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W1 "I 1 �� Az,,�,,,�,�-!,;,��,,`, ,% I , 1i i IMffilPM M%Ir, . �, I fl,04 `�T?'IT 1��1411'110;11'f 111�01'�Ilt�'�;�, .1 ­1 __11't� �Awimxwlx i-ball 4R10__,A L�11 0 JK H NPH h'"' to AN WAR Ali 149100gowniqlatRi�i 5'z2 7 �U ;w Town of Barnstable *Permit# - 1 — I S 73 Tres 6 months from sue date Regulatory Service® _ _ wee ,_ 4 nsa�ssS..I� � Richard V.Scali,Director A �f Building Divisia � MAY 2 220 Paul Roma,Building Commisst� � ', 200 Main Street,Hyannis,MA 026011� � www.town.bamstable.ma.us HNSIA Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /� I Property Address 2g L�+•uU t�Nc 5 21esidential Value of Work$ (' Q oo — Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address LCR_�, 1N (a Contractor's Name d5tz T ere Q Telephone Number 333 ')53.3 Home Improvement Contractor License#(if applicable) IC4 I 5'19- Email: 7bSCQ blrt 1 le2s @_ 66A1GPS N PA' Construction Supervisor's License#(if applicable) Q 4 Z q5-7 ❑Workman's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 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) 8'*'Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement.Contractors License&Construction Supervisors License is requ ed. SIGNATURE. QAWPFILES\FORMS\building permit formsTYPRESS.doC 01/25/17 f 27w CoznwomreaWt qfMksYadruYetis Deparltlfent gf1udxsfti Accicie7ds Orwe 00nw&i997fiG= 600 Was, fiWoa r�ireet Boston,CIA 02I11 ni mt masmgopldia W►iarlmrs' CunTensgica Iusu a ce Affidavit:Bwlder /Coniractars/E.Iecfmicians/Phanhers Al UcardIIIfMM33f 1V Pleas@Prm ¢ X Na=Musm��o &&viduaW- Cy CD V1 S J _4 C., - -- Addr P. k 46 Cii yfi at�lir A c�Pl..e_ M Phaae 3 3 Are you an employer?Checkthe appropriate ba= ' T of project r L❑ I am a 1 u� 4. ❑I am a gemrd embmdor and I Yl� e 3 � ��d}= _ ----—-employer 6. ❑New oomstz� employees(fallaedforparttime * 1mveliredthesub-coutracfors 2.0 I am a sole proprietor orpartner- Tisfed on`the.art bed sheet. }. El Remodeling ski and have no employees y Th sub-confractors bale 8. Q Demolition w�M^g, for BM is employees and have wormers' "" '`e 3`- , � I 9. ❑Building acld6on jido ors comp.insuzm e � r ed-] - 5. We are a cmporationand its 10-[]Ele�repairs or adc27=s 3. I au a bnmeauner doing alb work off cen hm exRrcised fit 1L Q P3umbingrepairs Of bddilions. lf v�ukers' fig of esempfion per MGI. �se �o - c.1�2, §I{4kandwe5aare� L.❑Roofrepairs ` ir�encas�re wed I 13.El Other employees.[No woAoe& com3p-mmmmmm required_] •$ay apgFcrs2�sc�he�shaa�l�aLsa fiIla�the sectioabeTiaw�smdag ffiea•wo�cea}compeasariaupnTuyia�rmsao� • ffaa�eosvae�svrha snb�i d9s af�dacu indar�*•g dray axe3oio�slfwodc amnid�eabiie nut iderratnctoas�st.snbmitanewaMds&indicabna sacFi a nrs3�s2 c3�ecl�iius 6aoc most e�3 addi6®sl sheer slawing tbenmne of llie sub-cis sad stye ube let ornordmse enfidesbne em19ures.'If tbesn5-caata±M1zVe emploFe.si tbe}'=.srgmtdde•&w uarkM°ramp.palky n=bm -rain are stxpiar Seat isgrauidrir„warlrers'totrrtsrdzart ittsriratrce 'vr emTPTo3�ees Seioty is YfiaPzrIicy'artd jali sfta ftt�armrtiiatL • - Irrsmance Companyibime: Policy-4 or self-ins.I.ic.-*1L rnq infionDate: Job Site Address: citylstatefzap: Aff2ch a copy of the workers'compensationpaUcydecLaration page(showing the policy number and expiration date). Fair=to secure coverage as requirednuder Se-c6on 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine ap to$UOD_OU andfor one-year impdson--rFt as we11 as civil penaltiees m the foaa of a STOP WORK OBDERand a fame of up to$250-0 l a clay a„aind the violator. Be adtdsed flint a copy of this statement maybe forwarded to the Office of ns Itrves igatia offhe DIA,for coverage s oil "Fdo hereby csr ' 7-.7 s arrd psrlatties Ftt rrr!'fhatfiie aifar ao vir prwufed abw�i�bats aird avrrect Date: A 21,412 0j'kial uss amity. I3a irrrt trrtb3 fit S�crxea,br be tvtugtetesd by1 cdp Qrtenm ntjacfat City] or Town- Perinitff i ense 4 Issuing Auflority(drde floe): L Board of Health 1.BmWn Department S.#�jh ylTown aerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Con€ et Person: Phone#: Information and 11nstrue-dons Mecca��Geheaal Laws chapfea 152 regnass aU mVloP=to provide wom3cems'comp man f ac their employees_ this ,an m7gInpee is defined as¢—eYeaYPesson in die se�vire of aaot3�er ffides any co�ract ofb�, empress or auplieC�'oral or wmitmm_°' An eznpIoyer is defined as=an inc ideal,paxin=94,=DGIation,corporafon or other,Iegal emffy,or any two or mole of tiie foregoing 3 ff e I of a deceased employer,or the ma Dint a�ndinclnding ���� re.din or trustee:of an bxrvidaaI,par[n=hip,=ociafmn or other Iegal mlity,emTkymg CnTIoY=g- However the oven=[of a dweIla house having not more than three apmimmi s and who resides therein„or the occ¢�t of the- dw Mag houSe of ano9mer who employs pessomms tD do mammmiaman ,r.