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BAAN3CABLE. �
15 LAKEWOOD DRIVE, CENTERVILLEU
Case#,� CA.9 565
Case#: C-19-565 Address: 15 LAKEWOOD DRIVE, Date: 7/11/2019
CENTERVILLE
Owner Info: Property Info:
FLEMMING, KENNETH S & MBL:
COLLEEN M
15 LAKEWOOD DR 212-021
CENTERVILLE MA 02632
Owner Notified?:
Complaint Details:
Type of Complaint Classification of Complaint Method of Complaint
Zoning, Medium Priority Phone
Complaint Summary:
Tenant complains that landlord is the postmaster of Centerville and refuses to allow her mail to be
deliivered to her at his address where she resides in an "in-law"apartment. As a result, even her license
renewal from the RMV was returned as well as some paychecks that were mailed to her. She inquired
about the status and definition of an in-law apartment.
Action History:
Action Taken Date Description Fee Inspector'
Inspector Assigned to Complaint: lauzonj Filed by: andersor
Comments:
Comment Date Commenter Comment
Date 7111/2019 � e �kz Tovi n of Barnstable
.".1" `?s W 1V aagn ,yk .xte A b ro..� PMaL �
I40A Vl�zA�
Town of Barnstable
rAeL& ' 200 Main Street, Hyannis MA 02601 508-862-4038
s"9.
Application for Building Permit
AP g
Application No: TB-17-4347 Date Recieved: 12/18/2017
Job Location: 15 LAKEWOOD DRIVE, CENTERVILLE
Permit For: Building- Insulation- Residential
Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No: CSSL-102776
Address: West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398
(Home)Owner's Name: FLEMMING, KENNETH S& COLLEEN Phone: (774)487-7683
M
(Home)Owner's Address: 15 LAKEWOOD DR, CENTERVILLE,MA 02632
Work Description: Add 2" rigid insulation to the attic kneewalls. Air seal the attic plane with expanding foam. General
weatherization.
co
d
Total Value Of Work To Be Performed: $1,400.00 -
k
Structure Size: 0.00 0.00 9 0.00,.,
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensatiori insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to:have coverage unless he files his intent to
accept coverage.
I hereby certify that.1 am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the�best of my knowledge and belief.
Alt permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: William McCloskey 12/18/2017 (508)398-0398
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $1,400.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $85.00 12/18/2017 $35.00 7C0X{X700{7C0o{- Credit Card
0299
Total Permit Fee Paid: $85.00 12/18/2017 $50.00 )CM-)CM-)CM- Credit Card
i 0299
s THIS S NOT: A PERMIT I k
. Town of Barnstable
Building
n t■AEN$A '
Post
6� Poste
C Permit
11rea e
Permit No. B-17-3659 Applicant Name: Neal Holmgren Approvals
Date Issued: 11/03/2017 Current Use: Structure
Permit.Type: Building-Solar Panel-Residential Expiration Date: 05/03/2018 Foundation:
Location: 15 LAKEWOOD DRIVE,CENTERVILLE u Map/Lot: 212-021 e Zoning District: RD-1 Sheathing:
Owner on Record: FLEMMING,KENNETH S&COLLEEN M � Contra
' ctor:Name �NEAL F HOLMGREN Framing: 1
s -' r
Address: 15 LAKEWOOD DR Contractor•Ucense CS 088921 2
CENTERVILLE,MA 02632 E"st Project Cost: $36,448.00 Chimney:
Description: Installation of 34'Lg 335watt solar modulesflush mour ed on three Permit Fee: $235.88
existing roof. 11.39kw 510sgft 1 F� _ Insulation:
Fee Paid $235.88
Final: kv,- 11130)17
Project Review Req: Date 11/3/2017
Plumbing/Gas
5
Rough Plumbing:
Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authozeby this permit is commenced within six months-at er'jssuance.
All work authorized by this permit shall conform to the approved applkat�on and the=approved construction documents for which this permit has beengranted. Rough Gas:
nr.
