. p {`' UE LAND —r— BLDGS. I u '•• TOTAL e..._ LANU _I:----, BLDGS. I b TOTAL .__._ �--- -----+ - - j. ----_._ - LAND BLDGS. _. -- TOTAL f s — LAND. - .. —_ . ' V, at BLDGS: M TOTAL S ` ANC'. A L D ! ) t NL 1 SEW: LAND — .__ . BLDGS. -- - -- S --- - TOWN: WAii_C ��----- ! H!G;', G L v-L TOTAL F — — -- - —p --- -- - —i D Lv�r Di J !. - 7 LAN i-- --- ---- - _i— -- -- ` I SWl t10 rD BLDGS. -� *'OUNDATION" x BSMT &`ATTIC PLUMSINGGLD n tir_'" PRICING° +•'�*"'n r Fm Bsmt Area-s=�,,,�a^ -, - -,Bath Room- �,C r x LAND COST - he y« 0r one..Blk°Walls a" e Bsmt Recn R �oom� 7st:.Shower;Bath� It# g{ F BLDG COST z S 4 PUt2CH ,DATE nc Slab s "i Bsmf^GaraHe St;Shower Ext. Walls Yh. $r 7 SPURCFi.PRICE rick WallsR it' ' Atbc•FI &Stairs, `•Toilet Room r x �y 00 Roof ne:Walls ;a?°� 3 �� Fri:-Attic *Two FatKBath � °ers `+-' < L INTERIOR FINISH -- 'Lavatory Extrayp Floors Sink s/ :rh r 3/ .. S Plaster ' y 3 ' ? .Water Clo Extra kr. Attic h = 3 00 b 7 �' '30 EXTERIOR--WA Knotty Pme := Pam- t >' Water Only uble Siding,.:{' - °- Plywood '! + No Plumbing.` Bsmt.Fin.' Y mgle Siding r" Plasterboard t ='' Int.Fin.' a p 9 8 p iU v C/O TILING �f ,.. _ nc.'Blk. r.� G- F., P Bath Fl Heat `� u� .� ,�- * . ace'Brk:`On r Int.Layout Bafh FI.&Wains. Auto Ht.Unit y bQ S c FIA Q47s S_ Veneer Int.Cond. Bath FI.&Walls Fireplace r Brk.On - >= - HEATING -_� Toilet Rm.Ff. _ _ _ Plumbing ��S:�.O .,..°d Com. Brk _ Hot Air . Toilet Rm.Fl.&Waing. Tiling `S Steam ✓ Toilet Rm. Ff.&Walls , :ket Ins Hot Water - St. Shower - - Ins. Air Cond. Tub Area Total _. Floor Fury F OOFING - - -- COMPUTATIONS Shingle. .' Pipeless Furn. - t S. F. Nod I fdo Heat hsbe-'..Shingle c Gil Burner. ..,} S.F. I ::t Coal Stoker _S. F. . a S. _ � 3s I jC, r7 I O�i':esi ,._T3iiv__ TYPE S F ° - rr .. r 1 S.F. i {� G ; 3 j i i1 ; - S G Ei Si10; - _71 z C ^�i _ tit- r I rc cE L:= _S F. i j - '1 1=itr round. ; - -i amh_! � �— '--r r:r r fit.ck� .,.,:f - - Vdsli Found. 7 FFL—Jw4S { LP-;TEC -- I a E_v(Ge TINE I ^K'e. ag. y �/� i Roll £ t - I i Shingle Walls I s ._ _ �t t. :..• i I I iardwood - L �'c�`"°.Oi:4S p - - - - - Cement F.ik. I ! Electric l ° j ! - - - —- 1 -- T;'^ - Bsmt. ,1st -�-� .TOTAL Brick ° Int. Finish _..___ ynd //� I did FACTO^ ../v l) • =.G.:t REPLACEMENT 'PANCY CONSTRUCTION SIZE AREA -CLASS AGE I REMOD: CONO. REPL. VAL. Phy.Dep. . PHYS. VALUE Funct.Dep. ACTUAL VAL.- :� n=. h Frp 5 Rio 7 S f y✓� /� �1 / r;u _..__.._. 5 t TOTAL I "T�R.K' "' a.: r�s�nnw...x,:,•ie5 `. :..sy';' ....,{_s -a-y"'„.""-'".""'.:^`�4 - n., -+'+�e`'..,—t..'_ .. RESIDENTIAL PROP m p f LOL1�L0.. FIRE DISTRICT SUMMARY sTRErT 1258Craipv lle Beach Rd. Centerville p _ - - G+_O �73 LAND a go OWNER BLDGS. aG J4) TOTAL -3-7 7 SrO 8I LAND Z O A w RECORD OF TRAM' FER DATE BK PG I.R.S. REMARKS: DV #1 -- - - _ BLDGS. TOTAL 6 LAND =�'-- .;! ". Zi`fgo -- _� r C:'•3 �..^-. - .>f�...fr. .f•.6$i::,`,r �:%✓C? i .._�� BLDGS. - -- - — 0) TOTAL c _ 7(u� Fps `rtL3 D LAND -._ Tic,+f7 r:^C:I^Ci.nn V r ,� !t _ _—< r_ ���1 P BLDGS. �.G�. TOTAL _.,. ------------------- "LAND ti --- ---- -- ---- ---- ---t_._.. _ t BLDGS. E TOTAL - � I LAND -- BLDGS. f i TOTAL LAND BLDGS. ' -— `--- TOTAL -- . .LAND BLDGS. - ~ - t TOTAL __.._. LAND � BLDGS. TOTAL g:r- i s LAND ......._ . BLDGS - _._.. .' .-__...__. .`�✓/ I—_._�' __- — '=.C _ -`- --� _-- �.7� -- 01 / - TOTAL -._.. v t v 'Dos LAND ...__... s BLDGS. 2Df IV - - - d r fis for cal 81 into three TOTAL ----- -- --- r-- LAND ...._. • I - ------- ,---- --- rt o t s (6-2 C-I8 5 BLDGS. - ---- _-_---- �-- -- _.. :-- ---- ----_ ___- _----- ----—-- ", �` /y� •- TOTAL RTc LAN D _ --- 1.-... =- BLDGS. —... tp _ till - -— -- — - —Y ,.-,----__-__ --.--- ..._�� FACTORS i AND TOTAL STnEel r .' TOWN _._ SE\'✓ER LAND _. !-- —"- :------,- --I K -e i BLDGS. TO ER T TOTAL _. � �• "?-= �;,�' ;_ _ GRAVEL RD. _ LAND g. i DIRT PD. 6 ry NO Rt?. BLDGS. ... ............................. .............. ....... -N ........ ............... .......X. ......A.......C..........O...... RD .. V ....... ...............N ............... .......... ................... ........ DATE(MM/DD/YY) ...... .... .......... 08/19/96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Fredericks Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. O. Box 427 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1046 Main Street COMPANIES AFFORDING COVERAGE Osterville MA 02655-0427 COMPANY (508) 428-8999 A THE TRAVELERS INSURED COMPANY Ledgewood Manor Corporation B LIBERTY MUTUAL INS CO P 0 Box 617 COMPANY C West Barnstable MA 02668-0617 COMPANY (508) 775J1925 D ........... .... ......... ........... .......... .............. ...................... ........ ............................. ........................:......... .................. .. .......... ................................. ....... ............................ ..... ..................................... ... ........... ................. ............................ : ....... ............................. ................ ........ .......... ::::: ....... .......................... .... .................... ...................................... .............. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR LIMITS DATE(MR41DD/YY) DATE(MM/DD/YY) A GENERAL LIABILITY GENERAL AGGREGATE $2000000 VOL COMMERCIAL GENERAL LIABILITY 680-599W3397 08/15/96 08/15/97 PRODUCTS-COMP/OP AGG $2000000 I CLAIMS MADE FI]OCCUR PERSONAL&ADV INJURY $10000oo OWNERS&CONTRACTOR'S PROT EACH OCCURRENCE $1000000 FIRE DAMAGE(Any one fire) $s0000 MED EXP(Any one person) $5000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) F1 PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ............. ..........-... ANY AUTO OTHER THAN AUTO ONLY: ................ EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ W TATU- 1 I OTH- B WORKERS COMPENSATION AND TOC SRYLIMITS I ER EMPLOYERS'LIABILITY WC2-31S-598672-026 08/18/96 08/18/97 EL EACH ACCIDENT $ THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: B(CL EL DISEASE-EA EMPLOYEE,$ OTHER I I I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CARPENTRY, PAINTING, AND LANDSCAPE GARDENING OPERATIONS. WORKERS COMPENSATION INSURANCE COVERAGE IS PROVIDED BY LIBERTY MUTUAL INS CO UNDER THE MASS. ASSIGNED RISK WORKERS COMPENSATION PLAN, WHO WILL ISSUE A CERTIFICATE OF INSURANCE WITHIN FIVE DAYS. ................................... ............... ......................... ........ .............. ...................... .... ...................... ........................................... ............... ................................. .... . ......*".],".. "N........ .... ......................... .................................................................................................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Town Of Barnstable, Ma lo DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Building Department BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 367 Main Street OF ANY KIND UPON THE _COMPANY, ITS AGENTS OR REPRESENTATIVES. Hyannis MA 02601 AUT ED REP ESENTATIV ................................i............................ ................................................................................................................................ ..... .... ...... . .... .... I .....I............... .............................................. .......................... ............... ............ ...... .............................................. ...... ................. A 0. ............................... ........ 17 .............................. ............... CERTfiICATE Of INSURANCE ISSUE DATE 08-27-96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND Bgyden Insurance Agency Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 125 Route 6A Sandwich MA 02563 (508) 888-2244 COMPANIES AFFORDING COVERAGE CO LETTER A Commerce Insurance Company IRSURED CO LETTER B L it t l e ,xConcVete CO LETTER C P.O.e 744tt1e CO LETTER D Eastern Casualty Sandwich MA 02563 COVERAGES CO LETTER E THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED•NOTWITHSTANDING ANY REOoUIREMENT•TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFI- CATE MAY 4E ISSUED OR MAY PERTAIA• THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS;EXCLUSIONS AR CONDITIONS OF SUCH POLICIES. IMITS SHOWN MAY HAVE BEEN RED CED BY PAID CLAIMS. CLOT TYPE OF INSURANCE POLICY NUMBER DATEC� E%DD/YY) DATEC(MMFJDD%YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY GENERAL AGGREGATE 300 A X COMMERCIAL GEHL LIABILITY 96K24387 08-18-96 08-18-97 PROD-COMP AGGREGATE 300 PERS & AD E CLA MS MADE X OCCURRENCE VV R. INJURY 300 OWNER S & CONTRACTORS PROT. EACH OCCURRENCE 300 FIRE DAMAGE(ANY ONE FIRE 50 MED. EXP.((A�iu�Y ONE PERSON 5 AUTOMOBILE LIABILITY COMBINED B ANY AUTO SINGLE $ ALL OWNED AUTOS LIMIT SCHEDULED AUTOS BODILY INJURY INJURY HIRED AUTOS PER PERSON NON-OWNED AUTOS _ BODILY $ INJURY GARAGE LIAB. PER ACCIDENT AOPERTY DAMAGE-$ C EXCESS LIABILITY jEfH OCCURRENCE $AGGREGATE OTHER THAN UMBRELLA FORM TATUTO Y D WORKER''SSDCOMPENSATION WCGIO03602A 06-12-96 06-12-97 500 EACH ACCIDENT EMPLOYER'S LIABILITY 500 DISEASE EACHCEMPLOYEE OTHER E DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS CERTIFICATE HOLDER CANCELLATION LEDGEWOOD MANOR CORP SHOULD ANY pF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE P 0 BOX 617 EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL WEST BARNSTABLE MA 02668 10 DAYS WRITTEN NOTICt TO THE CERTIFICATE HOLDER NAMED TO THE THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATIM OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRXWATIVES. AUTHO ZED PRE I TAS FORM 25-S (3/88) r�17 11 , ; fNY�5MP�3 +N+4.�.rx..wm4twnr�le+MMW+p rY�M'Maaad'ewYbry�el�®WNatMAr,M11a I4'fs y t 4F 'yiii ' t^'i•, �r�e �trraataa�ememlldlc�J�ZaM�tcx�rue(r1 i J I. �ij•f e - - HOME IMPROVEMENT CONTRACTOR Registration 102026e Type - PRIVATE CORPORATION `I Expiration 06/30/98 LEDGEWOOD MANOR CORP. -- { ichard C. Thomas 4 !ADMINISTRATOR 1248,CTaigviylle Beach Road Centerville MA 02632 j ia.t t DEPARTMENT OF PUBLIC SAFETY " CONSTRUCTION SUPERVISOR LICENSE Number:.., - Expires: Restricted To:.. 00 ; OAVIA E THOMAS 238 OLD COUNTY RO EAST SANDWICH, NA 02537 f �ti 1,7 1 '6 f i I' • f . I • I • s I k i Ik I3 . Y `s le I'^ �� �,.' _r-p,wn,.- ,-�,�s .--r..._yrv��-....� m.�,r.K`_"T�°�h"" "i ""''[.,�..,ny�-,.. -r:r,..n.r •�.�..�+w,,r,.ryry€.;"nr�i»:.`s°`.'-x'V'_S�lY:"•*",`'i"..a,.., ..sqy:�m�.rr..c� Pr T i+0 xLice nse or registration valid for individual F use only before expiration date.' If found f return to:One Ashburton Place Rm 1301 Boston Ma.02108 �»tea :.::.::r,;:.Xi=,:.7..i�.�.�... i . ,• Restricted To.. ee BB - None 614 9 lA - Masonry only ' 16 - 1 5 2 Family Homes Failure to possess a current edition of the Massachusetts State Buiilding Code f,f' is cause for revocation of this license. 'F:.... �r F f ji „ h I � f I �k i, ,E 4 ICI F4 Fil li i{3 is 44, 4! f 1 I II SAND - I (FILL) (BURIED LOAMY 44 SEASHELLS 1 7YR5/8 (SAND - . (BURIED I 60, •�oTs) 5YR5/6 SILTY T - SAND SILTY 5YR5/6 I �L , 14' i SAND 4120 NO WA ER 0 NTEREo OBSERVATION PIT TYPICAL 1500 GAL. SEPTIC T PERCOLATION RATE: S 2R'i n AWL /VOT '70 5(,4Z.,`- OBSERVATIONS BY: GERALD DUNNING NOI-E TANKS REINFOf�CED FHROUGHOUT V. TOWN OF BARNSTABLE .BOARD OF HEALTH ELECTRIC WFL[)ED WIRE WITH 24-1 ENGINEER: ARO ENGINEERING INC. EMBEDDED `)TLL:I.- RODS ,IN TOP F3 B' DATE OCTOBER 12,1995 TOM. CON'"RE T E- I'; 4,000 P I 11.ST O ID U-) O T O 1 102 s 0Y (U S 17'29'33" W -Ts 151.08 1�r. OD co CA OD W �' D SMH T �5 � ... Ste"" i J— R!M-2O.9 I�, Inv Ie•18.70 �9•" i 4+►' �::.' '. ��t 9 �EO O Inv ou0t•d�6� 2 �' ..,•: 6 *"8E RE 2 Ts 2 N EXISTING CESSPOOLS AND : . �n LEACH PIT To Of PUMPED- �"'�(01 u� V' OUT AND FILLED IN �Kh�y1 �"j'� cn SEXIST. �� 1 ' ' CESSPOOL \\'.`:\ ®�t 'l'a G_� •_ J. I \\.z .\ �s ' To e� 7�F 17 45'50" W • �.�\� �; rs� 36. t1' 1q�76 •` \ 1 • ' PROPO9Ep `P I500 GAL 61 P �`, /i.a � SEPTIC TANK 01258 y . 16 EXISTING x. EXISTING BE I DWELLING . \ TANK TO 8E �" � .. PUMPED-OUT FI.EI.■21.40 AND REMOVED— �p •\ ,. tD 'GEMT. \ .'8 . O rn LEACH PIT E 1 \ �' e6 28515_sf 6 PARCEL 81-1 3 I Wo, NI 45*16" E g 6 CRAIGVILLE BEACH ROAD J I� 69 Town of Barnstable *Permit# Expires 6 months om ' e date * ; Regulatory Services Fee EMANSTA33M . Thomas F.Geiler,Director i639. Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY q Not Valid without Red X-Press Imprint Map/parcel Number U� / Property Address Residential Value of Work$ pr,5-0®. — Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name--, rQi7 Telephone Number Home Improvement Contractor License#(if applicable) /0JW �_ Email: 4 E 'Calf Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance SEP 10 2013. Check one: I ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF BARNSTABLE ] I have Worker's Compensation Insurance Insurance Company Name XC/C Workman's Comp.Policy# � �` SOU g�t'nit�13 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Q� Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. (Zq;pired. y of the Ho rove nt Contractors License&Construction Supervisors License is SIGNATURE: QAWPFILES\FORMS\building permit forms\EXFRESS.doc Revised 060513 q . ..-- the Commonwealth of Vassachuse is Depar Meet of liuks l Accidents Owe of investigations s ... . ' 600 Washington Street Boston,AM 02111 wivil.7nass.govIdia Workets' Compensation Iusnrauce 4 idavit: Builders/Contractors/ElectriciansTlumbers Applicant Information Please Print LegibIX Name(Susinessl(hgaluzationlbndividwl)_ Address: ,357 City/State/Zip: nV//d Vr�W�C.�/ �� /`/ �as�7 PhMe ik i/✓� � C�/� Are you an employer?Check time appropriate box: T : o#, o ect r 4. I aroii a contractor and I 3'i� 1?�' .1 (required): 1..,l I am a employer with � 6_ ❑New won employees(fu11 and/or part-ime)* have hired the sub-contractors. 2_❑ I am a sole proprietor or partner listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition w forme in an c ct �- employees and have woticers' orhCing Y � 13 1 9_ ❑Building addition [Nn.worken' cutup.insurance comp.insurance-1 5. ❑ We area corporation and its 10-.0 Electrical repairs or additions ' 3111 am a homeowner doing all work officers have exercised their 11_0 Plumbing repairs or additions myself [No workers'comp- right of exemption.per MGL 12_.