„,ch Sri;ran repay wow on sack dwelling house or on the grounds or buUft app�d�therefo sbzR nDtbecaase of sash=3ploymed be deemed to be an employe'° MG`L r�spter I52,§?5C(6)also sues that aeverp c or local Fcensimff agency shall withhold ffie fssuance or renewal of a jice-a a or permit to operate a business or to eons mct bundh2gs zn the commmm.DILwealth for any applicantwho has notprDdneed acceptable edamce of commpM-mmwifli the ftmurance.coverageregozired Addhionagy,MGM dnptrr 152,§25CM sf lh s Neither flie cammigawtalfh nor;�ny ofits political sobdrnfsioms shall ester info any cam tract bathe pence ofpublio wcaic unfurl acceptable evidence of oommmpHanmwbh the f mmmC6.. re L===fs oftbm chapter hxmbeenpresmtrdto the mIdL�.ammfho V:' �-PPHcan-fs Please fiIl out the VMI='compensafiDu afEdavft cox=plete n by ch=Idng;he boars ffist apply to yo11r situation amend;if necessary,S13PPly sub-cant mctor(s)names), addresses)and phone nmbem(s)alongwi&their certificate(s)of prance Lmmifed Liabm7ity Carapamries(LLC)or Lh0dt Liabffity`P�hiFs(LT l')7a n° mIOY�other than tine members or pmtaexs,are not rbqafiesd to cant'wurkn& compensafion fnsarance. If an LLC or LLP does have empIoyees,mpolicyismquiR4 Br,advisedthat this af &-vitmaybesabmitfedtotiieDeparfinentoflndustrial Accidents for conEmnalion of insurance coverage Also be sure to sigiz and dafEthe of tdavif: The affidavit should beTetomned to ffie city or town timat the application for the permit or license is being regaesbA not the D e--p artmeaf of Irdusfrial 1A_ccidenfs. SbDnldyou have any qu�ms g the law or ifyon are requaed in obtain a vtomltcrs' compeosaEonpolicy,pleasecaatheDepaEtneotatthenumb=listed below: pelf-ins�nedco�anies�ovldeD�t13ieir self-msin- ce Ifcrnse m=iber on the agpr%3dafe hno City or Town OfU als . t Please be sure that$ie affidavit is complete andpmi> Jegibly. 'the Deparfmmthas provided a space at the bottom. of the affidavit for you to f is out in the event the Office oflnvestigat ons has to commfactyou reg=aing the applicant Please be sure to fM in the pemmit/lice mse mmmmber which wdl be used as a r 5xmce ammber. Ih addition,an applicant that mm7st sabmnit mvldple pennsdliceose appht shons m any fine year,need only submit one affidav t indcatmg=ent p olicy iimfomzation �ifsamy)and under">obe 14s"the applic�should vie-all lams in Cady or town)»A copy of i3me affidavitl3mathas bey officially sl ed az ma>�bythm city or town may be provided to fie applicant as proof that a valid affidavit is on file for t�re'pe�mits or licenses. Anew affidavit mmmnst be:filled out each year.,Where a bourne owned or citizen is obtaining a license or permit not relaind to any business or commercial vie Cie.a.dog license or peanit to bum Imves eft.)said person is NOT regakrd to complete-[his affidavit The Office ofInvestigafinns wauIdL7fleto thankyouin.advaa=foryour cooperation and shouldyouhave any questions, P . lease do nothesifafm to givO m a call The I}epm m mes ads,telepllone and fax mumnbm- ' T��a�tttbE of .c1l�tts . ent c6f InialAwi� ' Off ce a$favafio= MA�4�asbmg�. • 02111 Ta 4 617-' -4940 wt 4-06 Qr 1477 MA MA E Fax#617 727-7M R-mvised4-24-07 maa gP Offa `:' f Ylassachusetts Department of public Safety Board of Building Regulations and Standards License: CS-042957 Construction Supervisor J SCOT!CIMENO PO BW564 SAGAMORE MA 0256� i. , Expiration: Commissioner 09/20/2 018 r r Constructioh Supervisor a Restricted to: Unrestricted-Buildings of any use group which contain , less than 35,000 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW-MASS._._ GOV/DPS Office of Consumer Affairs '� fie�pomvrraoazu�ea�i o�C?�ac�uaeCGl i i &Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only Type: Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulatior 50 10/26/2016. 10 Park Plaza-Suite 5170 Boston,MA 02116 Cimco Construc4ioiafinc. 1„ J,Scott Cimeno 37 Yearling Run Bourne,"MA 0252.. `'' " Undersecretary Not valid without signature u` Town of Barnstable Regulatory Services s" Richard V. Scaly Director Building Division. Paul Roma,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 and Sign This Section' If Using A Builder; I `--)(-a w as Owner of the subject property hereby authorize WI to act on my behalf, in all matters relative to work authorized by this building pemnit application for. (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 "--Si&0&weSf Applicant C4it S �9 a ���a yJ ►..