All construction,alterations and,changes of use of any building and strre uctus shall be incompliance with the local zoning by laws and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspectio for the entire duration of the final Gas
work until the completion of the same. t
> ± Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the.,'Building and Fire Off icials a e:provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work: Service:
1.Foundation or Footing n
2.Sheathing Inspection
-.• Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed '
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final'
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: .
6.Insulation
7.Final Inspection before Occupancy Low Voltage.Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
:Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
- Building plans are to be available on site
All Permit Cards are the property,of the APPLICANT-ISSUED RECIPIENT Final
Town of Barnstable R0.EC�,EfiIP,�TX
eartnsrast a
MAss. 200 Main Street, Hyannis MA 02601 508-862-4038 -�
Application for Building Permit " ZE
Application No: TB-17-3659 Date Recieved: 10/22/2017 `'�
Job Location: 15 LAKEWOOD DRIVE,CENTERVILLE 20
U3
Permit For: Building-Solar Panel-Residential ; n
Contractor's Name: NEAL F HOLMGREN State Lic. No: CS-088921
Address: EAST SANDWICH, MA 02537 Applicant Phone: (508) 744-6284
(Home)Owner's Name: FLEMMING,KENNETH S& COLLEEN Phone: (774)487-7683
M
(Home)Owner's Address: 15 LAKEWOOD DR, CENTERVILLE,MA 02632
Work Description: Installation of 34 Lg 335watt solar modules flush mounted on three existing roof. 11.39kw 510sgft S
Total Value Of Work To Be Performed: $36,448.00
Structure Size: -0.00 • 0.00 0.00.
Width Depth Total Area
1 hereby swear and attest that I will require proof of workers'compensation insurance for evefy contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Neal Holmgren 10/22/201.7 (508)744-6284
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $36,448.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $235.88 10/22/2017 $185 88 XXXX XXXX XXXX Credit Card
........ 2197
Total Permit Fee Paid: $235.88
10/22/2017 $50.00 XXXX-XXXX XXXX- Credit Card
i 2197
_ . .., d �j.r-::,�..�Ji`3,_..... .z, ..� dk'3 e,Win, � �. m �' ✓ ..,vn�� .c � �b
LOT 7 N
22,600 sq.ft.
0� ��- CD
� o
15 �PKEWO2Ar6
L�96 6
S 80-02'40" W 3g•2!
existing
43'10 foundation
1
C�7 9�9• N
08 cn � W
.S�• � S 7g.22 SO
I Or,46
S 79'39'00"
W
70.91
I CERTIFY THAT THE STRUCTURES ARE SHOWN ON THE PLAN AS THEY EXIST ON THE GROUND
AND CONFORM TO THE TOWN OF BARNSTABLE ZONING SETBACK REQUIREMENTS.
DATE PROFESSIONAL LAND SURVEYO
PLOT PLAN
��•tN OF
gFGISTERf� 4+g
PEPARED FOR: MR. & MRS. MORIARTY J.
�TEPHEN o
[FLOOD
CATON: LOT 7, LAKEWOOD DRIVE, CENTERVILLE J_
TE: JUNE 4, 1997 DOYLE
ALE: 1" = 40' Ift3755?
PLAIN DATA: LOCUS LIES IN ZONE "C" — (NOT A HAZARD ZONE)EPARED BY: STEF'HEN J. DOYLE AND ASSOCIATES42 CANTERBURY LANE, EAST FALMOUTH, MA.
._ Tr_El' 10NE: 508/540-2534
�. w TQ* OF BARNSTABLE
CERTIFICATE OF OCCUPANCY
.PARCEL ID 212
ADDRESS 15XAKEWOOD DRIVE PHONE :
x,CtNTERV I LLE ZIP -
LOT 7 BLOCK LOT SIZE
DBA DEVELOPMENT -DISTRICT CO - -
PERMIT 26069 DESCRIPTION
PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: I
BOND -$.00 ZME
CONSTRUCTION COSTS $.00
BAANSTABLF.
MASS.
