HomeMy WebLinkAbout0084 NOTTINGHAM DRIVE ACTIVE
'�' SolarGt
_ y. v
Date: 06/22/2016
To: Barnstable Building Dept.
From: SolarCity Corporation --4
Cape CodWarehouse F- ZE
112 Great Western Rd - z
South Dennis,MA 02660
NOTICE OF CANCELLATION W
r�
This notice certifies our proposal to install Solar/PV @ -84 Nottingham Dr will not move forward.
The customer and SolarCity have decided to no longer move forward with this project.
Please cancel Building Permit#B20152869 and the accompanying Electrical Permit.
Please contact myself directly with any questions/concerns.
Thank you for your assistance.
Best regards,
Nathan Tissot
Permit Coordinator—Cape Cod
SolarCity Corporation
112 Great Western Rd
South Dennis MA 02660
Work#508-640-5389
ntissot@solarcity.com
t
SOLARCITY.COM
AY f 213771'iiOC7d5.1MVR0�77:;98.CA f_lCx8881G?.CO ICAu.t1.GT H r,0532778 El"C WZ5 v35,IX Nil lGi 186 cL'C`_>.W,1,0 G,JT7Q,kW HK-168572.KLA Et-113VOR.'AD',4Nn;128o-18,
NJ OR 102 PA iI�GPAo;73413.T\.W.L12700l.,WA6'CIPAC'414]1.BOi.A.RC'u".k.P Q M4 St.N AR�''TY CORPOHNITUN.ALL RIW IS HESUNED
1a , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 11 a Parcel O 1l¢ Application # ad J d �y3s
Health Division Date Issued lolly),j-
Conservation Division Application Fee Iel
Planning Dept. Permit Fee "
Date Definitive Plan Approved by Planning Board
Historic - OKH WO _ Preservation/ Hyannis
Project Street Address
Village C� n�c�✓ I1�
Owner Tc�4\�.. c� -I-nccic���I� �.��q.R Address 'H IN.
Telephone ; t 3�.
Permit Request �..�� Sn\� �5I - , h U-)
<< (o b, c
1N G AI a.Z1S
Square feet: 1 st floor: existing proposed —2nd o exist'`1� proposed Total new
Zoning District R,G Flood Plain roundwater Overlay
Project Valuation *S @0 zoc o uction Typ
Lot Size andfathe ❑Yes 9No If yes, attach supporting documentation.
Dwelling Type: SingCam . o F 'ly ❑ Multi-Family (# units)
Age of Existing Struu m Histori House: ❑Yes �-No On Old King's Highway: ❑Yes ANo
Basement Type: ❑ awl ❑ Ikout ❑ Other
Basement FinishedBasement Unfinished Area (sq.ft)Number of Baths: F new Half: existing new
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
(Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
t` Detached garage: ❑ existing ❑ new sizq�*ool: ❑ existing ❑ new size f�Barn: ❑ exi!§tj g ❑ new sizAll#_
C4-1
Attached garage: ❑ existing ❑ new sizeV-S-hed: ❑ existing ❑ new size)'--Other: L ,
4
b
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes $NO If yes, site plan review# y
Current Use Proposed Use Ar0 w L '
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name I,-(- 335 Telephone Number �(0 S3i'�
Address 1 \a- A,,,t �c5�cs-(1 I�D�cI License# 0-S - (bg w s
��t\rl
S a(. 0 Home Improvement Contractor#
Email I'i��r1,S�c� Worker's Compensation # WaD 1$01D(S -Z)b
ALL CO RUCTION DEBRIS RESULTIN ROM THIS PROJECT 11 ILL BETAKEN TO u
b Cock-d
SIGNATURE DATE 1, a 5. d-d IS
All-
FOR OFFICIAL USE ONLY
APPLICATION#
< 4
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER t =
47 DATE OF INSPECTION: _
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
40
PLUMBING: ROUGH FINAL
GAS: ROUGH '"--.r�_ FINAL -
FINAL BUILDING
DATE CLOSED OUT Al
ASSOCIATION PLAN NO. - _ -
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map W Parcel Application #l2 D I 0 V 0 I
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation/ Hyannis
Project Street Address /D /4 IJ
Village
Owner �✓ Address eLlm lP a� dV tO
Telephone 3
Permit Request i ✓ S Cc ex I n
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. M--' 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 c_a n W 4
ze,--,
Number of Bedrooms: existing _new o
p
Total Room Count (not including baths): existing new First Floor R om Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove?` Yet❑ No
r rr
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ex sting ❑*w size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER) C
Name WM ► I ►c �SKe L �1 u(01 Telephone Number
Address C �w��✓Z �Q �V License # / 0 0- / �J
d ia� a4041,1 Home Improvement Contractor#
Email Worker's Compensation # -fk/ C
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ydv^m 0 41
SIGNATURE DATE /7
r FOR OFFICIAL USE ONLY
f
APPLICATION# .,- . • _,j
DATE ISSUED
' MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
r -
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
j ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
*' GAS: ROUGH FINAL
FINAL BUILDING
f
DATE CLOSED OUT
ASSOCIATION PLAN NO.