� M G�2 Print Name Print Name Date F QFORMS:OWNERPERMISSIONPOOIS Town of Barnstable Regulatory Services pF1HE Richard V.Scali,Director Building Division • Paul Roma,Building Commissioner I g6 & 200 Main Street, Hyannis,MA 02601 Ep www.town.barnstable.ma.us Office: 508-862-403 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION n �1 Please Print DATE: [22 L JOB LOCATION: Ta W G� n 1 ar number nn street village "HOMEOWNER": LLe, tr4 name ��/j home phone# work phone# CURRENT MAILING ADDRESS: U GG city/town state zip code The current exemption for"homeowners"w pextended to include owner-o u ied dwellin s of six units or less and to allow homeowners to engage an individual for hire o does not possess a licens ,provided that the owner acts as supervisor. DEFINITION OF H011 WNER Person(s)who owns a parcel of land on which h /she resides or intends reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use d/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Sucbf`homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shalhbe res onsible fo all such work performed under the buildin ermit: (Section 109.1.1) The undersigned"homeowner"assumes responsibility�for compli ce with the State Building Code and other applicable codes, bylaws,rules and regulations. 1 The and d"homeowner"certifies that he/she under the Town of Barnstable Building Department minimum inspection pro ce requirements and that he/she will comply wi said procedures and requirements. S• f Homeowner it Approval of Bu du►g Official Note: Three-family dwellings containing 35, 00 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. OMEOWNER' EXEMPTION. The Code states that: "An homeowner erformin wo for which a building permit is required shall be exempt Y g gP q P from the provisions of this section Section 109. .1-Licensing of construction Supervisors); rovided that if the homeowner ( gP engages a person(s)for hire to do such work,th t such Homeowne shall act as supervisor. Many homeowners who use this ezem lion are unaware th t they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Li rising Construction S pervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly whe the homeowner hires licensed persons. In this case,our Board cannot proceed against the unlicensed person as it ould with a licensed Sup isor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is f y aware of his/her respons ilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands a responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns.' You may care to am e d and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fomis\E)TRESS.doc 06/20/16 W,/ 'ngineering-,Deptr.(3rd floor) Mao q 0 ,P,jrcel ��Q �`�. Permit# �� --'• House# (9) T_::J Date Issued " 9 Board of Health(3rd floor)(8:15 9:30/1:00-4:30) Fee � �ao Conservation Office(4th floor)(8:30- 9:30/1:00 2:00) Planning Dept.(1st floor/School Admin.'Bldg.) THE►q ' Definitive Plan Approve ing Board 19 BARN STABLE. ` MASS + TOWN OF'BARNSTABLE{ } Building Permit Application Project Street Address �'� /A:&miu. .AagLz, Clev '(� Village Owner /l. _ 1t,a L!/)!� Address 4d11g614 L Telephone 7 'Permit Request F -First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size + Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) ' Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name / /I y&Yo/L k-. 9 j'c,6(aOta_jL_ Telephone Number -7 ?$'7.7 b 3 Address P. ® . ' l' �// License# /10 _ y Z C Home Improvement Contractor# Worker's Compensation# 190 f/L, qyq 0g7 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 SIGNA RE ��1�5�_ �( ��,�� lYl(.�� DATE, BUILDING PERMIT DENIED FOR THE LLOWIN REASON(S) -' -' FOR OFFICIAL USE ONLY PERMIT NO. Z D�TE ISSUED. MAP/PARCEL NO. ADDRESS '�, VILLAGE, � + . : _ a {: � � � �. '� • �` w OWNER u DATE OF INSPECTION: FANDATION FRAME � , E � •' i � -� + -.- rt + INSULATION FIREPLACE , p r s ELECTRICAL: ' ROUGH FINAL PLUMBING: ROUGH .� FINAL GAS: ROUGH FINAL ` FINAL BUILDING - MATE CLOSED OUT. ` ASSOCIATION PLAN NO. ', r a HOM �• - � , °Boarg I PB0ijd Y ENT ONT ACTORS - RE I TRATIO ing egu atlons GG s N One Ashburton Place and standard i - Room 1301 s Boston, Massachusetts 02108 , r , �4 f HOME IMPROVEMENT CONTRACTOR I Registrat 108 - # Type_ DBA�n R18 Expiration 08/ 98 27% - --- - --.-- ---- THEODORE f_. : HITCHCOCK HOME IMPROVEMENT CONTRACTOR TtfEQDORE L HITCHCOCK. t Registration 108918 PO BOX 211/55 LISA L.N TYPe - DRA t h! BARf,.IS TABLE MA 02668 Expiration 08/27/98 THEODORE L. HITCHCOC K 3 THEODORE L., HITCHGOCK.., �BOx 211155 LISA LN aoMirvisTanroa 8ARNSTABCE MA 02668 t r �L The T® of Barnstable .. .� 9� 1e Department of Senith Safety and Environments Services Building Division 367 Main Styr;Hyannis MA=601 !Office: 508-;'90-6Z'7 Ralph C 7 Balph _ Fax: 508-'�90-bZ 0 For office use Only Permit no. Date AI`MAVIT HOME MOROVElMENT CONTRACTOR LAW SUPPLEME:`1T TO PERMIT APPLICATION ry MGL c. 142A requires that the "reconstruction, alterations, renovation, MPair, moderni=z conversion, improvement, removal, demolition, or construction of an addition to any pro--xin owner occupied building containing at feast one but not more than four dwelling ani s or structures which are adjacent to such residence or building be done by rcgistered contractors, A certain exceptions.along with other requirements . _ Fat. Cost Type of Worst: —Jz-y� �dlor=Address of Work: Owner's Nunte_lL oDJi��J�A..