OWNER CAMPBELL JOHN E
ADDRESS % MORIARTY KEVIN & CAROL A F�
15 LAKEWOOD DR BUILD , D SIO
CENTERVILLE MA BY
DATE ISSUED 10/02/1997 EXPIRATION DATE
TOWN r�F,BARNSTABLE s ', l`"
-"- Ury p yNw PERMIT
PARbEL_ID 212 021 ' GROB 5E ID 1.3170
ADDRESS i15 LAKR"W'Q}q'DRIVLr+ _ . :L�HONE
Cente A'Ar e ZIP
LOT 7 ��' , t B1,OC'K. ` _ LC3`" SIZE
DBA /'' DEVELOPMENTDISTRICT CO
P 'fi '(1 T )22858 DESCRIPTION SINGLE FAMILY DWELLING
.PEER;M:I:T P'YPE BUILD TITLE NEW RESIDENTIAL BLDG PAST
CONTRACTORS, PRE}PE4TY OWNER � ��_ Department of Health,:Safety
ARCHtTE' TS: �. and Environmental Services
TOTAL F' ES:
CON T.RU�CITIUN ,GQS'I,S $135 y 300.0}0
I
161. ; SI:NGIZ FAM ROME DETACHED 1: -PR:>VATE P
* EIIARNMBU4 •
MASS. �►
OWN14R MORIARTY D 1F.VIN 16 39� ADO; CC
ADDRESS 389 'ANNABLE PT RIB '
n
BUILDINGrDIsVISION
DATE ISSUED 08/05/1997 ExPI RAT ION DATE,/.%��
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN-
CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS
PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE
1.'FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH-
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS.
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE.
4.FINAL INSPECTION BEFORE OCCUPANCY.
VISIBLEPOST THIS CARD SO IT IS
UILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
7
n) 4
2 r 2 2 �AjA
3 , / -HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
J� 0
2, Cy . i.. Ci F HEA H
OTHER: SITE PLAN REVIEW APPROVALh4- j
Aa4l
WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX` CARD CAN BE ARRANGED FOR BY
VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
TION.' NOTED ABOVE. TION.
ha
r
C
' ,y
Engineeridg.Dept. (3rd floor) Map 2 z- Parcel 02 I I-Yermit#
House# /$r Date Issued
Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) .. i BE
YPB
Conservation�Office.(4th.floor)(8:30- 9:30/1:00-2:00) S�On INSTALLED IN COMPLIANCE G/�ly y3
Planning Dept.(1st floor/School Admin. Bldg.) WITH TI
VIRONMEN ND
De e Plan Approved by Planning Board -a - o� 519;� OWN RE � entYvsrA
TOWN OF BARNS TABLE
Building Permit Application
Pro' treet Address j` k Q p avail �R,`UC- DL� zor h
Village Genfer-ylll-e—
Owner . �ei)j n M, q 12a)I M op i ney Address ,Sn -finnCbf-e -P j I► +- d
Telephone - 0
Permit Request C b
�1/6d
First Floor square feet Second Floor /LIQ square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size 600 Grandfathered Yes ❑No
Dwelling Type: Single Family I Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes Er o On Old King's Highway ❑Yes Rio
Basement Type: ❑Full ❑Crawl Ur6alkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /0 y7
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New —3
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: B'Gas ❑Oil ❑Electric ❑Other
Central Air Lr eS ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes Leo
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) J,7&J6,
ttached(size) r1clr ❑Barn(size) J70192
❑None ❑Shed(size) 00//le "
❑Other(size) /20 //P—
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review# -
Current Use Proposed Use
Bui ormation
Name 0 I elephone Number `�� �d 3
Address 1 ( License#
`._ Home Improvement Contractor#
Worker's Compensation#
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
SIGNATURE ; DATE
BUILDING PERMIT DENIED OR HE WING REASON(S)
±
FOR OFFICIAL USE ONLY
PERMIT NO. 41 J - y
DATE ISSUED'
MAP/PARCEL NO. '
ADDRESS VILLAGE "
OWNER ;.
DATE OF INSPECTION: ±
FOUNDATION ,
s
FRAME
^ ,
INSULATION T7 , <i
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: '.; ROUGH FINAL
GAS: ` ' r 'ROUGH FINAL _ ±
FINAL BUILDING•
DATE CLOSEDvOUT_
ASSOCIATION PLAN NO.