❑Roof repairs insurance required,]3 c.152,§1(4),and we hzn p-no employees_(No workers' 13_❑Other comp_insurance required-J. *Any applicwt that checks boa#1 mast also U out the section below shooing ilea wod us'compensation policy ix&rmxiam. T Homeowners who submit this affidavit indicating they an doing all wade sad then hire outride couttactors must submit a new afizin t mduatiog mrh- jCbnttactors that check this bax must attached an additional sheet ebotirmg the name of the sob-contacton and state whether or not those eNities have ervic gees. If the solo-contractors hwe employees,they must provide their warkers'comp.policy number. .Taman employer that is protdding nwrkers'compensadon insurance for my emptnyea s. Below is the policy and job site information. _ Insurance Company.Name: Policy#or Self-ins_Lie- �CG SI�OSrUt�F1 SCE l o?o/a Expiration Date: �d a�/ Job Site Address: &� Y a Aaoyl 14 City,'State/zip: ✓`Z �i��i� /; Ua�a 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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the foim of a STOP WORK ORDER and a fine of up to S250-00 a.day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Im estigations of IA fDr insurance coverage verification- I do h by certi ti th s and pe akies ofpedury that the inforttmation protzdfed above is trio,and correct Si tune: Bate: Phone Qaki l use only. Ili not write in this area,to be completed by city or town officiaL City or Town: PermitUcense# Issuing Authority(circle one): 1.Board.of Health 2.Building Department 3.Cityffown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other _ Contact Person: Phone#: 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 IocaI 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-coatractor(s)name(s),address(es)and phone numbei(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. "I'lie 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 permitllicense 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 lice 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 kvestigatiom 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 at 406 or 1-9 MASWE Revised 4-24-07 Fax#617-727-7749 www.ma,.s&gov/dia r 7 e J OpTHE T Town of Barnstable °+ Regulatory Services qsaxiv i EMAM ► Thomas F.Geiler,Director .40. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and7 Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name /Z-3 Date QTORM&OWNERPERMISSIONPOOLS 62012 W pkjKE Town of Barnstable Regulatory Services sw BLAM iE Thomas F.Geiler,Director �E16 9.�• � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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 shall be responsible for all such work performed under the buildingpermitunder the buildingpermit. (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 cons6ucti6n 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\ContentOutlook\QRE6ZUBN\EXPRESS.doc Revised 053012 Client#:22235 2LEDGEWOODMA DATE(MMIDD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 09/09/2013 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 CONTACT NAME: Dowling&O'Neil PHONE 508 775-1620 FAX HONE No Ext: AIC,No): 5087781218 Insurance Agency E-MAIL 973 lyannough Rd., PO Box 1990 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Hyannis,MA 02601 INSURER A:National Grange Mutual Insuranc INSURED INSURER B:Associated Employers Insurance Ledgewood Manor Corp. INSURER C P.0.Box 617 West Barnstable,MA 02668 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. �TRR TYPE OF INSURANCE NSRADDL WVD POLICY NUMBER MM/DDY� MM/DDY� LIMITS A GENERAL LIABILITY MPF7998P 8/15/2013 0811512014 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED r nce $500,000 CLAIMS-MADE I OCCUR MED EXP(Any one person) $10,000 X PD Ded:250 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 JECT LOC $ A AUTOMOBILE LIABILITY M9F7998P 12/31/2012 12/31/201 EeacccdenSINGLELIMIT 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident A X UMBRELLA LIAB X OCCUR CUF7998P 8/15/2013 08/15/2014 EACH OCCURRENCE $1 000000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I X RETENTION$10000 $ TORY LIMITSB WORKERS COMPENSATION WCC50050085012013A 8/18/2013 08/18/201 X WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N - E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500 OOO If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT s500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) David E.Thomas is excluded from the workers compensation policy. RE: 1248 Cragiville Beach Road,Centerville,MA 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 Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 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 #S117135/M117133 KKM Massachusetts-Department of Public.Safety 1 Re ulations and Standards Board of Building 9 - , Construction Supervisor Licenser CS-001714 Y . DAVID E THOM89 238 OLD COUNTI RO© 137 EAST SANDWIcit Expiration 0612312014 , Commissioner � rct�ccc ace -. f, V/aea�rcnua�eureal a�P/j� ire �;,' . se onlyLicense or registration valid for individul u , •� Office of consumer Affairs&Business Regulation before the expiration date. If found return to- OME IMPROVEMENT CONTRACTOR Type Office of Consumer Affairs and Business Regulation. - Uqegistration: 102026 lO Park Plaza-Suite 5170 tx iration:f>613012U14; PrivateCorporatiy� ' p _ #. Boston,MA 02116 "� _ ' t- LED:GEWOOD MANOR-COR y t 1 DAVID THOMAS ` ,_ ^— '�' 238 OLD COUNTY RD 1 E.SANDWICH,MA 02537 - Undersecretary Not valid without signature C o� �2 CraA 1 U t t i t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel w Permit# ' 4- Health Health Division q!i"i�R w ® 4, 13�,F�.s5 1ABLIE- Date Issued - ,Conservation Division fJ b W03 Jpl,? 1) /PL����'3 53 u r Application Fie © ® C7 Tax Collector, Permit Fee Z6 �7 . �----_`SEPTIC SYSTEM MUSS'QE Treasurer t11�/;ti,fC INSTALLED IN COMPLIANC . Planning Dept: VI'Th V TITLE. 5 Date Definitive Plan Approved by Planning Board EWRONMENTAL OODI`A TOWFM REGUL& 1104`�"3 Historic-OKH Preservation/Hyannis Project Street Address �[ (2 )6'///11C 46-27ew 4 Village Owner /(ETf44- �4-VI,7<& ( , l4 Address cw////� -`al Telephone Z Permit Request \/9D�tT< r &—momn , AMOVZU Sc) 12c 8Lj/1_DvN Square feet: 1st floor: existing proposed 3�9 0 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay > Project Valuations rho 6&e Construction Type 4)0,0�D FItAM&c:� t, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 29 Two Family ❑ Multi-Family(#units) Age of Existing Structure 6'd YeS. Historic House: ❑Yes ®No On Old King's Highway: ❑Yes 14 No Basement Type: 19 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 V S new Total Room Count(not including baths): existing 9 new l First Floor Room Count .� Heat Type and Fuel: A Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes W No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:a existing ❑new size Barn:❑existing ❑new size Attached garage:;q existing ❑new size Shed: W existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ®No If yes, site plan review# -Current_Use. __-- Proposed Use _--_ BUILDER INFORMATION Name Zzuevzrb Al';x ��j4 Telephone Number �A3'e1S Address 86*� License# C6 00/7/1V Home Improvement Contractor# lDa o a 6 a . Worker's Compensation# kJC S003��3914 6/ Ro ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _ /9�G9�/�C �U�'iZ-- 45',Awlb4,1c,00_ 11,9. SIGNATURE DATE 9Z�f�G, FOR OFFICIAL USE ONLY r t PERMIT NO. y DATE ISSUED MAP/PARCEL'NO. ADDRESS VILLAGE {? OWNER DATE OF INSPECTION: FOUNDATION `4,Sbv� u�e FRAME ���" 2� 3^ p-A CL2, INSULATION A FIREPLACE . ELECTRICAL:- ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDING ' DATL CLOSID OUT ASSOCIATION PLAN NO. .