� A Date of Permit Application: I hereby certify that: Registrtion is not rcquired for the fciIowing rr=on(s): . Work excluded by law _Jab under S1,000. Building not owner-occupied s F _ Owner puiling own permit Notice is hercbv given that: OWNERS PULLING TIiEjg OWN 'PERMIT OR DEALING NITS UNREGM=1 ` CONTRACTORS ..FOR �P�C��O GR<�.M OR HomE �JRA�D UNDER MGWORK DO �O 24Z,.�'RA� . ACCESS TO THE. ITI;ATION P. < ; SIGNED UNDER PENALTIES OF PE.RJYJRY I hereby appiy for a permit as the agent of the owner: _ LT1ID ten-1� Da Cintractor flame Departnrcrrt of ludustrial Accidents �� �,.�. �.�"l� • !�' 011iceellayestlgatlans '-\.�:• ...._i 4,600 !1"uslliu"'tuit Street ' '•4,� k.�. % +' Btt.�•tutt. •'11uaa: U3111 Ulurk-en' Compensation Insurance AMdavit �lhrlic minftirmntinn Pic'ts'e PRINT Z-iliiv T Inc inn �7 cin ��ifL�l9 ��-� � nhnnr.e 715;�7, l a homeowner per:ormin_ all work myself. — 1 am a sale proprietor and have no one workin_ in an'. capac:ry [ I am an employer providing^workers compensation for my empiovees working on this job. Mnrn tm n tmr cir� ��Jn.lnl,Or�i(iG nhnnr a• ��®�� /.7.� 77(.�� incur nrr n / /l�}i11zx��.0) nnlir� t! p© [ I am a�olc proprietor. esneral contractor. or homeoi%,ner(circie otter and have hired the contrat::ors listed beiow .A the "odowin_ .vorKerr' cam oensation.pai ez: cnmr•rnv 9ninr• - Jtlrlrr•�• _ ct• .. nhnnr a• in•nr-nrr rn _ _ �__ _�j`.. •. _� � �_ mot.-_�_ _.T.:�.�.�..t:' __ T►... cnn,^^n,. 'limy•• - nchirr— rtrl. brine d• nniic'� incur:-nrr rn. Att_crt additional sncct if necr_san - Fauurc to�ccurC ntvcrat:c as requtrcu�unucr�eeuon—"Aof 11G:. 1S2 can tcau to the tmpo mw;o1 criminal penaiues of a lint up to Sl_t1U.UL Unr cars' impn.onment a. l.t11 :ti nsti penalties in the form of a STOP WORK ORDER and a fine ufS100.00 a day against me. l understan. copy of thk aatcutcut nta,% Uc funl nracu to the Qnicr of Invcstit:znons of the DIA for coverigi:verification. /do irercM c r. {i tritrr�r rlte prritrt nua pcttnllir of perjurr that the information provided above is true nud correct. oalc iir:n -W., Phone 9 / olTiciat ttse unit do not%•rite to this area to be completed by city or town 0Mc321 i' permitllicenst:R t—tluildint;Department cttt or tntrn: CU.Cnstn_ 13uard Cticittamcn*.orfiCr cncer irlmlitcuiatc respunse is required (_'iticsith Ucpartment _ A Phone>i; —Utbcr :cnra::;nrrcnn: . • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, Map Parcel ApplicationD C Health-Division Date Issued I� a Conservation Division Application.Fe Planning Dept. Permit Fe •06 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address ,(. j � J��`l • Village Owner Address � 1� Ln . Telephone " ✓V�s • �� � 1� Permit Request 1 �� Square feet: 1 st floor: existing proposed 2nd.floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑'No if yes, attach supporting documentation. Dwelling Type: Single Family -❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's_FH ghway: 'q Yes-Z!:❑ No CD1Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft)l % k. Number of Baths: Full: existing new _ Half: existing - new Number of Bedrooms: . existing _new saw Total Room Count (not including baths): existing new_ First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing__New _ Existing wood/coal stove: ❑Yes ❑ No Detached garage: 0 existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # _ Current Use �lEla l'XS� �.Q Proposed Use APPLICANT INFORMATION LDER OR HOMEOWNER.) Name _ Telephone Number Ad ress ���` �,J —�J "I License# 6o Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO T SIGNATURE ll DATE 3 �� FOR OFFICIAL USE ONLY 44, APPLICATION# ..,:,DATE ISSUED 4.-,MAP/PARCEL NO: F3 c7z: ADDRESS VILLAGE OWNER Z. DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE if ELECTRICAL: ROUGH FINAL-,.! PLUMBING: ROUGH FINAL—. c e>- GAS: ROUGH FINAL .,FINAL BUILDING DATE CLOSED OUT 72 ASSOCIATION PLAN NO. I F.t . The Commonwealth of Massachusetts 43) Department of IndustrialAccidents m Office of Investigations d 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibly Hanle (Business/Organization/Individual): M.T. McMahon and Son, Inc "Address: 19 Fieldstone Way City/State/Zip: Plymouth , Ma 02360 Phone#:781-831-1234 Are you an employer? Check the appropriate box: Type of project(required): 1. ■❑ I am a employer with 9 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.9 Other Weatherization comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Aim Insurance Policy#or Self-ins. Lic. #:VCW-100-6014109-201 Expiration Date: 12/08/2015 Job Site Address: 2XL,1) L V 1 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided bove is true and correct. Si ature: Date: Phone#: 