I�r'
Building Permit Authorization
I, Fred Lepore y y , as owner
hereby give my permission to
Cape Save, Inc.
7-D Huntington Avenue
South Yarmouth, MA 02664
Office: 508-398-0398
to take all necessary steps to obtain a building permit to
perform work at my property located at '
84 Nottingham Dr
Centerville, MA 02632
Signed -
Date % 7
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
I Congress Street, Suite 100
YI Boston, MA 02114-2017
a www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Please Print Legibly
Applicant Information
Name (Business/OrganizationMdividual):
Cape Save,Inc.
Address: 7D Huntington Avenue
City/State/Zip:
South Yarmouth, MA 02664 Phone #: 508-398-0398
Are you an employer?Check the appropriate box: Type of project(required):
1.❑✓ I am a employer with 17 4. ❑ I am a general contractor and I 6 ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
❑7. .Remodeling
2.❑ I am a sole proprietor or partner- listed on the attached sheet.These sub-contractors have g. ❑Demolition
ship and have no employees
working for me in any capacity.
employees and have workers 9. ❑ Building addition
comp. insurance
[No workers' comp. insurance co 10.❑Electrical repairs or additions
required.] 5. ❑ We are a corporation and its
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
c. 152, §1(4),and we have no 13.❑✓ Other Insulation
insurance required.]f employees. [No workers'
comp.insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors 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.
T
Insurance Company Name: Technology Insurance Company
TWC 3353968 Expiration Date: 04/09/2014
Policy#or Self-ins.Lic.#: ("ei )n
�6�Job Site Address: rL hav✓( I ® City/State/Zip:
Attach a copy of the workers' com ensation 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.
tion provided strove is true uia correct
I do here h certi under the pains and penalties of perjury t at the informa
---
- - - - -— 'Date --- - - - ---.
Phone#: 508-398-0398
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Phone#:
Contact Person:
® DATE(MMIDDIYYYY)
A�O CERTIFICATE OF LIABILITY INSURANCE 10i22i2013
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 pollcy(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 endorsements.
PRODUCER co
NAME Colleen Crowley
Risk strategies Company PHONE (781)986-4400 FAC No:(7e1)963-4420
15 Pacella Park Drive AI
Spite 240 INSURERS AFFORDING COVERAGE NAIC
Randolph MA 02368 INSURERA:Selective Ins. of America
INSURED INSURERB:Safety Insurance Company 3618
Cape Save, Inc INSURER C:Technology Insurance Company
7 D Huntington Ave INSURERD:
INSURER E:
south Yarmouth MA 02664 INSURERF:
COVERAGES CERTIFICATE NUMBER:CL13102268490 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�TRR TYPE OF INSURANCE POLICY NUMBER MOI D EFF MPMIDDPIYYYI EXP LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000
A CLAIMS-MADE Q OCCUR S1994480 0/16/2013 0/16/2014 MED EXP(Any one person) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:' PRODUCTS-COMP/OP AGG $ 2,000,000
riPOLICY X PRO- X LOC COMBINED $
AUTOMOBILE LIABILITY Ea a dent SINGL LIMI 1,000,000
B ANY AUTO BODILY INJURY(Per person) $
ALL OWNED X SCHEDULED 208200 1/6/2013 1/6/2014 BODILY INJURY( accident) $
AUTOS AUTOS
X X NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS Per accident
$
X UMBRELLA LIAB X JOCCUR EACH OCCURRENCE $ 1,000,000
A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000
tDED RETENTION$ Nil S1994480 0/16/2013 0/16/2014 $
C WORKERS COMPENSATION Dfficers Included for X I VvC Y STATU- OTH-
AND EMPLOYERS'LIABILITYYIN IMI O.
ANY PROPRIETOR/PARTNER/EXECUTIVE NIA overage E.L.EACH ACCIDENT $ 500,000
OFFICEWMEMBER EXCLUDED? 33539fi8 /9/2013 /9/2014
(Mandatory in NH) E.L.DISEASE-EA EMPLOY $ 500,000
Ityyees,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
DESCRIPTION OF OPERATIONS(LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required)
Weatherization Specialists
GL: Blnkt AI, Blnkt PNC, Blnkt WOS,, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow & Ice
Removal/OCIP/Wrap Ups
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
[dichael Christian/CLC ��
ACORD 25(2010105) U 1988-2010 ACORD CORPORATION. All rights reserved.