1
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Ae %ClION ffOUi2i GAGA( M" W45 6
learm•e
TOWN OF BARNSTABLE
, BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE - - r
JOB. LOCATION k6(ke_a)0,nC1
Number Street address Section of town
"HOMEOWNER" Oorol 0-0,0 02ORMP-TV 77J5__-A6 2
Name Home phone Work phone - -
PRESENT MAILING ADDRESS /-6- kc-Aa (,Good
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 such homeowners to engage an in-
dividual for hire who does not possess a license, provided that the owner
acts as supervisor.
DEFINITION OF HOMEOWNER:
Person(sj who owns a parcel of land on which he/she resides or intends to re-
side, 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 OfficiE
on a form acoaptable to the Building Official, that he/she shall be responsibl
for all such work performed under the building permit. (Section 109.1. 1)
The undersigned "homeowner" assumes . responsibility for compliance with the Sta
Building Code and other applicable codes, by-laws, 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.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwellings 35, 000 cuic feet,to comply with State Building Code Section 127.0,�ConstructionlControlquired
1
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner performing work for which a building
permit is required shall be exempt from the provisions of this section
(Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if
Home Owner engages a person (s) for hire to do such work, that such Home Owner.
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor (see Appendix Q, Rules and Regulations
for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
often results in serious problems, particularly when the Home Owner hires
unlicensed persons. In this case our Board cannot proceed against the
inlicensed person as it would with licensed Supervisor. The Home "dwner actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/Fier responsibilities, man
communities require, as part of the permit application, that the Home Owner
certify that he/she understands the responsibilities of a supervisor. On the
la--t page of this issue is a form currently used by several towns. You may
care to amend and adopt such a form/certification for use in your community.
a
:r
The Conr»tutzw+ alth of:1fassachusetts
Department of Industrial Accidents
• "" _r 6110 11'ashitrg%run Street
Bunton. A1uas. 02111
Workers' Compensation Insurance Affidavit
prltcant inirmation: Please PRINT le- ]
✓ m 1 \ � � i'/ '
location- /tS I\Q Ai ri aQ� / R/�
r� ty 1. e �x h 1 #
am a homeowner performing all wort:myself.
I am a sole proprietor and have no one working in any capacity
- r,s- -n+�•..nr.vw..s'�7[.�T'-+.w.�.'/�+e';..:/•n�......r....n�T.;.��.-.w+A�.w�.w...�'Y"`•......�.w-+..w.••�..•ww+...-...�-...,.:.
Ci I am an employer providing workers' compensation for-my employees working on this job.
comnam• name:
add ress-
cites ohnne#•
insurance cn. nniicv#
I am a sole proprietor. general contractor, •homeo�+•ne circle one) and have hired the contractors listed below who have
the following workers. compensation policen
c m any name: CL�
77
" v
a ad,<ires5•
c hone#• JcY
(l insurincr ro. - -- - alley tt
1 •1' .. •1.ram - - - '�:�"' •..- �r'^��.•:��tL iT•'S^.�l.w:y��� ^,1�;._.� ti...�-.• _
tt"'cnm an.• name � y
(� 1address:
- hone
insurnnce c `-'� lic•#
Attach additional sheet if cessar:� .,-
nd Section •+ -,+ :..:,y •'.--- %�•.''^'- _ "• ,'-•~'"': -'." _=
Failure to sccurc coverage as required uer+�i 25A of 51GL 152 can lead to the imposition of criminal penalties of a line up to S1.500.0 0 andrur
unc N cars'imprisonment as wcll as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a daV against me. 1 understand that a
cope of this statement mac be forwarded to the Office of Investigations of the DIA for coverage verification.
1 t10 hereby cerri iuttler the pains and penalties of perjuty that the information provided above is true attd correct.
Sicnature Date
Print name �Cf t-6 -fin f7 V'1 191,
�`lAKV hone# . Z.�— —23
' offciai use unlp do not write in this area to.be completed by city or town official `
city or town: permit/license# r tlluilding Department
Licensing Huard
tt rl check if immediate response is required C3Seleetmen's Office l
f c31lc2lth Department .
contact person: phone#: r•JOther
• _
Information and Instructions '
Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers* compensation for tllc:
employees. As quoted from the "faa". an enrpl({ree is defined as every person in the service of another under an\•
contract of hire, express or implied. oral or written.