• ti i The Commonwealth of Massachusetts Department of Industrial Accidents == = Office oflnyestfgations . 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name 1/24Na ©2 location City A • o Phone# ❑ I am a homeowner performing all work myself. ❑ I am a, le r netor and have no one workii iiin capacity /%%%%//G%%%%/%%%%%%%%%%///%%/// .. I am an employer providing workers' compensation for my employees working on this job. :.:....... ................. :com an ::name:;::>:>': :::: .:::»' . :': :... :::�:'::.:::•:;;':�;: : • •:; .; . ' 5.. .� ,.. . .. �::. :: ... ... .. . hone# :...::: . :< P:>:':;.:::.::;:•::<::::>:;:::::<>.. tftr�...#...._ .::......_.... ... ......... ...... :.:. :.::::::.::.: ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: .$ '' ' ..... : < ?N< < ?+'j?>isi i;? <i�i'i'is '{ii;i i2%%S'isi i ji is%f ?if?`�+%> :f ii i .i•`:?> .:.......; :xom air n adress..•.:::....... . .. :............... 3. one: S i?S is i<i:iii`•"3' ?r? i'??^ %% 2`ia< i_i•;'•ii't"is?: ? iti:':'<'%%':` `sU ....;.;,:..•;:..�.;:;.�.:.:.::..::.:.:::.....:.:••>:.::::•:::}::ii:•ii:•i:::o::�;:�::?;•:::Y;:;:;::::<;;::;;;:;::;:::;r;:-::<•;:.;::•;x;•:�:•::•>;:istii:::;•>:•:�:;<:•;:<:::`;:;::;::;:i:•i:•::•:;;>:;: <•::::.::>:.::>?::•:::.::•::. ::•is:i::::%::f•:::::::;::::;•r:::; ?;:;:;;:::::::•:::•:;:;::::::$':3::3Sii3:::.:,,:::�:2::'<:::i::::�:::?.;:t`.i:::::>::: ;inslrran ....................................:::.:....::::::::::::::::::::....:::::::::: :.... ::::::::::::::::.::::::::.::::: :... ::. ...........:... ;:riam :ad :.:..:.:.::..:............:::.::.::.::.... h II .......................................................................:.:..................................... •`•.'? ?iiE:''•%` 'i•`.?i`;i'i?? ii .,..1'..._�. ,a. . Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereb ettify u the d pen 'es of perjury that the information provided above is truo and correct Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# []Building Department f. - - ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office OHealth Department contact person: phone#; _ Other (revised S 95 NA) ' Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral'or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of e and including the legal representatives of a deceased employer, or the receiver or the foregoing engaged in a joint enterprise, g g p . 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 of such employment be deemed to be an employer. ant thereto shall not because building appurtenant MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of'Compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the boxthat applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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 as workers' compensation policy,please call the Department at the number listed below. ME City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permrtllicense number which will be used as a reference number. The affidavits may be retume''in- the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 1 Town of Barnstable ti Regulatory Services STAHn S& . MAss. ` Thomas F.Geller,Director a 16119. 00.� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date , AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: P41)i%/(A Q" &MaZe ?�c/ Estimated Cost 70000. Address of Work: /off cY (/1 A/e510a/� 8CA"l7 Owner's Name: t ice'%� ( 0-S%/ Date of Application: I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 OBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALT OF PE I hereby apply for a permit as the agent of the owner: eleb6- � Am rm,�a � ioa oat Date' Contractor Name Registration No. OR - Date Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings_Additions $50.00 moo. ® o Alterations/Renovatious $25.00 - Building Permit Amendment $25.00t /�D S FEE VALUE WORKSAEET NEW LIVING SPACE Q square feet x$96/sq.foot plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= plus from below(if applicable) ----- 167 -73 GARAGES (attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming-Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) / .— Y —S • Permit Fee,_ / � e T{o CMK Appendix 1 Table d3.2.1b(continued) prescriptiye packages for One and Two-Family Residential Baildlnp Heated with Fossil Fue1sN MINIMUM MAXIMUM g� Hcuing/Cooling Glazing Glazing Ceiling Wall Floor Basement eses Equipment EtHcicney' Arcz'(1/0 U-value' R-valuej R-value' R-valuer Rw� t A� � ue Pack&Se 5701 to 6500 Heating Degrre Days' Narmai 6 Q 12% 0.40 38 13 19 10 6 Normal R i2% 0.52 30 l9 19 10 6 85 AFUE g 12Y. 0.50 38 13 19 10 N/A Normal T 15% 0.36 38 13 25 N/A 6 Normal U 15% 0.46 38 19 19 10 N/A ES AFUE v 15% 0.44 38 13 Z5 N/A 6 85 AFUE Rr 15% 0.52 30 19 19 10 N/A Normal X 18% 0.32 38 13 25 N/A25 N/A. Nantsai }( 18% 0.42 38 19 19 13 19 10 6 90 AFUE Z 18% 0.42 38 6 90 AFUE AA 18% 0 50 30 19 14 10 1. ADDRESS OF PROPERTY: Z. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4, %GLAZING AREA(93 DIVIDED BY 92): 5. SELECT PACKAGE(Q--AA see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: EYES: NO: q-forms-f9.80303a `. 780 CMR Appendix J Footnotes to Table J8.2.Ib: lass doors, skylights, and I Glazing area is the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 if of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. The ceiling•R-values do not assume a raised or oversized fruss construction. If the insulation achieves the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity. insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-franie or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. s The floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 11 The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement dt-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package, . 'For Heating Degree Day requirements of the closest city or town see-Table J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). F THE T°�Y Town of Barnstable - ti Regulatory Services snaxsrnsLE. ' v MASS. $ Thomas F.Geiler,Director fc39. �°1� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section, If Using A Builder I, Z- 12 7��{ as Owner of the subject property hereby authorizee��/dJQt ale to act on my behalf, in all matters relative to work authorized by this building permit application for: 1.2 (A at LL e (Address of Job) y Signature of Owner rti Date • �d•��� s, Print Name r Y r. a tr y ..; .. y, f a ., ✓ � a M art,✓ ,... ,e x'«.' '�. 