IN8025(201005).01 The ACORD name and logo are registered marks of ACORD
i
Mass ltssce's -Deoal?f it_*? u'3 ?C Sa+ciV1
Board of Buildina
Constr uctifin SuperN-iCltr Spechihy
_ice;,s2: CSSL-102776 -
WILLL&M J MC C-LUSKEY-
37 NAUSET ROA6
West Yarmouth NA 02673
em^iSS1*0fIe, 06/28/2015
:q� Office of Consumer Affairs and Business Regulation
10 Park Plaza - Suite 5170
Boston, Massachusetts 02116
Home Improvement Contractor Registration:
Registration: 171380
Type: Corporation
- - Expiration: 3/14/2014 Tr# 222184
CAPE SAVE INC.
WILLIAM McCLUSKEY
7-D HUNTINGTON AVENUE
SOUTH YARMOUTH, MA 02664
Update Address and return card.Mark reason for change.
- _ Address Renewal �j Employment Lost Card
DPS-CA1'0 50PA-04104-G10121e'
,> ✓/3e ea�mvirwiweall` c� lLat ac�iclise
Office of Consumer Affairs&BJsiness Regulation License or registration valid for individul use only
before the expiration date. If found return to:
,. HOME IMPROVEMENT CONTRACTOR
�v Py Registration: - =17(380 Type: Office of Consumer Affairs and Business Regulation
gu
Expiration: --3114/2014 Corporation 10 Park Plaza-Suite 5170
p Boston,MA 02116
CAPE SAVE INC.' .r-
WILLIAM MCCLUSKEY \
7-D HUNTINGTON AVENUE
SOUTH YARMOUTH MA`.42664: Undersecretary Not valid wit a signs
Cape Save Inc.
7-1) Huntington Avenue
South Yarmouth, MA 02664
Tel: 508-398-0398 Fax: 508-398-0399
11/10/2014
Thomas Perry CBO
Town of Barnstable
Building Division
200 Main St.
Hyannis,MA 02601
RE: Insulation Permits
Dear Mr. Perry
This affidavit is to certify that all work completed for 84 Nottingham Drive(#201400692) has
been inspected by a third party Certified Building Performance Institute(BPI)Inspector.
All work performed meets or exceeds Federal and State Requirements. .
Sincerely,
William McCluskey
NOISIAICI
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
r �, •1 • �n F !t � �..
Map Z Parcel 1 �-4� Application# ro
Health Division
Conservation Division Permit#
Tax Collector f1,0111' t)'l Date Issued 10
Treasurer Application Fe
Planning Dept. Permit Fee t30° OD
Date Definitive Plan Approved by Planning Board �f/�0/06
plf—
Historic-OKH Preservation/Hyannis
Project Street Address t!
Village ozn�v� 1 it OAA V&-3Z
Owner Red f e- r®r� Address N1�
Telephone �5 a'qZ0 "cP2q6-
ermit Request .f
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new
Zoning District Flood
od Plain Groundwater Overlay
e Project Valuation instruction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family / Two Family ❑ Multi-Family(#units)
ge of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths):existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
_ R
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION /1�t
Name I 1 Telephone NumberVy���'���P�
Address License# � � 77j
Ih�1 Gl1��tn,-n �VL P�I IS flI/1,� !�Z(D � Home Improvement Contractor#
Worker's Compensation �
s# ��� �
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Al I0Y7flC ,NG tl,
SIGNATURE DATE D
FOR OFFICIAL USE ONLY
PERMIT NO.
f, DATE ISSUED f,
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
o y
FRAME
INSULATION
FIREPLACE
r
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
`' ASSOCIATION PLAN NO.
Department oflndustrialAccidents
Office`of Investigations
600 Washington Street
Boston,MA 02111
www mass.gov/dia
Workers' Compensation'Insurance Affidavit: Builders/Contractors/EIectricians/PluniLliers
Applicant Information Please Print Legibly
Name(Business/oroanizatimVIndividual):
Address:�z�
City/State/Zip: Mar/9 '25)iQ it� MA Phone#:
Are you an employer? Check the'appropriate bog: Type of project(required):
1.[ I am a employer with 57 4. ❑ I am a general contractor and I 6. ❑ New construction
employees(full and/or part-time).* have hired the.sub-contractors
2.❑ I am a soli proprietor or patner=
listed on the attached sheet t ❑ Remodeling
ship and have no employees These sub-contractors have 8: ❑ Demolition
working for me in any capacity.' workers' comp.insurance. 9. ❑ Building addition
o workers' Comp.insurance 5. ❑ We are a corporation and its
� 10.❑ Electrical repairs.or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs o additions
myself.(No workers' comp. - c. 152,§1(4),and we have no 12.❑ Roof rep
ai
rs
insurance required.] t . employees.[No workers' 13.&then
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 anew affidavit indicating such
#Contractors that check this box must attached an additional sbeat showing the name of the sub-contractors and their workers'comp,policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information. [�
Insurance Company Name: / t
Policy#or Self-ins.Lic.#: Expiration Date:
oil Job Site Address: ,'tylState/Zip:
Attach a copy of the workers' comp sation policy declaration page(showing the policy number and expiration date)..