An etnplt rer is defined as an individual, partnership, association. corporation or other legal entity, or any two or nor(
the fore-oina enuaged 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 till
owner of a dwelling, house haying not more than three apartments and who resides therein, or the occupant of the
dwcllin- house of another who employs persons to do maintenance , construction or repair work on such dwellin-g hot
or on.the �srounds or building appurtenant thereto shall not because of such employment be deemed to be in employer
MGL chapter 152 section 25 also states that ever% state or local licensing agenc,% shall withhold the issuance or
rencival of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant u•Ito 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 11
been presented to the contracting authority.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying company names. address and phone numbers 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 a workers* compensation policy. please call the Department at the number listed below. .
City' or gowns
Please be sure that the affidavit is complete and printed legibly. The Department Itas 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. Plea
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t
the Department by mail or FAX unless other arrangements have been made.
Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any question.
please do not hesitate to `_ive us a call. .
The Department's address. telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Investigations s
600 R'ashington Street
Boston,Ma. 02111
fax #: (617) 727-7749
phone #: (617) 727-4900 ext. 406, 409 or 375
�p-�urao ao .< a ante �c�
(�G�� y7e
e�4
Aelllz
--- -- - - - - - - i/e O _U_ /7 - ---__..--
.-� --
f"
" ftxF 'a!-•
P,oyms M: AWRM- - -
Wary Public
LY
i
�114E r The Town of Barnstable
o�
BAH E.MASS. Department of Health Safety and Environmental Services
MASS.
�Eo3�a Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection -
Location o _, Permit Number ' ('
Owner r ,,7 ,,. , Builder
�.. One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
( k a— , ... _ ! -1—Cc.e tl 4,v & �'+?.ut.'P1 0—. ) `P 4`t w ' u �UJ 4-'
f
/awn g-VC .S a sue,, /OV
Please call: 508-790-6227 f.r re-inspection.
f
Inspected by
v
Date
t
LAW OFFICES OF
PHILIP M. BOUDREAU
396 NORTH STREET
HYANNIS,MASSACHUSETTS 02601
Telephone:(508)775-1085
Telefax:(508)771-0722
E-MAIL:pmichb@capecod.net
-Philip M.Boudreau
Philip Michael Boudreau
Mark H. Boudreau
May 1, 1997
Ralph Crossen, Building Commissioner
Town of Barnstable
367 Main Street
Hyannis, MA 02601
Re: Lot 7, Lakewood Drive, Centerville, MA
Dear Mr. Crossen:
Please be advised that I have run the record title to the above-referenced lot as
well as to all abutting properties and find,that said lot has been held in ownership separate
from all abutting lots since March 12, 1971, when it was sold to John E. and Alice
Campbell. Since that date, on November 8, 1989, Mrs. Campbell conveyed her interest
to her husband. Thus, current title resides in John E. Campbell.
The lot lies in an RD-1 Zoning District and it became nonconforming when the
intensity of use requirements were amended in the early 1980s.
For your information, locus is shown as Lot 7 on a subdivision plan'recorded with
the Barnstable County Registry of Deeds in Plan Book 204, Page 23. A reduced copy
thereof is enclosed for your reference, as is a copy of the recorded Release of Covenant.
I understand that the above information will be helpful towards your issuance of a
building permit for the premises. If you have any questions or need anything further,
don't hesitate to contact me. Thank you for your consideration in this regard.
Sincerely,
lip Michael Boudreau
PMB/hcg
Enclosures
1�EY MAP
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/ e/ynA.Cbnnon
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.00
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23200 't h rQ S •AMA 'q,7p G
y 21000 21800
25900
Yq ••
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h A N
13
It 10/00
0 ~`'
'S Isf.00 �qO 4eeas tw• F r NS �v /2 ...p
22700
26.000
Goo
10
A : 135,11
M200 1! $ 27500 o.