1 a Q:FORMS': W RPERMLSSION r a °FTMEr°�� The Town 'of Barnstable 4 BARHSTABLE. ' Department of Health Safety and Environmental Services '. - - MASS. Building Division PEED MP'�a• , 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 r PLAN REVIEW _ T Owner: _C�S 44 Map/Parcel: 2 0 (�'D Project Address:lLV' � 1 f+ A0 C�BUilder: The following items were noted on reviewing: 12 c-+ n 1 ci e e v N U ev, U 4 : r A _ t *_ r w wi a Y a • e +a . Reviewed by: "'' j• Date: P7, Cp--(� #uilding:forms review r BOARD OF BUILDING REGULATIONS . License CONSTRUCTION SUPERVISOR Number CS 001714 . .; Expires 06/23/2004 Tr.no: 25065 Res,,, d::,00 . DAVID E.THOMAS, �- 238 OLD COUNTY'RO EAST SANDWICH, MA 02537 Administrator l Board of Building Regulations and Standards License or registration valid for individul use only x HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: C = Board of Building Regulations and Standards Registration 102026 One Ashburton Place Rm 1301 Expiration '6/30/2004 � _ .. Boston,Ma.02108 t Type Private Corporation LEDGEWOOD MANOR-CORP. DAVID THOMAS a 238 OLD COUNTY RD E.SANDWICH,MA 02537 s a ?u + "lsl:; " ►,�:��<«,A" +tier° �-. - -i7���� m ap .� 'v d • d 7■ ■ . ■ . 1. �4 I, �■wwA\ �wmo�■ rw �r\Nw■ rawr� �■wYw vas_ r\. �rrmlrwrl �wlwr\ wrv\. �r��rrr� \wYwwlw J ��■�w•r� �Yww•® i rY.Yww\. uwYYrlrwY■. ■w��rlN'- w�>•NYY!•tOs��� r�w■wrr I - woi ®ii OYY■�Y YY�Yw i C�� �wr\mw�r --- - ' loll Ell -777 �1����■�I YrVt®YID �� 0 �YY� ����w�N u!� - - - wmwN� w� lww.wlN� YYiQiIN� ■ ®�_w■�O Ing omm® 'w■ �uwUti■a'e r�ri w I �r�rriar ❑ w�wot4 iY ®I�r �AR� �wr m■m.. \ �� ®wwwN �r iwnowmww �l�BI Nm ■n►aww �y NYYr♦YNlrl wo® ■Yw �l'Nwl AOr� �wwlwlm mmwwfr■P_.._—._-' wmwwmwY .rsawow �me �r■mi■n _ rwrmrwloNa �Bi��we• � � IEi�e��l ���rnii '�� ir■®� ... rurm.wwYY�YwYwwmw wuwwrm�nr N�®YYw®ar■ u \m1Aw ra■�w\r�w.9r�aw®wY®�� \or urrmwwrwwp�wYwmw�®wOwm�ww♦ ',mrmwwww� V� 7om wwwrwrw®rv,®wmrr I�� R' h,-a rrsTpy�t —tzsF-c — - czEr>;aPM- -- 0R,1,_�NC7 LYL.fi. =TQ 2.``n�t_ t�I1.n�Fag�a�ty 31-4csu= —F Fi t'O-F*�—TY�T FTE .j•T Lz Pa-'t-z�'ir, c..,c"�'t���'t'FSCS-c-_'\-s-ta ly . nt-Cj -EP-Peaan4 N.EyJ_$t-_ <�, A `� NEW 1,:11�tt1 Z _ -In Tu� .51 _m � O u\ O m '�•s SS ,��� �„�G�T1d.E.DRAC....GEt�tN.C•�O ,. i� a .. gErnvv� :Epxit-rl.W G No 2-V P.P�a_e�s_5:Era-Fsn n i T'rp�4 - ' C1M/ 7 -- —.r Leo:_1311L1 1+eAD T`f p i _ N dl — _6 � n 4---:.rsu — :P--C'-� �1- 1.. ��rrC:oNST2eTtts �4aAtL�SE �I CaN r 6�Ti Fje��� Et�l 1!o° - --FCrPo NtriF1 C.E U,7 T'II� ALMAhyAC"'c.H LOGA.L'Tovatil f15El!'i .O.WmaE 0U\LD\NC� GO E ANC> — 2_ Al 1 D\MENS�OtJ.s jW.ta�L 6E �lERilF.1:E� ©u -r*H E.. Crnlnl EFS5STjaf`"a @�r <Cr7t,4PA EL COwITF�AGTO. .. PFSIOp� TO T'H� 3. A>_t_.ro UN l o N...K00-r,:Rl r S S:N ALA-,.e�E- _..—F�LltlbEt�.'�1 tl�cptsnl�-c�u�.u1Ta�c:E: .. L -._... fAS'PFl"JKC1`...,5'F4f1.1LE5- 1 1 N IAR 2x4."STUPS@1[."0.�_ .e--5w T: z .:ate —._ 1I'L .G ox i He 4Tt4 I uC9 _ :14TN 0 •h,c r2.::zi-o I g T.17:(?_..12--o.G o 4:x U" :$ILL_) F.T.: 9h-C 1.�5�fi:9- 5'C1�TE. 6C:LLLP1-f:1C� C.A_D..E A:N�: _TOWriA5 taRC7 . 21I A DiIvtENy'f:DIJS SHAIe BE vEFy:iFIE>" `! T711^ oWrIE35 :A "D.:' �. ' f"C�E�FFI?i.AC, CQN:TPIAGT.O% I"P210%TO. THE :5.T9FiT_.OP..GOFIST.P�LLGT�_Oh,t� ��' I � !'" 1 I. I , C6�E==QL1,4TJ=. L:ASS'S1� _P�SU' h!•-_QP�!' ':_ ': S;:.p.YA_1...:p_ _1�f:I:GM�.E�.�. P��::FA.-�CPa1- '� 4:: .'.LE, ...I�: I G ':PI?3OPoSE.IQ -:AC9PIT.;I Ol�l''Y"L?'.5'1E�'. 16.:GE�faIC��l11-E Yi"Gs4H HJ4—SN 1_C Z °F SHE A ' : . •/jr The Town of Barnstable 9 KAM Department of Health Safety and Environmental Services �10 P Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION leg y//- I G# 2) Location of shed(address) Village /�.�%r�✓c+�t .�.Mwt,G�4t-,6c� I7.r1�c�va��►tTs � 0AF— Property owner's name Telephone number Size of Shed Map/Parcel# �' DO Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction?. Conservation Commission(signature required) . �' W PLEASE NOTE: IF YOU ARE WITHIN TBE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM,MUST BE ACCOMP D BY A PLOT PLAN Q-forms-shedreg Assessor's map and lot num .......�., f` AG431 _- THE ` Swage Permit number ...............4�a ........ cd... tidouse number 11T1.E 5 �YAY�\ TOWN OF BARNS " '�' ' �Tpl BUILDING INSPECTOR R S APPLICATION FOR PERMIT TO G� .0 .. ...................................................................................... �� /f TYPE OF CONSTRUCTION ....G.!�.�.U..JI........��.�.�.....................................:......................................... ................19<.��. . TO THE INSPECTOR OF BUILDINGS: .ram _-..-R•.........:-.n-..n.-.wn.-..w� .. Ms. � - The undersigned hereby applies for a permit accor ing a Location ... .. . ................. ...................................................................................................................... ProposedUse ... ...... . ........................ < .....��-�/ "' l�� ....................................................................... ZoningDistrict ........................................................................Fire District ..................................................................... Name of Owner O c/�1�f YrC�. .�............Addresse.... /./P .. ......��.C!�1, Name of Builder . . ......U� ... Uf .. ...................Address ........ T£�r.�'1....... ...... Name of Architect ....Address Numberof Rooms ..../..................... ....................................Foundatio` rim .................................... .... ..................... �G? Exterior ���d.........��....�� ............................Roofing ... .. ..... ...,...�.:Ll ....... W........... Floors ........... .................................................................Interior . ........ ...�aP Heating 1i�:.... ............................Plumbing C? .Q . �...A,A.............................. Fireplace .. . .. ................................................Approximate Cost to.�.�.........d...... .......... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area (l!Y.. f...,- ...... Diagram of Lot and Building with Dimensions Fee / SUBJECT TO APPROVAL OF BOARD OF HEALTH •1 J, f I E I hereby agree to conform to all the Rules and Regulations of the own'of Barnstable regarding the above construction. Name ... .... .... . . ................................ 4 ^"^^"^^^" Gordon ` ] t � ! ^�� . ~^ / ' .682 remodel dwelling ~�� � No --.���— Permit for --^������—�����.- � ( ......... \ Ho Location --- ahoa._Laoe________ . � Centerville . . . --------------------------. ' | ' Qordon �orr�z�1 Owner ---_—_______-----_--'. �ro�e . � ` Type of Construction -------------- ' rr --_. ................................................. \' ' | Plot '. �� ................................ / --------. ^ ' ' \ ` Parmit' Gronuyd --. ..2b......lA ' 70 , / ` Date of Inspection -----------']P | -~ Date Completed ...................................... ' ! / ' ^ PERMIT REFUSED } ' u 19 . . . � .................................................. � i ' | ' ----' | � | / ---- - �y ----. . . . . . . . / ' ` lQ ' ' . ............................................- . - �� . � —..--.—.=--~~—.~~...--,—..----.. . � . ----------------........—.. `--. , . ` �� '1C7 Assessor's map and lot number ......... altLl S, umber ... ewage Permit n . ... ........... BARNSTIBLE, ,c*se number ........................................................................ MA81L 1639- 0 TOWN OF BA RNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... ................................................................................... TYPE OF CONSTRUCTION ....4&2Z�...... ................. .................................................................................. 75� ................19......... TOPTHE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location /4 ............... ............................................................................................... ...................................... Proposed Use ....... ......7e<�.-, ..... ......................... ... ....................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. 1 . \ '_�gfCKC11 .............A ........................ ............... Name of Owner ........................ .. ........... ddress�,..� Name of Builder �.141_ of ...................Address .................................................. -Name of Architect ..................................................................Address ..................................................................................... Number of Rooms ...7 Foundotion`---..6'V ...........0......................... Exlerior ......... ..Roofing ......447-e?.-I.;.�.�.I.,�...V......./.../..... ..................... . .......... .... ... ... .................................... ..... . ..... Floors ...... n te r i a r J ........................ .................................................................................I Heating ............Plumbing ..... ............................................................. Fiieplace ................................................Approximate Cost ...........................I.......................... Definitive Plan Approved by Planning Board ---------------—---------------19---------- Are. chl..W/ .,e.......... Diagram of Lot and Building with Dimensions Fee ............ .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH A I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 7.................................................. Name ..,................ Torazzi, Gord A=206-81 A, no 216�JF P. Y. remod6l dwelling No .............. rmit for ........ ........................... ............ . ;53 KS Location ................................................................ Centerville ............................................................................... Gordon Torrazzi Owner .................................................................. frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ... ............................. 40' Permit Granted ...........3�.p\te b e r ... ................ ....19 79 Date of Inspection .................. .................19 Date Completed ................... ...................19 PERMIT EFUSED .............D1. Z........... ...X..A. 19 ........... ... ........... ................. rill ... .. ... . .............. ... . . . . ................................................... Approved........ 9 .................................. .................................. ................. ............................................................. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' r -42,3 Map . 0�0 go'' Parcel Dk/ 6 el[ Permit# Health Division ��/� �'�/d��, +" -.Date Issued 1 o ` 90 Conservation iyi 'ori 'Ilhpjql Fee 7• ;2_0 Tax Collector. y I ` Treasurer 'PTIC,SYSTEM MIDST DE x STALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board - ENVIRONMENTAL CODE AND 'Historic-OKH Preservation/Hyannis ` TOWN REGULATIONS Project Street Address sVillage ,Owner C�Cgy�t2-�T-e ��hu N/Ul C1� r Address' p >CQ , x ICE Telephone Permit Request °C�ti Cif �?,�C,CZ���,� �-J cam.�w� pc:2c . J GTea JC ,�o\ l_7 ��5 ANY 1, `�,v i�e_ n Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost\`Z 000 Zoning District Flood Plain Groundwater Overlay Construction Type �� L 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 Highw ay: .❑Yes L 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 w Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No \' Detached garage:❑existing,O new size Poll%existing '►J new size t2� Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size' Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded LJ Commercial ❑Yes--'S No .If yes, site plan review# Current Use - Proposed Use BUILDER INFORMATION Name nAct CbW iz_Aj Telephone Number L�_,:�b—l46 Address License# 'e)u;)_ NI Home Improvement Contractor# Worker's Compensation#W L�) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN'TO rnQ - r ) ; SIGNATURES DATE \��Z<�� ► • s • r FOR OFFICIAL USE ONLY "PERMIT NO. =DATE ISSUED` _ A � - i _ `. T • Y . - r, : . - . ° F- f ' r ' - "` ' 1r'a i. - .0 ♦ l f . 1_- ! ,,.-`} ; `- ,•r MAP/PARCEL NO. ADDRESS + �' VILLAGE " OWNER „ €� ! DATE OF INSPECTWN:: FOUNDATION FRAME j INSULATION FIREPLACE ELECTRICAL: , ROUGH FINAL + _ PLUMBING: ROUGH r_ �o FINAL _ tr GAS: ROUGH 0 '7 �, _ � FINAL r r �. ®. f f FINAL BUILDING fti3 0 rn fico t"! DATE CLOSED OUT ,a) C! 0 - ' - ASSOCIATION PLAN NO: f s t' ( 9 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 ffrce: 508-862-4038 Ralph Cressen ax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work 2tiV C6ot4n C o\e ls�Z A-w 1 Estimated CostQ-�000 Address of Work: Owner's Name: 9R Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:fomis:Affidav --_: The Commonwealth of Massachusetts L4.a ==_ = Department of Industrial Accidents ONCe otiff restfoattofis 600 Washington Street Boston,Mass. 02111 CoTyensation Insurance Affidavit . ... /Mwf� r�����r ri � name: location: ` ,2 city �a� y,��Q M� phone#�30 ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one workin in any ca acity ❑ I am an employer providing workers compensation for my employees working on this job. companv name: address: city: nhone#. `-1 c insurance co. Co Policv#OC3--M% lL•i' r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors Iisted below who have the folloning workers' compensation polices: company name: address: city phone#� insurance co. ;::;:,•;.. oiiiiiaiiaiaiioiaiiiio�iiaiiiioaiiiiiaiiioi�iaiiaiiaiiiaiiiiiii//aii�aiiii� .. .::.;.,.:..::. . company name: address: city- phone M .......:.: insurance co. :::: .. ::::::.... ....:.:::..: Rolf cv# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to SI.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and aline of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Ofilce of Investigations of the DIA for coverage verification. I do hereby certify under the pains d p allies of perjury that the information provided above is tru.-and correct Signature � r DateCic, _ Prmt name official use oniv do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: - - phone#; ❑Other . . . ....:.... ... ...,...... ..::.. ... (hasp 9;95 P1A) �`t��l'niRs• Structural Design Approved _ S only when installed in �-IO N'f strict Accordance with ?, , Th+: r � / �`R �r..0 Manufacturer's Instructions s CIVII 1.�r^'1. T. Walker. P.E. So 1�No. 313iG ]j 1$T MAX.SLOPE/SON 7. fsga�IrJit ��� V✓✓ �`` ,. .• COPING LAYOUT ` /2' /D'—+� sonata 26'/" /qr L= �W 2' PANEL LAYOUT 1'X1RhptpS e 7r >� /2r .Ij—'-- 7r�—�i X•9RACE ZAX SLOPE !'ON 7'. Pool Pool • - DtTA0.A INOaaImsEPAD. Area Capacity Glum ak ann eat-WARM Mort a`r` . 