Failure to secure coverage as required under Section 25A of MGL c. 152 can Iead to the imposition of criminal penalties of a
fine up to$1,50Q.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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and enalties of perjury that the information provided above is true and correct
Si ature: Date: 1�1 c0 t ocp
Phone#' �M 6
r
�cial use only. Do not write in this area,to be completed by city or town official
ty or Town: Permit/License#
suing Authority (circle one):
Bo are of#health 2.Building Department 3.City/Town Clerk 4.Electrical inspector 5.Fiumbina laaspectur
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 hjre,
express or implied,oral or written."
An employer is defined "an individual,.parmership, association, corporation or other legal entity, or any two or more
of the foregoing engaged a joint enterprise, and including the legal representatives of a deceased employer, or the .
trustee of an in 'dual,partnership, association or other legal entity,employing employees. However the
receiver or
owner of a dwelling house ha ' g not more than three apartments and who resides therein, or the occupant of the
dwelling house of another who loys persons to do mainten ce, construction or repair work on such dwelling house
or.on the grounds or building app errant thereto shall not be a of such employment-be deemed to be an employer."
MGL chapter 152, §25C(6)also stat that"every state or 1 cal licensing agency shall withhold the issuance or
renewal of a license or permit to op,e ate a business or to construct buildings in the commonwealth for any
applicant who has not produced acce able evidence of ompliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7) tates"Neither commonwealth nor any of its political subdivisions shall
enter into any contract for the performanc ofpublic work td acceptable evidence of compliance with the insurance
requirements of this chapter have been pres ted to the acting authority."
Applicaats
Please fill out the workers'compensation affid ' comp tely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractOT(s)name(s),addr s(es) nd phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies(LLC)or unit Liability Partnerships(LLP)with no employees other than the
members or partners, are net required to carry work ensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this davit maybe submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Al o be sure to sign and date the affidavit. The-affidavit should
be returned to the city or town that the application for permit or license is being requested, not the Deparitnent of
Industrial Accidents. Should you have any questio reg ding the law or if you are required to obtain a workers'
compensation policy,please call the Department at e n er listed below. Self-insured companies should enter their
self-insurance license number on the appropriate e.
City or Town Officials .
Please be sure that the affidavit is complete and Tinted legibly. Th Deparhnent has provided a space at the bottom. -
of the affidavit for you to fill out in the event th Office of Investigate ns has to contactyou regarding the applicant .
Please be sure to fill in the permit/license n er which will be used as reference number. In addition,an applicant
that unrst submit multiple permit/license appli ations in any given year,n d only submit one affidavit indicating current
policy information(if necessary)and under" b Site Address"the appli should write"all locations in (city or
town)."A copy of the affidavit that has been :Egcially stamped or marked by a city or town may be provided to the
applicant as proof that.a valid affidavit is on a for future permits or licenses. new affidavit must be filled out each '
year.Where a home owner or citizen is ob ' g a license or permit not related any business or commercial venture
(i.e. a dog license or permit to burn leaves a c.)said person is NOT required to c lete this affidavit:
The Office of Investigations would like to auk you in advance for your cooperation d should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and f number:
The ommonwealth of Massachusetts
D ent of Industrial Accidents
�ffirYe of Invesfigations
0 Washington Street
Boston,MA 02111
Tel. +;617-727-4900 erit 406'or 1-877-1VIASSAFE
Fax#617-727-7749
Revised 5-26-05
wwwmass.crov/cha
�pINE ley, Town of Barnstable
� O
Regulatory Services
• sn t E MASS. � Thomas F.Geiler,Director
y ninss. ,
n;A. & 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
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: Estimated Costy�o
Address of Work: kb.
Owner's Name: R&I Lf-AW,
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
El Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Co*ntrhctor Signature Registration No.
OR
Date Owner's Signature
Q mpfiles.forms:homeaffiday
Rev: 060606
Town of Barnstable
Regulatory Services
L W MASS.�,
� Thomas F.Geiler,Director
v ns�ss g
Building Division.
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA b2601
www.town.b arnstabl e.ma.us
Office: 508-862-4038 Fax 508-790-6230
Property Owner Must
Complete and Sign This Scction.
If Using A Builder
L FW— d- ze as.Owner of the subject property
a
hereby authorized�� I,kJ 1 l to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Address pf Job)
Signature o Owner Date
Print Name
Q:F0RMS:0 WNERP.ERMISSION
�asaaa�oauu�ca`!� a���+ ac/Ii¢taek`6
Board of Building Regulations and Standards
HOME IM"OVEMENT CONTRACTOR
R !„ 1841
r 2006
i®Corpor®tlon
CE14TRAL CAP INC.