/� S 83. .r \�•�k y l.:'.d !p^^°^
/7dli .$78-22•5ow ''t c, ...r l^•n i., 6
Q - S so'S v•30'►'� J 5 73'3�w
S 81'26•SOW j3c�s i,✓ �< Jo ca T. Welch
•r Nilloid N Y
Elsie L Jones
/ce�l:ly/hof P spplon.oe mode rn
occondoncs w./h the Bem Job/. Olonn.nq 1 i
�oord in•l ucfonr ondlho/'�w pcnnonenf
po•n fr s/ao.. on IS's plan oca rn..i thrice
r the 9ry -j
/ HOWARD W. SEARS C/e,A o/Ihe la�'gr�
7or••n o/Uo�r+slob/s.Moee hereby ce/.Yy#-/' f_i �• ��oo� a RCVIOION OF Lore AT
/he norm afopp'oro/d•!hi►plon q>/rs i:F U[!r•; M �T by ppKnol Q tAw.o nrfob/�C/on.riny dooid/or be.n i.c.;-d JuL.I-igr,5 err or MvaTwu nQ� LAKE QOQ L5rATF-S
and ev c-4 do/h•%r elfce and ne vAro/ os L
/� �M,� N tG �I�o..� �CNTCRVILQ l•T1
irnrYed d�r':ny Ae f • fy days—f o/%i tUt S E CALI W rb'0 M- APMLI&� r
sLoh ie csipl and re eo•d my o/�vid�blar `---- �M_ o4� ��. i �� ."^"'•
Lola: 'M 6-H66 0vrr+CRS (ywr+rav��e. µ•era
as�/t
3<e o4e fi.��.�e7 rti.Sj EARLG M. 4 ROSISMARY MAR9TEF29 ..:r.
Fotm O
CERTIFICATE OF PERFORMANCE *
I (Cor.ent w ApW vGj It, .) 02175
S
r The undersigned, being Bomsroble, Marwrhv►eth,...Janu2 rl•(Z1g..6Q
o majority of the Planning Board of
i - artily that the r Barnstable, }
puiremenrs for work on the ground tolled for rM Mass, hereby
Ig...6.6.,and recorded In ,$p Y Covenant fy
;I rnsi.abla......... dined...J.
(or registered on Di.,,ict DKd, 1•••••»_. -
Cert icon o1 Title No. �r
Book ...13.40.., Page .....32g._.._, '`•'. r
how been ...................in R ,
•• completed to the solisfoaion of the Plonnin Registration Book ........, Page
on Pion entitled„^. 0 Board as to he following » 1
.LAkexoneL EB.tdt.e8."............ n9 enumerated lots shown Plan ..2 recorded with 3••••••••,(or registered In said land R acid Deeds, Plan Book K Grid sold lots on e0istry District, Pion Book 204..._
hereby released from the » ..., Plan .
n►thictionl ••.• .
................»
Loh desi no sole Grid building specifiedt hereprt,
0 Nd on sold Plan oe follows: Os to uildup �Pec+
._•wThe•entlre subdivialon -.
r r:
-.... (:
_........
_....__...._.. ,,4 r
.1�uthor
».... oionty oloZt:d
M f&ent
I •Ltna.nl...
'►Planning Board
i of the Town of
eonutable.
COMMONWEAITH.OF MASSACHUSETTS
Then personally appeared -IahA._.T,..Iia
board
the Torn of BatnetO��MOctwseth rind a821C_occke of the above named members of the Pl.�ntnlnp
and deed of MW Plots AV 6-4 before sn� nowledge'd the hoegaing instrvnr,en( 10 be tM
rory K fk
MY aommiss,on"0
eoo�142? PUE 24i
oS9 FEB 3- N69
BARN STABLE CO
REGISTRY OF DE
A TRUE COPY,A T '=r �;•;,..
_ NN F DER TE ;:
r�.