36Vt a '.;^ NON DIVING POOL Sq.Ft. Gallons Use of diving equipment prohibited Via.varuartn .nsrsrMU uwa rrrea A.WVM .. THIS BROCHURE IS FOR 1LLUSTRAINE PURPOSES ONLY . , MOVED M."TM The anufaear mike s es orgy V,oae representations which are stated In Its written warranty.Any other - - et' Poll EDITION :POOLS rewesentalions.statements.at contracts made by the dealer and/or the contractor to the customer regardrq any materials produced by the.mranufactwer are ettril ulabte to the dealer and/or the contras - tor only.The dealer or contractor who sells or Installs your pod Is an Independent contractor and root an 14' X 26' RECTANGLE agent or employee of the manufacturer.The construction methods Ylustrated are suggestions and apply r cagmt tooru hi••rot••tr r . only a normal ground condition:Thws may be additional precautions and/or methods of conslruction strluro 1tAtt The responsibgitylame contractors. wow>r 2' RADIUS CORNERS r tonow wntlW tor•.la•ar as - iaqwnmmw SCALE: NONE 1991 R J � w pGGL __ gQQco�c. 2 oec�c , .. 6 x IlO 4 Tp oa5D DEL\� QCZ2Q DO . ill atx s k 7^ai .S�'t. r , ' � or�E�,o�.rfLeae�tted3 § � tIMPROVEMEHT=CO�VR 'f 87'T Low ai k"°'"Mstw" ',' iOYHARWICH ✓fie v�o��nw�uuea�/ a�./�.avaac�ivaelYa BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 062015 Expires: 04/22/2001 Tr.no: 8789 w Restricted To: 00 MARK J COLEMAN 2 BARKLEY WAY G »� / N HARWICH, MA 02645 Administrator'. i r • E.j, BRB/SEAL . •' -R � - UTILITY POLE - FND - YARD LIGHT BOUND = STAKE & TACK SET r = MAG NAIL SET WATER METER GM = GAS METER T •: .. • ° EM = ELECTRIC METER -. a•• �•` • ' d„w-«H.-«�- = OVERHEAD WIRES Q •. ' 1^ = TREE LINE ' •••.•. 16.0 0 = TREES & SHRUBS 16.6 Ln 7.6 W/F B-1 Ld CONTOURS ` -i o0 a X 100.0 = SPOT GRADES z� � , : ,�t, ,• ` a EL = ELEVATION 16.3 16.0 70 s UP = UTILITY POLE •`o ; r' ' i 14.9 ----- CB = CONCRETE BOUND °`s3?60 w - s N� '� DH = DRILL HOLE ' l' 162.02`� 0 W BRB = BARNSTABLE ROAD BOUND LOCUS MAP SCALE: 1® = 2000' ' a �� 13.4 • F B-2 " ° i� 11,5 �� _ 1 " ,,�o /E M EOP _ EDGE OF PAVEMENT IJ 15 7 ` \�� ` �� 20NE 1 ' .4 •/ �'�� 8 BCC - BOTTOM OF CAPE COD BERM I 16�4 EOP ` A 1Q W/F 3 Q 16.e 59 13,9 �\- o _ =1.0) w/F B- �/ - WF = WELAND FLAG 16.4 , ,�- ,oP• w/ B 5 LSA LANDSCAPED AREA 15.E 17.0 01?SE SI-jo - uP�l 2 �, � -' 12.a � � ` _�.�� FND - FOUND 1, 40 �� ti,, R' \ 13.0 ' __ - HIDE pUB. ,'-� LAIVE W/F B-s PROJECT BENCHMARK: DATUM = NGVD o i r • ti'L \• - -_ 11, V'AY Ol 1.0 10,3 12.2 . S 80•33•26. E 1858 1AYo _ TBM = MAG NAIL SET IN PAVED DRIVE ® ELEV.= 21.08 loll CV W , LAWN 15. ____ '_ 1 _1g5.1g• BRB/SEAL _ ZONING DISTRICT: RD-1 (W) & RC (E) _ ___ B/DID 11.2 RD-1 o rr! / �8 _,tAFiDSCa►eEtr - - __- ----- ----_ _=_ -- - -_- -_-_---- - 3 D �2 _ MINIMUM FRONTAGE: 20' O ls.e� 4 '/ - _ "/�2EA " 21;8 --- _ - -_ __= _ _ - -,�� 2 .p�• R ~� MINIMUM WIDTH: 125' o , 16.5 18.8 _ _ 2�';�---- -- --- -_- 13 1 ors - - -G __ -� 3 4.8 8. FRONT YARD - 30' SIDE YARD - 10' REAR YARD - 10' 2.41 22.5 U1WN -- -X _ - '� o 4 W/F B- `�, , c 2L6 i 22,7 x�4`S� •� � sr 70 s,8 RC 17.2 ; �; 3 5 4• , O /�, 22.8 CpNCR 21.9 -�\: 15•b,� sp, MINIMUM FRONTAGE: 20' o , �1 47 S s / OCA�F 22.9 PAD 22.6 - , - qi)? 9.7 o MINIMUM WIDTH: 100' - - 3 �`L �= ` J- ANK 22.8 POOL 22.2 / , 22 8 '� ) '9s� `'�• STAKE/s FRONT YARD = 20' SIDE YARD - 10' REAR YARD - 10' ' v o 7 �� w 2.s Ho f \`- 22.6 �� \ OVERLAY DISTRICT AP (AQUIFER PROTECTION) o it ~I � / / 22.5* pOD 22.9 1 x 221 i 0 /y `�O z , , / r BRICK '7 , c�,� o OVERLAY DISTRICT RPOD (RESOURCE PROTECTION OVERLAY DISTRICT) r� / �I 20.9 22,43• �5q DECK ?2.9 PA11Q SWH 22.3 LAWN 23.,/� i / , I ��o LOCUS PROPERTY IS SHOWN AS: r `�► _p N r r / 22.4 21.8 �, l 4 C - r � ASSESSORS MAP 206 - PARCEL 81-1 rr ti ao/ � � I fXISTjNG L 1,9- III � �i tiF wN , o • I I ' DEEDSBOOKD 14408 PAGE 99 r Q 22, N°• 12�` C / LAM�SCAPED i I O ) i' / i i I I o ' ,� ' \22,4 PORCH a - 22-3 AR EA1 I PLAN REFERENCES: ,' , I\ �., / MAG LET / 7.4 PLAN BOOK 337 PAGE 59 20', 1 f* Sl* Fr. \ 22,4 \ 22• �' •� �, \\` 2� 3 /2 �' r �� INVERT EL.TIC 024' PLAN BOOK 147 PAGE 11 EL. 21.08 �� . • 3 - S' 2 -16.5 i�`9 2 ' ; l �1 22.5 LS�I 22 V / x 21.7 1 / o Doi / I o ,�, ,Q\ COMMUNITY PANEL NUMBER 250001 0008 D l x 20.9 ,/ a ; ` THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE C, UPS 106 BM i Oy 16.7 i 1 \\ �``22.1 22. y 22.3 21.7 �� ^ �j,,- O BQ \ , ft 0 , \ LAWN �� 2.0 __LSq__- 22 --_ 2'0 / x 21.5 �l ;/ %� l>h �Yp '0" '�`�c� N/F KAIN ,r�, AN AREA OF MINIMAL FLOODING. 1 8.0 A-s 500 ' y ' '1D am ?2.3 _ m _ �.8 21.7 ,� �� ti c �o +�:$ 70 WETLAND DELINEATION CONDUCTED BY SAMUEL HAINES AND NAOMI DeLOACH 17.2 0 i \ 16,8 21.7 ,' ' ,' vtiF °.� ' se• / 7 OF ENSR ON 1/10/03 17.2 i x18.. \ `� 21. _ 216 ---- e " 17.8 ' ON ',� _- 1 7; Q$ �/ LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND O Z \ 171 \ ES - v *6 a I 20. NE 20.5 PAVED DRIVE / Ff10� / �i �� Eoo SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE • W/F A-5 �-� � �1 1 117,4 185 ,, 9.6 17 18.4 18.7 , 19.7 ON � 20,6 �, / / MAG/SET UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. / g 6.1 _ 20,8 Nµ� MAG(SET 20.1 ,� ��' 1.8 SEPTIC SYSTEM LOCATION IS APPROXIMATE. 17,800 18.1 iO ON \ 21.a"D-80X 20 / 36 PLASTIC PIPE o MAcj/SET _ 20 9 --- 21.a % INVERT EL -0.04' PER INSTALLER'S CARD PERMIT 1 95-1818 'o� I6'iu - I 7 8,9x E ES 20,5- - ----- HING C 3 I IP FN .07 20.7 N 20.7 MBE x 19.5 � LINE BEARING DISTANCE 1.8 15.6 l - - 2 ,5 x 0 , / L1 S 30'56 31 W 22.83 1.8 THIS PLAN IS BASED ON AVAILABLE RECORD INFORMATION, N 84 12'S�"lp- P 106A-� - - --. � I00.29'-T3_______ _ _ ___-___ _ _ , i 12�81 L2 S 35'35 0s w 11.84 PLANS AND AN ON THE GROUND FIELD SURVEY BY THIS FIRM II ------- - ---------------------- -------- i�-0 ' / / UA'0�+ L3 S 6723 34 E 34.550 ON 3/21/03. ?, i 0. LE 1.8 PROPERTY OWNERS: -------------- --------- 17 6�49• ' �6�` _ 1 .3 x18.8 i / °,c o, /.°' w___- r\ 7.0� -'_ x 18.3 ��° 18 PATRICK MARGUERITE & TR. w7.2 A-4 `- 17.2 8 34.12 18.6 °4 4 EDGE HILL ROAD e/DH WELLESLEY; MA 02481 N W21'01' w FND ��v 1.8 2 ?�o' 1.7 k 1258 Craigeville Beach Road N/F THOMAS W/F A-3 S 24.00. 616 N °� Centerville, Massachusetts • - � o 14•,2S2. E ObO, � PREPARED FOR I ; N/F COPPERRIDER 0.72 N/F DOIRON 1.9 x Richard Thomas W/F A-2 100.0' ' TITLE = 1.8 1.9 Wetlands Permit Plan W/F A-1 1.6 6.6 3 N BAXTER, NYE & HOLMGREN, INC. 7 1`W ^' N OF M4s Registered Professional OF "As Engineers and Land Surveyors STEP L � 812 Main Street, Osterville, Massachusetts 02655 / LIS 2g87a 8 % No.3o2ts Phone - (508) 428-9131 Fax - (508) 428-3750 ' . � ! / fCrSTE _ G-5 20 0 20 40 h b�N 6 5 C 3 1 w SCALE IN FEET / 2 CONSTRUCTION NOTES: SCALE:1"=20' DATE: 05/12/03 35.24' 1 ) The existing septic tank is to be relocated as shown. REV. DATE: REMARKS N 80'S7'S4- w -1- 6104103 Relocate Septic Tank 2) All work is to conform to all applicable plumbing & building codes. Col DRAWING NUMBER H:\02\02- 119\survey\worksht\02- 119Prop2.dw 2002- 119 LOCUS 4 , NA 1VT l CKET SO IIND LOCATION MAC 0 j' BRB ( FND ) ASSESSORS MAP : 206 B O o PARCEL : 0 8 1 - I _ DEED DK . 5937 PG 115 R - 21 . 61 ' S3 2E ` BRB ( FND ) - A - 32 . 24 16S • fi- ..'""`„ R - 154 . 8Q PLnP1 DK . 33i �� . 59 LOT A - 7 5 0 r FLOOD ZONE : C FIRM 250001 PANEL 7 OF 25 BRB ( FND ) ZONING DISTRICT : RD - I ---_ _ t `� LOT �'8 . 