5TEPREN DEilL
261 ®i.i!kCKTFiCiRN
MARSTONSMILLS, MA►.,OQ i
. y. A1lmiutstrsibor
Ale
BOARD Of BUIUNNO REGULATIONS
4 Irlc�jac CQNSTRUCTION SUPERVISOR
047993 ;)
Tr. no' 18472
1�
261 @LACKTMOIN
MqR$TCNS lVi1LLS, MAC- 46 Commisotoner
t.
07/05/2006 22:48 15086561499 PAGE 01/01
-A DATE(Isp9IpD/YrrY)QQ, . CERT`IFICA'rE OF LIABILITY INSURANCE o7/oc/2ao6
PRODKER (508)656-1400 FAX I1;508)656-1499 THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION
Charles River Insurance Brokerage. Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
5 Whittier Street IHOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
A TER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
4th Floor
Framingham, MA 01701 INSURERS AFFORDING COVERAGE NAIL 0
INSURED Central Construction Co, 'Il1C. INSUR6RA; AIG 32220
261 Blackthorne Drive INSURERS, Ohio Casu�Ilty Group
Marston Mills, MA 02649 INSURER C
INSURER 0;
INSURER E:
COVERAGE
THE POLICIES OF INSURANCE LISTED EIELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT'INITM RESPECT TO 1AHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY-HE POLICIES OESCREED HEREIN IS EUCJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOVWN MAY HAVE SEEN REDUCED BY PAID CLAIMS.
TYPO OFWURANCE POLICYNUMBER EFffEC79VE. P D IONVh LItiVDTL I,
GENERAL LABILITY RHOS 34224427 11/03/200 11/03/20M EACH 000uRRENct s 11000,000
X COMMERCIAL GBNGRALLIABATry DAMAGETOR�NTED y SO d0
01
CLAIMS MADE 1 OCC4)q M 14Pli 4Pn na pe v
MeD exP(Any ona pe san) s 5,00
B - PGAWNAL t ADV INJURY S 0.000
GENERAL AGGREGATE Is 2,000 00—
GENLAGCIREGATE LIMIT APPLIES PPR; PRODUCTS-COMP/OPAt33 ' Z.00O,OO
POLICY LOG
AUTOUO2Sr
AUTO AWLITY COMBINED SINGLE LIMIT ANY g� s
)
ALL OV,tWAUTO& .
BODILY INJURY :
SCHEDULED AUTOS {Per Perecnl
HIRED AUTOS
ROD
ILYINJURY S
NON.OVlM60 ALROS (Per eecldoMl
PROPERTY DAMAGE
71 (Parecewga q
GARAGE LIABILITY AUTO ONLY,EA ACCIDENT $
ANY AUTO
- OTHERTNAN EA ACC !
ALTO ONLY, AGO $
£XGESS MIKEU,ALIABILRT GACFIOCCURRENCE S
OCCU" 0 CLAIMS MADE AGGREGATE S
DEDUCTIBLE
S
RETENTION S '
WO"MCOMPENSATIONAND WC894-01-91 OS/14/2009 05/14/2007 wcsTATLL vTrr
EMPLOYERS'UAMUTY tOR7J.1
A ANY PROPRIETORIPARTNQRffiXWUrrA E.L.EACH ACCIDENT $ 100
OPFIOEMMEMBER EXCLUDED'
E UAd(Ar .L.D19EASE•EA EMPLOYE $ Sjoo e
DeCiA�l.PROM E.L.DISEASE-POLICY LIMIT S 1OO
OTHER - -
A I
DESCRIPTION OF OPERATIONSb LOCATIONSI VEHICLES("CLUSIONS ADDED ICY FNDCIRMEMENT ISPECIAL PROVISIONS
I--
CERTIFICATE,HOLDER NCELLATION
SFIOULD ANY OF THE ASOVC DCOM690 POLICIES BE CANCELLED BEFORE THE
EkE1RAT10N DATE THRRWF,THC 16SU)NO 1N81J+tER WILL ENDEAVOR 70 MA9-
DAYS WRITTEN NOTICE TO THE CERTINCAT6 HOLBER NAMED TO THE LEFT.
T6wn Of Barnstable BUT FAILURE TO MAIL SUCH NOTICIR tINALL IMPOSE NO OBLIGA710N OR LIABILITY
ZOO Main Street Of ANY HIND UPON THE INSURER,ITS AGENTS OR REPRESENTArVES.
Hyannis. KA 02601 AurNaRIUD REPRHMTATIVE
Gerry Kenn
ACORD 25{20o1ro8) FAX! 008)790-6a;30 OACORD CORPORATION 1988
P 172
2
MA
22
AP
21
MAP 172
2
\Desktop\Conservation.dgn 7/3/2006 12:06:56 PM
Town of Barnstable *Pit# I
� OF THE 1p� *Permit ,
Expires 6 months from issue date
• Regulatory Services Fee `r�?� s
anaxsrest.e.
