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0149 POINT OF PINES AVENUE
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'"�1v, J ',.; ,4' ;1� ,'.C..5 �3 '� ;i k... $, .,n. _ :. .. r, x. ,r. t. t fr. d .,_ i,. 1, r,.,. .� w..�, -L. . „ C .e� r, ,.4�. d= "..;,d..:r '.:k� r'',�'.t, 4'^'�5'.7� s @ ,,,`1+fii r 1:e. k.. 1:. .'�' .<< ',.�.c,,..., c .m ,,. ,.GS. .s .::' ?r a- �'. 1, +C J-.:r: a;.`" ti, 1 .!u. 4t, w. _ ui b ti .'. h Ya w ,,•far:, 3 gas �r pp i y . 4 -p j+ h "'fit w,{ I I- i !!• . ,. .. .. � r, � / 1. t , �, .� -;< - w , . 3 41 v 11 1 7N j. ,'G 4 -.4 A. r , ;r } t' -�� +j Y D r y -, n r. - , G .. , j '.. _ .. c y ' • u i, 0 .. . .. Town of BarnstableBuilding 's •. °Post.:This Card So,.T.hat rt isUisible:From'the"Street A`¢ rouetl;PlansMust be'=Retained on=Job'a�nd:this Card;Must be.Ke t{ - my ,.F '•;,� .. ,'�3..�' v' pp+.� � .. 3 z ;:�R a �', ..� '; t' •' " � � : p�k .t,�� O M PostedUntil`Final Inspection=Has Been'Nlade g k i. ibsp- , .Y' .� +° Where aCertificateof Oceu anc �s Re wired 'such,Buldin "'slall:.Not>be'Occu ied:until a Final Ins ection has.been made Perini� p Y A g� � xp .:� , p. Permit No. B-18-3206 Applicant.Name: MATTHEW R ANTON Approvals Date Issued: 10/24/2018 Current Use: Structure Permit Type: Building—Addition/Alteration-Residential Expiration Dater 04/24/2019: Foundation:." Location: .149 POINT OF PINES AVENUE,CENTERVILLE Map/Lot: LL230-072 Zoning District: RD-1 Sheathing: Owner on Record: KENT; PETER E&KERRY M Contractor Name:', MATTHEW R ANTON Framing: 1 Address: 48 TROWBRIDGE LANE Contractor License: CS7095345. 2 - SHREWSBURY, MA 01545 Est. Project Cost: $ 13,000.00 Chimney: Description: New Windows, Door New Roofing and Deck in Front Permit Fee: $116:30 ^ Insulation: Project Review Req: ENGINEERING NEEDED FOR LVL RIDGE, Fee Paid; $ 116.30 Date. 10/24/2018 Final: Plumbing/Gas Rough Plumbing: ;.: Building Official x Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afternissuance. Rough Gas: All work authorized by this permit shall conform to the approved applicatioma'nd the approved construction documents.for which this permit has been granted. All construction,alterations and changes of use of any building and structures-shall be in compliance with the local zoning by laws and codes. Final Gas:, ;;This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. . Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the.Buildmg and Fire OffSicials are provided on this'permit. Service; Minimum of Five Call Inspections Required for All Construction Work:; •` 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low-Voltage Rough: 6Jnsulation 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT APyfiwfiMwM « ).Ss.. .... it� pesm!tFee..........................:.......«...Od<erFee...«.......«...:...». Total Fee Paid...«.........»..6—o:.3-0.. «.......»..«..........» TOWN OF BARNSTABLE Eby•-- ••••• BUELDMG PERMIT a2 j APPLICATION - Section 1-Owner's Information and Project Location project Address %�/� �'D�h� or� �ncS f�✓c Village C ��ilii/le Owners Name Owners Legal Address :�Z��e,d City Staw T_._.Zip 4 S owners cell# •-533 2. ken e /"A /. coin Section 2-Use of Structure Use Group : ❑ commercial Sbwcture over 35,000 cubic feet ❑ commercial Sw=taw under 35,000 cubic feet Single/Two Family Dwelbg Section 3-Type of Permit ❑ New omhnation ❑ Move/Relocate ❑ Amory Struchnce [I Change of use ❑ D../(-f-sh,e—) ❑ Fmish Basement ❑ F=iV/M=sty ❑ Fire Alum REbm'Id ❑ Deck Apartment ❑ der Sys ❑ Addition ❑ Retaining wall. ❑ Solar z C CIA r- M,Renomdon ❑ Pool ❑ Insulation n. Other Specify G) z ® M Section.4-Work Description Cl)V. CD Q u/ r eu9 S ��/`rFn I ApplicationNumber.................... ............................... Section 5—Detail Cost of Proposed Contraction__IJQZGQD Square Footage of Project Age of Structure DigSafeNumber #Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Vrmd Zone Compliance Method ❑ MA Checklist p wFCM Cbwldist Q Design Section 6—Project Specifics ❑ wring Q Od Tank Storage Q Smoke Detectors Q PI mbing ❑ Gas ' ❑ Fare Suppression ❑ Heating System ❑ Chimney ❑Addhelocate bedroom water Supply LJ Public pemae Sewage Disposal ❑ Municipal '❑ on Site Historic District ❑ Hyannis FStoric District p Old Sings highway Debris Disposal Fami�t'y: I am using a crane ❑ Yes ❑ No Section 7 Flood Zone Flood Zone Designation 'W&n or adjacent to a wedand,coastal bank? Yes ❑ No ❑ Section 8--Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total 'roniage Peke of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yana Required.