514 SO FT-` III 4g Jig 1�, . 65 ACRES �o /P p -/ 9s _ �o w N, DWG r NG NQ O co 00 DR I — L • 99 . 07 ' CB /DH ( FND ) - 4' .. 690 62 49 •33 , 10 N88` 2 01 W Cb /DH ( f \'D, ) CERTIFY THAT THE DWELLING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS S HOWty , , , "EREON AND THAT I T COMPLIED TO 1 258 C€tA I GV I I_ t F BEACH RO��D THE ZONING BY - LAWS OF THE TOWN OF BARNSTABLE AT THE TIME OF CONSTRUCTION CERTIFIED PLOT PLAN AS REGARDS TO SET BACK REQUIREMENTS OF M� Cl �� a,Nn�os���G OF LAND IN CEN7'I' ?V I LLE, Af ASS. F'<<�Y. MONCEVICz y AS PREPARED FOR TM mm SCALE GATE MAY 19.t _ �c'"1'f' trt:'y�i rR• Y .o 'P No.?WSl�Q 4 Ic ,' Fcr r�� w� PATRICK M. MARGUERITE f-2o' REV. TPOFFS S I ON�,L LAND SURVEYOR DATE �� ' ,! vssyoN � Ea�a DONALD Fir. MONCEVICZ, PROFESSIONAL ENGINEER iST T It , ' au �aMa S `' ,' 40 POPD STREET - WEST DENv�. hJA 02670 t5�J81 391-0�49 y, 19 9 FILE NO. _ _._Sf EET OF t685-00 v..._ ._. . 1. y+QtHlt,' u w ij X '�'1"'.r�!F ' ' *Yi ' ,`• a '; r,+fir" �r. 1 ,` . , •), ` ,,''. ,r R' ?�','"; �"+^ ,' ►:ri ..'F;{ t 4 "trl, +'k :�..,.>��. • ,.y, Y!�";, "u,1.�, rjt ' . ,{i,r 7' '•J '! ,;,,,:J'r`�`.., , I ,�•,`.� a - � '. Yr tiS.-s.•({ r.Y• '�.S;�I .M� tl •:T..�i ...>, S '1 r '• . , r T FST CHIT 4`•1 TEST PIT #2 � 7�"� �' �S , R�!� ah # t u� �,:�, '�,: t 1;. f, �� �j' v+ GI5NERAI. NOES w�e I° { r ♦l l� t� '{`F, i 1 ��;i'MJ, t �4��' F I._F.`J - I4X4G b„ I-LA.`.' "• _ ,p1 ,. 1:`'AL.L ELEVATIONS SHOWN ARE BASED UPON AN� SANDY ' Ip fR.1 i t ' l_UANi I IOYa3/4 LOAM ► b L�1m1� n Iqg�1�` ► `,A D �.. i I N ,:,. .. 1 _ SSUMED A'1'UM. _- ,.-.. .__..- FI - _ ► 10=gg=. d PITCH ALI_ LINES A MINIMUM 0� 1/81i l r T. UNLESS LOAMY � i ) ` � � ;- ,, ' ;; � �' :► _ � OTHERWISE ICI h 7Yf?`�/A SAND � �Q,, � IF----- tC'1 ,I `� f SpECi ED. II i (PILL) _ (OURIED ; I LOAMY �� " �'r `,'• r " 8' - s' 3.,�.ALL PIPES TO ANb IN THE SYSTEM SHALL �E CAST 4-4— �EasNEtrLs�j 7YRs 's SANO ! �z ;. ..- _._ . _ ... .. _ _. _ �, E =N T + - -- --- ---- IRON !)R SCHtDULE 40 PVC: ROOTS) �� ,r "- ' , _. „. . • d.; ALL SEPTIC �'4kks, DISTRIBUTION BOXES, AND PE N FO HEEL 1-a �,}�� - � •i ` . ,� LEAC N PIPS .SHALL DESIG ED R N-�0 W -- - - 4 KNOCKO T 5YR5/6 SILTY / �' r �� "r : LOADINGS WHEN UNDER PAVING. i 1 1;. ,i r w, 20'MAMETER COVEN . -� i { �r4 < � �:, y,, �' �! REMOVE ALL UN 'T A SILTY ( �� 5.�• RE 0 SU, AF31_F MATERIAL BENE f THE I SAND 5YR5/6 a I I j 14 w , „''x 4"KNOCKOUT '^ •'KNOCKOUT ry INVERT ELEVATIONS ' HE I=LOW DIFFUSOR FOR I I SAND I lD -�— _ I N 'c r — I TYPICAL DISTRIBU�'TUN B0X 1 : ,k, ,' A DISTANCE OF_ 5 F1 AND gACKFILi_ °�ll�! GLl1Y .. - �1AV1 A PERCOLAtION FATE I i I.Iral IID t E't{_I_ I . . " ' ;:. •� Y , , FREE ,,AND 8t' GRAVEL NG NOT TQ SCALE y 4"KNO9x0UT• 'OF 2 MINUTES PER INCH OR USS. 120" 1�9" .. .:r BOttFtD of HEnL$P; MUST - --- J — L --- NZLF," 01STRIBUTION BOX AND --_ 6. THE TOWN 0�' BARN STABLE NA WATER EYCOUNTEREo .. .. '� GAL: REINFORCED SEPTIC TANK 8Y -�• o BE NOTIFIED WHEN THE SYSTEM IS NEAR COMPLETION OBSERVATION PIT TYPICAL 500 GAL, SEPTIC TANK .�' ,, ACME . PRECAST OR-.'EQUAL.. ' .i I Yr (CA � DIFFUSOR , �� �� AND PRIOR 1'0 eACKFIL� ING. 0 I L. EP NOTE-DIFFUSORS BY WIGGINS.Pf7ECAST :UNLESS OTHERWISE NOTED, ALL SYS"1 EM COMPONENTS PERCOLATION RATE- < 2m1n�lnch NOT TO SC��C E - -SHALL BE INSTALLED I N ACCORDANCE wITH TITLE•�'-- N . :� ' S' 'CORPORATION 4R EGit1AL,•- 'OF THE STATE SANI TAr�Y CODE AND _ANY-- L. OBSERVATIONS SY! GERAI_D DUNNING NOTE Tt11JKS REINFORCED THROUGHOUT WITH TOWN OF BARNS 1ABLE �ir�Acj') 0° 1E{�Ll N E!. �C;TRIC WELDED WIRE WITH 24-1/2" r RULES WHICH MAY !.F''�'i Y. ENG!NEER ARO ENGINE RING INC. ElrlbEDDED =STEEL_ RODS IN TOP Al BOT- CONTRACTOR IS TO NOTIFY ENGINEER PRIOR TO THE LL EFITI(' SYSTEM, OF ANY DISCREP DATE 0070RE 12,1995 TOM CONCRETE !:; 4,OOC S PSI TEST, I riNSTn ATION OF r a C�O� h-1o��1r ANCIES BETWEEN TEST �'IT RtSdLTS AND FIELD CONDITIONS. f x1 , • ° ���,� �cL �'�` 9.,� ACCESS MANHOLES TO SEPTIC TANKS ),ND LEACHING J , , ,.•r-- ' '' ,' '' Y. ''' , °:" ' .. PITS TO BE BUILT UFO TO 42 INCHES BtLOW FINISH ' �q _.. ..... _•.,. ...d............_... rj�' �c�S vc r-.C��1 v J GRADE, { 10. NORTH ARROW NOT TO BE USED POR SOLAR 7 ,OF 17'29 �3' w a.. r.. r FOUND. Tt10N. ;, 151.0�1 t►ft c .. .- -'., r ��., _._. F I I•V * FJN15N G ADE OVE.F? I F,AC'HING TF - �g �--. . .�" � __, •z „ � ! WISH GFtA()E M�1 � i r r J "RIAOL'. .J V r�1•.f AIY�. RIM-- GO+J 1 �0 4-IPJI`'H•c' � I f �--P E•y + „ �� ►. .ar �;� t .as m L.t :V 19*5 ►b.n r 1 I V, 19+5 _.:-" t w' "�,. S `b p I _ EXIST, GROUND �+ , l �:r 1, c Ilk" I ,,� ` _._.__ FINISH GPADi ..�, t _ _.. _. _ w "' '..';. v.�• '.f �J a�J •. �"` !. {' � •, -.-,a-.___.__,_,..._:,,R .•-.�..,. ..« ,�..,.... �'� .�,,,;.�r.•......•.n_,. •�rs � ti. r1`;C"[� ••�',^ (-���'}C - N#..-,N :„ •' �yV.: Y,k 1 • .. `' t•••' '•' '4 It� u' N) ,� , «1!F'M.�"'WtI:•' i I I• `. - 'I''.. _ r •,y...y,y b.... I. -' .v+F..+.. 1 �A•N t v "!fir �'•. vs+ r<., 00, , ' IN '1 'xa, f ' I El_ _ 15*G I �° TtSq 150Q ,��nl. IN_V.-17+ 5 -INV,= { , , I ��;,- try a\ •� ' � ot•tt�� .`•t, �t I FtL INI (ikCE D I - I 4 /e"•7i4" t :()rX BETE yr _ - — stlru `;t ' o . . • N • C 1.x'GSi1H(', CI<'SA+'�!K 1 AN17 7t7i-_'� I iI Il i�_ S��a '��� _ WASHEo 4fONE IT LFACH11tYToJWM*A-Fr,_ Y� \;`v rX to SL! TIC T4.NK • V =14 4 �'i �� fJ _ !�t - _ f) our arv,,�^�t Fv ,►. ,. \ I (1 Eif- I L L YABL.E ) 1LL� • =13 ,� r. • TYPICAL SEWAGE SYSTEM PROF LE TY E S I tct!+T Nor ro SCALE hoTF_s<,Ew+Fxrs� t1+ATl]+ T, b�. , LPVPl. AND 9tAbt.� l)In >sI� 1*11q{Tp, p -1- -- • ; ', b,,y. LEGEND � M00 GAL " • 1 S ` • E S s��►nc TAN r rn K'�_ ..• �,SA �:;. � ��' MAP �>EGTIUN PARCEL LOT ADUIz _ ` EXIST. CONTOUR _ _ -_-- - I GxIsTINGt; ; 8 6 . 2 6 (..... �Yt,l�rrc�0rc DwELUNt3 �. � � ,-, ____ lr 0 --------- - --__-_ -• --- ----- • TAW *r•EO OUT `� I FL tl..91.4o ','� �. y PROPOSED CO S t'DUR Ain r�e►.c�v�-C� "I, 3f ,$ �� E XIST� SPOTELEVATION 8 X 0 . �� ,.' \ P`.,'r PROPOSE4 SPOT ..ELEVA.T ION 8 + O' __-- ! �� �' FL000 1� AZ'� 1"JNE PERCOLATION•,TEST m BONING DIS'1'R!C_ _ _ 2 8 515± 's ro W. \ 0BSERVATION,,PiT'. RC PARCEL I P ► -, k �� REMEDIAL CONS I Rl. CMION DEaIGN CRITERIA ; PROPOSED SEWERAGE UP--GRAD: •`�' . _ / NUMBER OF BEDROOMS N 1744.5'16" E PERSON PCF BF-0 00M __2-- �ti� a�,l P RC-EL 814#1258) CPAIGVIL.LE BEACH I M _ _. __ •: .,, _, GALLONS,P�.*PERSON PCH DAY w5``)— C TEF�VILLE tpARNStA 1LE) I1ifA �r. 8 1,3wf `. • " RAIGVILI-. I._E`ACHING f�'EQUIRED - E BEACH ROAD LEACHING F'ROVfDED "`909.4�t APPLICANTN , ; 1 �, L , . ':►EWER DESIGN y �.4 JOAN M. BRL*IMCK A�tO ENGINEERING INC, per.,..,.. , 12SeCRAIGVI�L.E BEACH R �9 ST RIPER LANE FALMOUT!i, MA. 02536 S I DEWA S N • ► CENTERVILMMA. 021e6 SCAI_F IN FEET —�;,- 11.- C•5?+57+IU7-4U7).'W'v` 272.7 sf ROT TOM. + sc F DAIF: I :,rIEF1 . 57-x I U 7 ) v 636.7 sf I ` ,, _:r�• AS SHOWN 1NOVEMSEA 8,1995 : 1 'I I' 1. • '' Tnrn�� 909.4 of _ �r ;'F ' +. ., ti � ��� � I)I�I1 P��; 11'(° i l'►II I• I � ; LIY AI'I '' , (='1 .�1N t`1�I APPLICA►TIQN RATE. 6 k V y 74 s F� 1� ___ - , C-A 1 AA U r L , ,: -':' > pY'^tix:. .per .:_•M � .,..,.v ..... -, ... -.:, . ..: ... r .. .. .... •r 1 >� t a , -1 a �;.' .,,,^Y,N:.. 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