9� "'"SS'163g6 �' Thomas F.Geiler,Director
A'ED1A°'` Building Division
Peter F.DiMatteo, Building Commissioner X-P I�E S S PERMIT
367 Main Street, Hyannis,MA 02601w /�
Office: 508-862-4038 ,J U L 1 7 2001
Fax: 508-790-6230
EXPRESS PERMIT APPLICATION TOWN OF BARNSTABLE�
/ Not Valid without Red X-Press Imprint
Map/parcel Number I ?a
Property Address S cI &477MkW90t -
1 �
U esidential OR ❑Commercial Value of Work `
Owner's Name&Address Alnt Grad S
Contractor's NameG � dl / Telephone Number
OlY�.
Home Improvement Contractor License#(if applicable) !�
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy
Permit Request(check box)
❑ Re-roof(stripping old shingles)
❑Re-roof(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Windows. U-Value (maximum.44)
❑ Other(specify)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation,etc.
Signature
Q:Forms:expmtrg:rev-070601
UR-214-2001 MON 02: 54 PM P. 003/003
c F.L4 No.1 • 2048®
job 0 l
SALES::f ' eooeil ��Ntgt U�o
D.Oe,Drmm Melt oVNew YOIIC LL Re QUALS 80.9�6'111 6u
-61 SIDING A a 1
�°Ny7°;600D'oeB°
8Dhu6BX/lhr are: CONTRACT a�iwceisNB, i
BOGBiIIpgdB
A/a pV] ACnRE89 NI ua No`��
anrr
T1 &M d y� P►tCNE(Harne)
• '� '`� JOB®ITEADDRUSrdD uff,n� `�� •L�PHONS
e�L 9Dla APnalf; VINYL&ALUMINU
a' wR Na a:; rmle�D al leewq 6 Apt Alueuealm elDN1a Celp,et p�,snrD„I,N�
Qaeual oemnla mn etwe'u't Ow °N
Ap »eM Nd
>ttl CDnefclot
0104 NY 11e08 I
TYPO aT Heyae p Fmm. C1 AAAaonrY APPrWL awl
Deto:
APpam celhPlelW Date'
O.w yeia ee�w1i MII N.I SRtkReATleaa
NO
L PLEAAG/nvNO OAROfUl1.Y G1L !I�TEULYI�j�Dano<
fOUDVCfll81DDf
D � yl er tlePaArorn'Tmv
D DIDANp lar 4�•
.r� mDm11 INCLUUDDpp IN VOUN ORDIR, i
u a"'YA1 ry Na isYAwtAp,Aw pNY Pe` �dry'�_ 1Npw.60e w
terra van D�t O EMA a tom emu wWtma
Qftnmren '®`6
INSULATION. vmi.w/p�aa hr u41M.nn cP �
p, ota"T"L aTurrls SNp'A1mro W IneiA1A0A,
S U"amin,pylbp=Alma lansmn. ILAtltlslard•1I f' Uq tleup ptunufs KHMA TAee AND RI now IAW ev,pey,WON IIII I
� WINDCW DPINrNep eTAIP NAm eonlrp�Opp
��PADI
JamD° wAA Senn FinaWN qle AIs vIA a"m III If ad"ry H a m talk e/garm.(Na pgAI M,NeNR.I
OeAnpe
I�nY wNdaw pA P tAs'J'f]DAenn11 eluaN• Daror���
yy WpUe b IIY.AnsaO,n bAl m DNVI°�I~ePDeCI rY 4r~�_
CAULN./ Damr
&D U alU g Ditaadtes taw • ~�
A Q wrAhwnhiyAlltlep�do.rnlesaVPiY�DtAAW
DAAA4IDOORiAAyEg.eow hUNM PalDlen
10.❑ O ejpW Q DDaAu W�wncWmLAne'PwAvpAYINrLcW �^�—,.Dour
fA7DIA-aueromaa.aM MISS q0I No MAU AWWtItII�I�DNar — ` \
12. SDRNT-Ieeolyoyprpp �°DRr'uvINYLDLADa�yNlhuN.18.1 0 ADYrtTJW ,eDw p.ep ""' �swAlvry�DeeDleOu �R1YeTAN, lW111taNWb1law.NW 1L a IAeDehaa PAgleeeoADA U umYU ,Corot
0 V1nyj O�e/IeI An tdege�Alb AamUus1 woos sImotyAIQOSpe*Aly Uoulaugnprees�egDNwAI
Abhn 0 Waptl EAN AenhInp), 1AtlnDOn
1A-p Dan oat!ny y nAY tttlstloP C3 Wata llsm0 C DIMr
PAW MUNC•elaayllpg epynvlaeDUD YwYI DiWSO eIATFNµ ro M faltpy�ANe1
11.❑ IflTm f1FAUegR�IUMNe w
A� tlO OroNdee F �YI mtlMjAySAn Dyp�,pAAewWW ey U sh°a4ra
99,GrevAsnDlum°y.0yat
ID.❑ QS guO IGMWUuM'DrcAO/uuuw0�ror`~PmuAetwvIndglIl�4ae�A;A�AaC —slrcyA
a"� � "N UP Prppw.u��mvmd we him wo�—v,M/.De1vtl4NaA Ap.CWOr
92 D wlWUepi•,p nYWr,P N6 cDnlYaebNro WAu
G WP•AAANNT•AmD t0 a10 p eRrcb S DONP- L(gtlI111Y ro m Kmlehlnls. pG�
H: G NVIDMONLUNI
m NON.AKV=abih DuaiYr 11� PelhLntl b reevnp, �'WJ All c�(
In All APgI p. A lees n 9111 PmtlW1e1Wn:-�, 1� oUAdQ ADOMAK•Aa1Pddivo0Ae.1, ~Coruna
PAvmaeLlAnn.tW
N Aahae.