7818311234 Official use only. Do not write in this area,to be completed by city or town official. City or Town: I'. .1�. Permit/License# Issuing Authority(circle one): ~+ 1.Board of Health'2.Building Department�3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATfl(NMlDOIYYW) CERTIFICATE OF LIABILITY INSURANCE ACORd CERTI� iz 9 �4 F INFORMATION ONLY AND CONFERS NO RI�NTS:UpnN AFFOR IDW BY THE POLICIES THIS CERWICA IS ISSUED AS.A MATTER 0 THE COVERAG CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMINO, EXTI=ND OR ALTER THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SETWESN:TW6 ISSUING INSURER(S),ALlSHORIZED BELOW, ust CATION>i D,Su O to REP RF.SENTATIVE ORPRODUCER,AND THE CERTIFICATE HOLDER. pOgTANT: I tha flCa holder IS an ADDlT10e A INSoq E�an endorsement..nm A eta mlent on tVd S certificate does not COA?MOB tO Hhe the terms end conditions of the POIICy,Certain po y certlRoate holder In II9U of such endorsements). , (78s) 335-0782 pROtXlCBR PHO E 781 -1890 Thompson insurance Bs;_ J�7Tinsd Comaas t.net _ and $inanai.al Services NAtC a INsuRe s a� PPORcu�a coveRA®e . 389 Union Street: r gRER A 7 Trauel ess� ,... Weymouth, xhA 02190_-316'_ _ .• _ _ .... . ._. _ _ _. -- INSURER B.A MUtual INSURED =n8u � S3 Ca O bon McMahon and Son Ync. NSURERC ti9®atexn �Q-�--- 19 Fieldstone way INsu eR. o Plymouth, MA 02360 1 RRE: INWRFRF: - REVIsION NUMBER: POLICYCOV@RAGES ERIOD CERTIFICATE N UMBER: ZECLUSES O CERTIFY THAT THE POLICIES OF INSURANCE E URANCERM 0 DCOND�ION OF ANY CONTRACT OR OTHER C RFI N WITH,FCTReS TO A'I TO,WHICH D NOTVVITHSTANDINO THE INSURANCE AFF0 CEO.BY THE POLICIES DESCRIBED HE IS SUBJECT TO A' THE TERMS, E MAY 8E ISSUED OR MAY PERTAIN, AND CONDITIONS OF SUCH POLICIES.LIMITS SHOVVN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LIMTB TYPO OPIN86RANCE UCYN M N 9/16/14 9/16/15 EACHOCCURRENCE 8 LLae,L y NP8S202484 D Mu „.�� S 1001.000 COMMERCIAL OENERALLIABIUTY MEDEXP(A oro enbh) 3 5 CLAIMS-MADE OCCUR PERSONAL&ADVINJURY 6- _ GENERAL AGORMATE i O 0 PRODUCTS-OOMPIOP AGG. S O GEN'LAGGREGATE LIMIT APPUESPER s - POLICY Loc 0/31/14 8/31/1S ae al rt14000,0 AUTOMOBILE LIABILITY BA 2CO92729 BODILY INJURY(Parp"0n) S ANY AUTO BODILY INJURY(Per W0141601 .i AUTOS ALLOWNED X AUTOS LP0 PgR T tbG S OREDMOS, X AUTO wNEO X I S UMBRELLAUM OCCUR 180313LI40ALI! 31/24/1d. 11/2d/15 EACH OCCURRENCE- S 1 '000.'000 D AGorae�ATE - s .1 000 000 EXCESS LIAR CLAIMS-MACEgo 8 V"lKERB 9M ENBATION VWC-100-6014109-201 12/s/la 12is $ AND EMPLOYERS'UAMUTY YIN L E CN 0 00.0 ANY PROPRIE70RIPARTNeRlEXECUTIVE PNIA 500E OOD OFFICERMIEMW EXCLUDSW (Mnbaeey M 1 E.L,rn 0•POLICY L 1 e - SOO 000 If a dleeelribeund� DESCRIPTION OP OPBRATIONB I LOCATIONS I VEMCLES(A#&Ch ACORD 101,Addhj0 iAI:RenMNO SCbedUIO,If nj0re eptC4 Ia rogllrod) CERTIFICATE HOLDER CANCELLATION F SHOULD ANY OF THE ABOVE OESGRISED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED :IN SS+l1NK ACCORDANCE WITH THE POLICY PROVISIONS. AUTMoa¢eo REPREEeNTATVE _ John J. Thom son O 1988.2010 ACORD CORPORATION. AU rlghte reserved. Federal ID#05-0405629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120970 A division of Thielsch Engineering. CT Contractor Registration No 620120 S Dupont Avenue,South Yarmouth,MA 02664 CONTRACT 508-568-1926 X-6613 FAX 508-568-1.933 CONTRACT Page 1 PROGRAM R I S E � THIS CONTRACT 19 ENTERED INTO BETWEEN RISE ENGINEERINGCLC-RCS ENOINEERINO ANO THE CUSTOMER FOR WORK AS DESCRIBED BELOW CUSTOMER PHONE DATE CLIENTS WORK OROER ' Elisabeth B Brown (508)775-1175 09/f 1/2015 199625 00002 SERVICE STREET _ BILLING STREET 28 Lawrence Lane 28 Lawrence Lane 'SERVICE CITY,STATE.ZIP BILLING CITY,STATE,ZIP Centerville,MA 02632 Centerville, MA 02632 JOB DESCRIPTION AIR SEALING:Provide labor and materials to seal areas ofyour home against wasteful,excess air.leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage-to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) (16)working hours. A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. $1;232.00 AIR SEALING:Provide labor and materials to install Q-Ion weatherstripping and a doorsweep to(2)dcor(s)to restrict air leakage. $154.00 ATTIC FLAT:Provide labor and materials to install a 9"layer of R-30 unfaced fiberglass butts to(414)square feet of attic slope. $794.88 ATTIC FLAT:Provide labor and materials to install a 9"layer of R-31 Class I Cellulose added to(520)square feet of open attic space. $686.40 KNEEWALL SLOPE:Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(212)square feet of kneewall rafter area. $701.72 ATTIC ACCESS:Provide labor and materials to make(1) temporary access to an attic area. The opening will.be closed with materials similar to those existing. Finish sanding and painting is not included. $74.19 VENTILATION:Provide labor and.materials to install ventilation chutes in(80)rafter bays