, ri :
Nyes
a• IT Stone
P Pt
.,I :/' `. �. QWIS
y '" o• i Hayes
Pt
root
Cranberry; _ I _
Boss
USGS LOCUS SCALE: 1 : 25,000 LO rT 5
ZONING DISTRICT: RD-1
OVERLAY DISTRICT: AP
0�e
0
SETBACKS: W E (.p, �lc���
FRONT YARD — 30' Bench Mark: ,.'-O-
SIDE YARD — 10' spk, in util/pole
REAR YARD — 10' el. = 72.94'
Datum: NGVD
A '
FEMA DATA: ZONE "C" GA6,' 6d
* 1rLr0 1
�4
APPLICANT:
KEVIN M. & CAROL A. MORIARTY �e-
389 ANNABEL POINT ROAD LOT q
CENTERVILLE, MA 02632 �� \
e
In
ASSESSORS MAP �fi PARCEL 21
LOCUS ADDRESS: Qo\e L`4O T 8
15 LAKEWOOD DRIVE -J><��� I 1 0
I /
CENTERVILLE, MA -Q- rn
o�P^ proposed '500 gallon tank /
serl'ce
a{ �e
OC Y L
oya
- �96 6 > 10.
> / `� /
!
proposed dirt/box / GA
i
80.02'40 o5e6
,4----------
L43.10 1 ,0 T 77-Spia /
22,600 sq.ft. h� P o
C:)'
ekrst hey P`e
'9 O T '73•� i
QUO cy 7 Z,4f
2
�I-e/ 8 17 C:)P
jl 73-A / / W 44' 4Z' coo
44
\\ / SHEET 1 OF 2
LOT 8 — /
ITE PLAN O F LAND
\` \ oo° �g39'p0 IN
_ 'T L
4-30-7' C ENT'ERVILL7
A OF f OF
�. 4ss
A ot� GISTER p ,cyG ��`� ''S,s 15 LAKE WO O D DRIVE
STEP E
GFAPHIC SCALE $ BEN y u T DEPICTING THE PROPOSED
20 0 10 20 40 80 \ ` \ No. 37559 + f110 29!)IQ H
SS, MO R IIDENC E
` '13.G l,4p0 SUH�EvO JJ"ON�I( IN FEET ) " SCALE: 1"
= 20' DATE: MARCH 25, 1997
1 inch = 20 ft.
U� Zyq�
-�'1 4, STEPHEN J. DOYLE AND ASSOCIATES
1 42 CANTERBURY LANE, EAST FALMOUTH, MA 02536
TELEPHONE: 508/540-2534
GENERAL CONSTRUCTION NOTES
1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE 5
THE PROFILE OF SEWAGE D I S P O S A L SYSTEM THED SUBSURFVACEO DISPOSALt OF SEWAGERULES AND REGULATIONS FOR
2. AT LEAST ONE ACCESS PORT OVER TANK TEES SHALL BE ACCESSIBLE
NOT TO SCALE WHITHIN SIX INCHES OF FINISH GRADE WITH ANY REMAINING ACCESS
PORTS BROUGHT TO WITHIN TWELVE INCHES OF FINISH GRADE.
3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF
' WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10'
TOP FOUND. EL. ' ' OF DRIVES OR PARKING. H-20 LOADING SHALL BE USED UNDER OR WITHIN
10' OF DRIVES OR PARKING UNLESS NOTED.
4. THE EXCAVATOR/CONTRACTOR SHALL VERIFY THE LOCATION OF ALL
t 1 SITE UTILITIES PRIOR TO .ANY EXCAVATION.
`x�Yr 5. SEWER PIPES SHALL BE 4" SCHEDULE 40 PVC LAID AT 0.02 SLOPE.
4
r 6. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE SHALL BE
INV. EL. -7 `� MORTARED IN PLACE.
Q` — WATER TIGHT COVER
FLOW LINE g
19" f \
7. FINISH GRADE SHALL HAVE A MINIMUM SLOPE OF 0.02 FEET PER FOOT.
Tp• WIN.
INV. EL. ?0 4 — 2• LEVEL_ �
v
10' MIN. 4' UQUID DEPTH
INV. EL. -If 7
� J
INV. EL. v I,
— INV. EL
2" MIN. - 1/8" TO 1/2" WASHED STONE
1500 GALLON PRECAST REINFORCED CONCRETE SEPTIC TANK
v
PRECAST REINFORCED CONCRETE c
MINIMUM CONSTRUCTION MATERIALS PER 310CMR 15.226(2) "`,' INFILTRATOR =`, 2
DISTRIBUTION BOX �L !