JCb TDIy S Las dspoa 4696
D 1(darmI �(FlN Cf0 y ,��,�� ��8811
art rc M1neM bym. Ma mar"Won, doge rtm InaludD tme �— 8hR '��
u D.bd.
n inN a famIn Mai; awn„a apnw wm°.woP rm�1 at 'vn°areWu renu,pArt
;;c:arv�DPww pY Dwnr m pp m,4p,f
OPnoslSm�e,,,e Dfthmt cab.. nlP Io1rml leletubah dQ d N dho
>d.❑ WORKNOTfaOlrcaaq rAOeny solanemp Ietlallle lY,aaA noel
y N1tN,tmA Jd
n'E3 �AwWa�l®up>mm�A,Ow„a
a etlr.u
r.ar A-I d b emvyw oaaea��
PALla11A
CWNER~ ` M•rer 'aA�'wa. NNaNDAUryloAnrTy
MAKE REpp;U Tt3 TO HAVE w„a UNe TAioe tgPNfEWATIONB 9741 TMMAAp COW
RECEIVEp A DUPLICATE DAIQINAL OF AND TNAT NONE NAveR�jp AaAuo To oR R 4�M aY
AQ"MEN' AND 7 THIS OWNI VOUA,pg
AGENT OP A 0 BE THE AUTHORfT�p IN DUPLIOAT!ORIOUTA rm g AB LY MIYID
UPON WHICH THEA1hIORK OR TMI8 PROPERTY
Aq6 TO BE SUPPLIED, THE MATt`eglA� "NOU Tk=_,_ sV eAllClL THI
ANY Apr Ppjpq` OCq TIAIVRACT10p AT
LE88EETDTHHNDMEOWN1R8),0UARANT ATTTAOgRO�rW[ATIOF THIS T�-ANe�A°pDrION=amiss
(0),CO-81GNER(S). 0R18L ATION Or tMIO NIQNT�t7,ywfipN�pIR PAN AN
teWsreQ at
u III
tlt envaan a1,aD MP,,w in RS�pONSIlL FOR A ON PER'"Mjp°jBUBTOW �WILLNi�
s• Oamw wAeewueTrpO anon Pernlq a10CIfINO PIG, AND q�
�hn9 O�Rtlmnel wnm�wra Dt Aka TtV COMPANY PL AAY Patton wwp N� Flu 141A CDMe WP FROM WLLl DEPOWT ALL ELO/IILB RGLIIVto
my �AOI amll�"'saa DtANe
119111111 e.I�+�.ad!� ���or elynod NS�1 UNTA Dy
D' OwnMy"Pm.ntlmmI Wlamm 141)namww.fMY Ig0MOT, WRtIIN NV[lUMEN DAYN JO I
Onp Pen heroel.ed Die e6wn y j eol� � Duo OP ITS
ow tan
p• ALL waTAlLpT10N LA60R Qy IDpnrlotw ■,ry hf nnkeemont
1(IR YEAIL It 8 D sod u oAtta,x IDyt'j as°6"FAd In
BerAr�ap� � r �hN a y nocce
' uPa�mpn� eIDA0.1an _ � t
lewtan �
81iNeAiN
RCLr4R5C Jilbp FOII AD)IT11 11111AI Tlg11 ANO �TroN6
17
pssor s map and lot number ............... ...........................
. �pF THE T��1
wage Permit number �... ...
w ace .
"LE,House number
1N11'M �lE s a
. , MENTAL Coo OMPY.a`00
001
TOWN OF BARNSTAMUE
y
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .......................... ..f. ......... to .... ............................ ...................
• TYPE OF CONSTRUCTION
a
..........�.. .�..:C...`.............19. .
TO THE INSPECTOR OF BUILDINGS: +
The undersigned hhee`rebyF applies for fa/p'ermit according to the following information:
Location ........ ....tst.Q
ProposedUse ..........si ..... ......�: .................CZ .l. ... L�.... .'...............................
C- b
ZoningDistrict ...... .. ................ 2 .....................................Fire District ..............................................................................