to maintain air Flow. $279.20 VENTILATION:Provide labor and materials to install(lo)4"X 16"rectangular aluminum soffit vents to increase ventilation in attic areas.Specify color.White $280.10 COMMON WALLS:Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(280)square feet of common wall area. $926.80 BASEMENT DOOR:Provide labor and materials to insulate the back of the basement door leading to the bulkhead with 2"rigid board that meets the sections R-316.5.4 and 316.6 requirements ofbuilding code. Seal all edges and seams with FSK tape. $72.22 INCENTIVE:RISE'Engineering will apply all applicable,eligible incentives to this contract.You will be billed only the Net amount. Currently,for households where total income.is less than or equal to 80"/6 of median income,the Cape Light Compact offers 100% incentive toward eligible insulation measures,not to exceed$4,000 per calendar year and an incentive of 1000/6 for the Air Sealing measures. For the safety and health of your home's indoor.air quality,we will be conducting a blower door diagnostic of the available air flow in your home both before the work is begun,and after the weatherization work is complete.We will also conduct a full assessment of the combustion safety of your heating system and water heater.This has a value of$90 and is at no cost to you. I Federal ID#05-0406629 RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division of'l'hielsch.Engineering CT Contractor Registration No 620120 5 Dupont Avenue,South Yarmouth,MA 02664 CONTRACT 508-568-1926 X-6613 FAX 508-568-1933 I S Page 2 PROGRAM THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING CLC-RCS DESC ENGINEERING ED HE CUSTOMER FOR WORK AS CUSTOMER PHONE DATE CLIENTS WORK ORDER Elisabeth B Brown (508)775-1175 09/11/2015 199625 00002 SERVICE STREET T'. - _ ��--BILLING STREET 28 Lawrence Lane 28 Lawrence Lane SERVICE CITY,STATE,LP �- - BILLING CITY,STATE,UP Centerville,MA 02632 Centerville,MA 02632 JOB DESCRIPTION $90.00 Total: $6,300.61 Program Incentive: $51300.51 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS,FOR THE SUM OF ***00/Dollars $0.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON.ANY UNPAID BALANCE AFTER 00 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION.SCHEOULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES AUTHORIZED 9rGNATURE-RISE Engtrreeting NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN GATE OF ACCEPTANCE1�.11_:-..2U 3 ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE DAYS. SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO GO THE WORK AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE I t• Town of Barnstable �_ oa�yeces ' R#cltard V. .Scalt Ah-wor Tom Perry,AugO agCupmkdoupx 200MakSbmt;$yannis-U&02601 WWWA wabarnstable ma m 00166.0M62A3$: Fax: SM 790,6230 Property Owner Must. Ca ple a and,S�tgn 'T` u'is Sec ,ion If Usine.ABdWr Qavueir.P: e.'s lec P r4erxY lr�baucdzz 1/) c: a !1!1`n1. So ;c?n: �. z. �a all matters.rev+e oQ work m6oamd byis buding..petmit application far. Address:af �`"�` 0O1 finca andiLims are The iesp6wiWiryoif the vpuic=t Pouts a'tae n tto be: d or utilized befog -fence 4'installed and ag final nspe-e ions=+ peifonned tmd agCVMP_a. .saiguanug of Applicant $ari it :PuatN=6 Dale. Q)&ORM&OWNMeMtMSIONP00L.4 f setts-. sa Department of Public:Safety. ' C��r. �ai�errs�,rrac(xl�o��llruac��iselGr r � Massachusetts _W- E Office of Consumer Aifaus&Busioit"ReguiNtio6 Board of Building Regulations and Standards OME IMPROVEMENT CONTRACTOR Constructi+n Superi,koregistraGon: Type: License:.CS-068111 xpiration 11/24l291:6 Private Corporatic- fir:) MICHAEL T MC�OLV .MICHAEL T.MCMAHON 8 SON1NC: " rt 19 HELDSTONE,WA'IY PLYMOUTH MAr 02360 r MICHAEL MCMAHON ,j ' 19•FIELDSTONE WAY , ! .r. FC -1yYMOUTH,MA 02360 �` 4 , , :• �,,�,, Expiration- Undersecretary + , 08/17/2016°• f Commissioner r f ice-- - Unrestricted=Buildings-of any use group 3j htc}i 1. T _� nr ree�strat•ion valid for individul use on.; , contain less than.35 000 cubic feet(991ttt of, t before the expiratio:r date. i .and return to: enclosed space.' Office of Consumer A ffairs and Busi sa':teaulat+on r 10 Park Plaza-Suite '170 ; t Boston,A1A,02116 '- i ► , Failure to possess a current edition of the Massachusetts j state Building Code is cause for revocation of this license. Not valid without signature For DPS licensing Information visit: www.Mass.Gov/DP5 l Complaint Number: 1620 ,Taken bv: LTILI� TG RVI S� CS - w 3. ,. m Date: 1 12 2000 yMan/parcel Referred to: huiL G _ SUBJECT OF COMPLAINT Business/Occubant Name:: LEE BROWN NumberStreet: ILAWRENCE LANE Village: _ CE ]ZVI.LLE . = LL COMPLAINT INFORMATION E _ Complainant's Name: JAKONY Address: a Telephone Number: _ ComplamCDescription: y RUNNING REAL ESTATE BUSINESS FROM _ r ; HOME--CARS COMING AND GOING ALL . DAY. _ .. _ Actions,Taken/Results:: REFER TO R J. 4 e ' n DateiClosed , 3 + TOWN OF BARNSTABLE Permit No. ----------_----------- { ]PA"n.n, Building Inspector N"& Cash ------------------------ 'oe OCCUPANCY PERMIT Bond ---—_-------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to [ii' 'riLr'Z V1 i iC LC3T t Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ............................I........................., 19......