TEES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC AND v y EFF. DEPTH
3/4' - 1 1/2" WASHED STONE i
SHALL EXTEND A MINIMUM OF 6" ABOVE THE FLOW LINE INSTALL ON A LEVEL BASE ` v
OF THE SEPTIC TANK AND BE ON THE CENTERLINE OF THE
SEPTIC TANK LOCATED DIRECTLY UNDER THE CLEAN-OUT
MINIMUM WALL THICKNESS = 2" /
MANHOLE.
MINIMUM INSIDE DIMENSION = 12" S.A.S. = sl LONG x IG WIDE x =_EFF. DEPTH
THE INLET PIPE ELEVATION SHALL BE NO LESS THAN 2" NOR INV. EL. <,�t WITH _ HIGH CAPACITY INF I_TRATOR CHAMBERS
MORE THAN 3" AE30VE rHE INVERT ELEVATION OF THE OUTLET INVERTS SHALL BE EI UAL TO EACH I
OUTLET PIPE. OTHER AND AT 2" MINIMUM E-LOW INLET INVERT.
SEPTIC TANK SHALL BE INSTALLED LEVEL AND TRUE TO GRADE THE DISTRIBUTION LINES FROM THE DISTRIBUTION BOX
ON A LEVEL STABLE BASE THAT HAS BEEN MECHANICALLY SHALL ALL HAVE EQUAL INVERTS AS DETERMINED BY FLOODING
COMPACTED AND ON TO WHICH SIX INCHES OF CRUSHED STONE THE DISTRIBUTION BOX TO THE HEIGHT OF THE DISTRIBUTION
HAS BEEN PLACED TO ENSURE STABILITY AND TO PREVENT LINE INVERT AFTER ALL LINES HAVE BEEN SEALED IN PLACE.
SETTLING. INVERT ADJUSTMENTS SHALL BE MADE BY FILLING WITH DURABLE +
AND NON-DEFORMABLE MATERIAL PERMANENTLY FASTEND TO THE
SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 LINE OR RECONSTRUCTING THE LINES UNTIL ALL INVERTS ARE OF
EQUAL ELEVATION. j
THREE 20" MANHOLES WITH READILY REMOVABLE IMPERMEABLE
COVERS OF DURABLE MATERIAL SHALL BE PROVIDED WITH ACCESS
PORTS BEING PLACED AT THE CENTER AND OVER THE INLET AND �'z Nb �� »ra-I?
OUTLET TEES.
THE OUTLET TEE SHALL BE EQUIPPED WITH GAS BAFFLE.
REFERENCE MAP:
SOIL OBSERVATION DATA: ,,_
CAPE COD DESIGN DATA:
WATER TABLE CONTOURS
AND STRUCTURE
PUBLIC WATER SUPPLY
TEST DAIS i`+`�A�1 w 3 i`l of
WELLHEAD PROTECTION AREAS TYPE NO. BEDROOMS GARBAGE DISPOSAL f
SOIL EVALUATOR -� i.(�>✓ SEPTEMBER 1995 �� { # "**MAP
DESIGN FLOW ,_ } "
WATER RESOURCES OFRCE Z,
B.O.H. AGENT CAPE COD COMMISSION
12
EXCAVATOR ,+i a ��-T7 �U-�� �SIo _ x .o.-zo = ti; 4i
PERC/RATE �- `�`• fv t. t SEPTIC TANK Zia.-
't31 LEACHING FACILITY g,� _ JA x r
SHEET 2 OF 2 1�; L,. ti,,j a�,.-, ,:I
r1 (s '_•--I c �..:, i \ l�.le..� t >��j► k_ !'
t Sfax 7 -L.u- A _
s� S�
_—_—
C_1
-- - — SCALE: AS SHOWN DATE:
Sy 7/j
Si 15ol, STEPHEN J. DOYLE AND ASSOCIATES
Crw� ;S '5 V, I 42 CANTERBURY LANE, FALMOUTH MA. 02536
L�r; 3- I TELEPHONE: 508/540-2534