Nameof Owner ..` ,1............ .. ........... .....Address .................................................... ...........................
Nameof Builder ....� ...........................................Address ....................................................................................
.Name of Architect �.Cero .................Address ..............................................................................:.....
.......................... ......... .
.Foundation ...................................................Number of Rooms, ................. �.............:............ ...........................
Exterior ........ .........[.ram` - .........................................Roofing ....................................................................................:
Floors � � ................................Interior ..........................:.........................................................
�. .. . .
Heating (.u..fl j �J---.............................................Plumbing ........................................... � ..�....................
Fireplace /..,)0.tj ..........................................Approximate Cost ..:.................................................................
Definitive Plan Approved by Planning Board ________________________________19________. Area ��`^'... :...........................
Diagram of.Lot and Building with Dimensions Fee ?s......................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
4
I hereby agree to conform to all the Rules and Regulations of the Town of Barn Ible re rding the above
construction.
........ ...6.............................
Bartet, Hugo
Nb ..2163.9.... Permit for .....atorage-shed.....
......................:........................................................
Location ........a4.-No-ttingham.-Drive..............
.......................Centev-ville...............................
Owner .............Hligo..Barnet.............................
Type of Construction .......................frame....... ...........
............................................................... ...........
Plot ............................ Lot .................................
Permit Granted ......September..12........19 79
Date of Inspection ....................................19
Date Completed ........ .19
PERMIT REFUSED
..................................... 19
....................................
. ......... ..................................................
rn
.................................................... .
r
CO ;;
ApprralK............................................... 19
...............................................................................
........................................................................ .......
y�fTNEt°�♦
TOWN OF BARNSTABLE
•
BARNSTABL
MUM
1619. BUILDING INSPECTOR
APPLICATION FOR PERMIT TO . ..................................
TYPE OF CONSTRUCTION ......... &.0.4k..-CRAMA.......................................................................................
............................xa............19.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to thb following information:
Location .... ........ .........af......QkV .gA17`1=—AV/j-L�...............................
......................... .
ProposedUse .....0.w ....4.A.V0..G-.Y..... . ................................................................................................
Zoning District ........................................................................Fire District ......4...
Name of Owner .....(./6mc.,5... K.........Address Jq-541 ..0-,q /:...........
Name of Builder ..................... n.&................................Address ......................(5.....A..
y ..............................................
Name of Architect ..................No.),)4.....................................Address ....................9.01A...................................................
Number of Rooms .....................4...........................................Foundation 10........0. . .................
Exierior CkAP.P3hAR.0..... ........................Roofing .........R . ......................................................
jR.to.(.T
Floors -WAL.1,10.....WALA.......C.AkRETS...............Interior .... ..................................................
Heating .�, VA.......... .....................................Plumbing ............. A.r/-/............................................
Fireplace .............. AE.I..............(........................................Approximatt- Cost ........ ..................................
6 / / So
Difinitive Plan Approved by Planning Board -----------------/-��-------19
Diagram of Lot and Building with Dimensions
CAP-ARE 3 g-f
La
< V I=—
< oTT N G 14 A M
U) M ��;
0 1-0
<
Ur C)
UJ
C) LLJ
Z-�
n- 14 ows it
J
�D
J-
Doo
UJ
C-1 IN
U)
< L U
C2
Z .4s,7-32=
<
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Z
Name ... ...........................
� Normest l000ao^ Inc.
�
�
^K /
'
�
/ ozaw atoz�� '
No —]1—.�.��—' Permkfor -----..�- .........
| single - dwelling
- -------------. .
Location -- __K_�.
( ^
�/
e^ ^ervllle _ =—.`—' ..
----.----------~~----. �
�
D���est Iomnas ] mc°
c�wmar --------._---.�---------
franom
Type o; Conotucton --------------
-.---~----.-----------.-----
,��
Plot --------_. Lot ...........
/
'
� J '
-a^~^a^� ' \
' Permit_ _ ..... ---_-- . �
`
""'= of Inspection" ` `
� `
/
� --- |
-
PERMIT REFUSED �
` !
�
.----_-----............................... lA
�
................................... |
{
/
--..—.~.~..--~---.---...—~.~—.— .
�
'—'---'---~'--`---'----^—^-----
_ .
'
---------~^^'—^^—^^^—^'—'^'~—^'^^— /
'
�
i
Approved ................................................. 19 ]
'
-------.—.,.------------~.--.. \
� .
--------'------------^^~^'^^^^
1
Y PROJECT-.TITLE
r .
PO
3
N GiCI
34
Wig•• �� J r
f
— Gss�
i S
PREPARED FOR
Centralt.on�#rucf ®n.tompany, nc.
f Szeve Devlin �President
I I 261:91G&hom Drive•Marstom Wh,MA 02648.508.420-1340
w
SCALE
/ to
DATE IDWG NO.
E DEStGN C
CHECK
. DRAWN
��