__ .................................... .............................._..... _._......._..__._.._. _ Building Inspector Assessor's reap and lot number .. .. . lC:... ' �'` THE • ' c V Sewbge Permit number ...':... .........�/ �:� .....:............ SEPTtiG NIP o„ 1NVALLE® 1N Co "�� T'6 G 5Z B ADLE. i House number ....................... .......................... � EN�R�Nl1�ENTAL CO ' 39• �0 �LAT�O MAI a TOWN ;OF "B,ARNSTA 1` = B U I L 0 INS`-IN S-P EC TO R APPLICATION FOR PERMIT TO ... G .. ..f. .. . ............... . ...................... ........... i . �� TYPE OF CONSTRUCTION .......................... ................................................................................................... .................. ................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... `.®. .J......a'.'¢ !�-e �.L V !!i E- v f�rJ�/ .................................. .......... ..... ....... .... Proposed Use .. ` .G�. .....�Z�. . .. +? f ,........................................................ Zoning District ......:..........................................................:......Fire District .....G� a Name of Owner ..... ................. ..U.` ..v�c. .. .:Address ..... �� Name of Builder ..........*w.e..""................................Address ............... .......................................... Nameof Architect ..................................................................Address .................................................................................... • Number of Rooms ............6.................................................Foundation �. Exterior Roofing ....................: .. . Floors .................. .�!....k.....................................Interior .................... Heating ` ..........................:.....Plumbing ......,. .................... ............................................... Fireplace !. .............. Fireplace ....... -............................................ ...........Approximate Cost ............. .... Definitive Plan Approved by Planning Board ____________________________19______— Area ....... '.... ....................... Diagram of Lot and Building with Dimensions Fee L!�............... . ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I tl2 I `t' Ida 2 I hereby agree to conform to all the Rules and Regulations of the Town Barnstable regarding the above ' construction'. Name ........................ ..................................................... TOTE CENTERVILLE CORP. t One 1�2 Story '1No ..:.22480............ Permit for „Single Family. Dwelling„ ,,„ Lot #5 2$ Lawrence La Location ...........J.....:.... Xle - Centerville ................................ ,f e Centervi 1 Owner le Corp,,-.,---,,, Type .of Construction ....Fr.d Q........................ - . ......................... ................................................ Plot ............................ Lot ............................... Permit Granted ...,,,September: 4.r...19 80 Date of Inspection ....1 ..�: � ...... ........19 Date Completed ...[..U..� ..................19 PERMIT REFUSED � ` ............. ,...... ;19 ............. ... `*. ............................................... •... ......... ' . .x............................................ i Approved :........................................ 19 - .............. ............................................................ Assessor's map and lot number ...^............,.:.......�... .. THE of ro d��� -41 7 t Sewatige Permit number ............-.......:................................. d Z MAHHSTADLE, i House number .......................y .. �"�.......................... 90 MAO& po,s639. �Ea MAI a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ��Z�, c,!C/ �(J TYPE OF CONSTRUCTION "`✓ 0Q d ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 40 Location /`. fir . �. 4;t.�E- c 10� .............. Proposed Use .. /lL'`�. ........ ...../....�`.��......z�f ZoningDistrict ........................................................................Fire District ..... -� ......................................................... Name of Owner � -� �/� ..`-{/7 ..Address _ T Nameof Builder ......... 'r t+...............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .............................................Foundation /4 ��0 a f-�R... ...............�. ..................... .^............................ Exierior ... �al �l�C � Roofin � C'' .`.............. g .....................:............ Floors ....................... .....................................Interior ....)":............................................................................ Heating ? .... ........................'7.....`�d-- '........................Plumbing ..11l111.....c...l•# C�145............................................ Fireplace ........0,/x�•'�..-:•...........................................................Approximate Cost ......��,j cid ....................:.... Definitive Plan Approved by Planning Board --------------------------------19--------. Area ........ �1.7 ...fl •....... Diagram of Lot and Building with Dimensions Fee V SUBJECT TO APPROVAL OF BOARD OF HEALTH 6 I hereby agree to conform to all the Rules and Regulations of the Town Barnstable regarding the above construction. ; � , Name ....:- .................................................... P� THE CENTERVILLE CORP. A=190-250 y 1100 0111j� No ...224.80. Permit for ...One..112 Story Single Family..Dwelling............... Location .Lot #5, 28...Lawrence Lane ........................ Centerville ............................................................................... , Owner ....The..Centerv„ille Corp.,,,,,,,, t .. Type of Construction Fra!, ,,,,,,,,,,,,,,,,,,,,,,,,,,,, Plot ............................ Lot ................................ Permit Granted ... .September ,,4,,,,,,19 80 Date of Inspection ....................................19 Date Completed \.'.'.`... .�...........................19 PERMI REFUSED ............ �. ....... ............... 19 ....... .... .. . . .1.. n�. ........... ......... .t.......... ............... ...........................ik�.......................................... ............................................................................... Approved ................................................ 19 ............................................................................... .................... ......................................................... i .�sv.o..• .�, r zs+rrrw 0-157 All Z. a•.t� �• ! 7`7s T L'QC 1 G. < C� 1 THEv,Vt�A T/�M. S�,! WN pf >, r` RICHARU C. RI HARD _ JAME5 ilq r HFARN ARN r ONo. 691 cn - ` No. 27871 F+IS 1F . i PISTE``' peg SANITk�EXIST.ING- SPOT 4ti�x� Qa� EEGE EXISTING CONTOUREVATIOONS :_OA 's-s'��'�;.z"L-yiv<� FINISHED SPOT ELEVATIONS fO.O FINISHED CONTOUR 0 PROPOSED PLOT PLAN APPROVED.% "BOARD OF HEALTH , MAS D:AT E AGENT ' : 07 r✓, f✓� " . - �✓ ..:: . .....:.. 1 CERTIFY THAT THE PROPOSED R. % O�HEARN, /NC.,'RLS, RS 8U'IL01NG.... SIiOWN ON -THIS . PLAN 1348 ROUTE: 134 CONFORMS TO T.H.E . ZONING . LAWS . EAST" DENN1 , MASS OF w4v, r ;, MASS. _ _. DATE : SCALE ' / ' E?0 —7G.�JOB NO. CLIENT: L•��-;�—r _ DATE GIST AND SURVEYOR, DR. 13Y SHEET` OF7777, 2 xr .17 SOIL TEST INVERT ELEVATIONS NOTEs: AT F. /i' 4}:d INVERT AT 1 f FT . ALL `W'ORKMQhSHLP AIJ'D' MATERIALS = . D E 0, , SOIL TEST IN ER BUI,LD NG WITNESSED BY �:Lr �2 iY'r- G� .r f INLET SEPTIC' TANK '= FT SHALL CONFORM TO D E Q:E. TITLE "FS OUTLET SEPTIC TANK �' , 3' FT F ,9 ,.r � IJAS PERCOLATION _ RATES-- - MIN./,INCH AND THE . TOWN O RAND : REGULATIONS FOR SUBSURFACE LON HOLE I RVATION OBE' INLET DISTRIBUTION BOX Sc- FT OUTLET ~`=DISTRIBUTION BOX ,, FT OBSERVATION:. OBSE I�_ 2 ; DISPOSAL OF SANITAR l SEWAGE.. EL E VA ION ELEVATION INLET LEACHING PIT ,. FT. r BOTTOM" .LEACHING PIT a. FT. Rr DESIGN CALCULATIONS NUMBER, OF BEDROOMS .. . . �f . . . . . . . . ,.. G DISP U ARBAGE . . ;OSAL: NfT . . . . . . . . . . �:. TOTAL ESTIMATED FLOW ( GAL./BR:/QAY x_ BR.)::. GAL./DaY' REQUIRED SEPTIC TANK CAPACITY. . GAL. h : v ACTUAL . SIZE OF SEPTIC TANK TO BE INSTAL.LED.. ...: GAL LEACHING AREA REQUIRE-ME:NTS. . SIDE WALL AREA?-ca GAL./S.F . ., BOTTOM AREA l a' GALL./S.F. 'EvIf:0vi✓� /� LEACHING CAPACITY ( BOTTOM SIDEWALL ).. . .. .. . . . 5" 'i, GAL: RESERVE: LEACH IN C.APACITY. . . ... , . c . . . . . . . . . : . _, GAL. #, TOP OF FOUND: ` ELEV. - CONCRETE .4" SCH.. 40 CLEAN SAND, CCOVERS PVC PIPE MINI PITCH 1 CONCRETE I'/8 PER: FT. COVER f i 1251 MAX. 4 2% MIN. PITCH it 11 11 .'t•' Rs'�!- 27. 'r t t 2 LAYER OF. t/8 -� 1/2 Ric�ARQ � .. FLOW..LINE — r.= J =: \ >E { ' - JAMES r I S S Nz aRN ti ONHE 11 -p z D WASHED H E D/ n T I{ W. �c 9 6N� r W ONE 4 CAST IRON — I 2 F 0 P{PE -.MI:N. . PITCHNITk , 3 , O�stR �� E V;ASHED STONE: ,1 IF4 PE'R FT.:: DIST.-. � .ry I L �- � PRECAST LEACHING' BOX �� � v w a .� BASIN OR EQUIV. I t!J n' a g TILL� b. U // �-:xF'_�-• J :r'"t!-C�•�.a/u�. �.�'iv!� yi n L!, o G� I aoQ GAL : = MASS. ! - SEPTIC'- F . - F RN, INC., RLS, RS I -r TANK � Gr 8 s. R. J. - A _ . . N SST. (RTE 28 ) v WEST DENNIS , MASS . �} ... ' PROF ' OF GROUND;. .WAT`E^R TABLE x JOB. NO: L'� CLIENT.. 1 . SEWAGE DISPGSAL. : SYSTEMf NOT TQ _SCALE IDAT "