-._ Proposed Rear Yazd Required Proposed Side Yard R Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No f • ApplicationNumber........................................... Section 9—Constmetion Supervisor Name Telephone Number_ - /(v Add= '73 o<d P1�Z�1 R�P �S°� ;� state Tap C"' License Number C;-0 7 5-3 Y.- License Type �Egphzdm Date ,To, Contraotors Emait Q A,.4 / '0 /-),cc,coca Cell#' 33 7 --2y� I mdeasfiamd my respomsfl)s nader the rates aad zegntatioms for Licensed Camstraction Sq adw is a=rdanca with 780 CMR the Massambmsetts State Bm'Idmg Code. I understand the coustncdm inspection pewodures,sperafic bVectiams and down=Ffn 4 by 780 Cti+1R and the Town of Barnstoble.. a copy of yoar Hcose. Signattn�e _ Date �� l Section-10—Home Improvement Contractor Named TelephoaNusnber • ' city C'4 'zip RegionNumber EVfiudc aDate o �( I understand my responses umd�the rates and regalatians for Home Cantraam in a=mdm=with 780 CHR the Massachns stb State BuDdmg Code. I umdmsbnd the cxm hucd m hwpectk m procedmres,specific inspections and doc mmembtiam " by 780 C d R and the T of Barnstable.Attach a copy of poor RIC- Signature Date Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I Mdersbad my respamstbEdim miff the roles and regatations for Mound C= ncdm Supervisor in accamdaace with 780 CMR the Massaftsett.a State Bull ft Coda I understand the constractiom mspecdoa pmcedmras,spefic iaspec d ms sad dean mphvd by 780 C MK and the Town of Barnstable. Sigt�abn�e Date LICANT SIGNATURE S' Date 03 (d Print Name Telephone Number 2 U Kati V. E-maffpezmftto: �m Q t �- ��. T..►...•iw....L It 1n~T o Section 12 y-Degeent Sign-C Health Department ❑ Zo=g Board(if regmred) ❑ ffista dr.District ❑ Sipe Plan Review Cirr ❑ Fire Department ❑ Conservation - ❑ For c mmff d world please takeyearplans Jrm*to the}lre depart od for gprovab Section 13—Owner's Authorization I, e•'�' �� as Owner of the-subject property hereby authorize �is�i�G�i✓C ��rar�,�r�,�Vc�d�s� GGv✓ato act on my behalf in all matters relative to work authorized by this building permit application for: 1417 P012�71- Q fle-s 1411e (Address of job) Si o date Print Name n �V J p� r1 lit NNG DEPT. OCT 03 2010 a Barnstable Bid •Dept' TOWN OF BARNSTABLE Appr�d by' -32ot� permit# : {� lit TI L BUILDING DEPI 01 OCT 03 2018 5� TOWN OF BARNSTABL, .r ve, f BUILDING DEPT OCT 0 3 2018 TOWN OF BARNSTABLk PSG �e �°Tiov( �V �d � 'jjSViSN8d8 -40 NMOJ- .Ld30 ONIOWIS 00 � ICI _L g ��lk lC7 OCT 0 3 2010 �axnstable 8ldcj Dept. TOWN OF BARNSTABLE ApplovedbY*- ` � EI S �' q ll _ BUILDING pCp Orl OCT 03 2018 �n 5� TOWN OF SARNSTABLL _.- --. --- i T Au BUILDING DEP7 OCT 03 2010 TOWN OF BARNSTABLE. ,A O�l Ll 3f/2 ------------ I ( ty/r ,``'--- i . Jd f r �O zc t BUILDING DEPT OCT 03 2010 -,- 6- TOWN OF BARNSTABLL . -�� x o ' I The Cotrmtomveakh:of Massachurett<r Departwd of IndrrsW dAccfdents pf�ofl ns 600 Washusgfmt Street Bost'br4 MA 02UI MM.mass~g0V1& fa Workers' Compensation Insmrance Affidavit:BulderslContractorsMectridans&lmnbers AvifficantInformatioit Please Print LezibIv Nameri r - �� e Address: Q9 o n O'1G &,t TZ---I- 't v.A Phone#: 831 9a4b Are you an empIoyer?Check the appropriate or. Type of project(required)• ' -1. I am a employer with . - 4• [ I am a gemmat coahactor andI 6. []New crostcndioon erVloym(hill an&br parMime):* have hired flee M&-cM*adUM 2.❑I am a cola proprietor or pariae r listed on the attathed.sheet. 7. O'R�mg ship andhave no employees These moors have S. ❑Demaolifion WMVMg for mein say capacity. �msmanca required.] ir ss' bave workers' 9. ❑Bm7dmg addition ed.] S.comp.insrnaace ❑ We are a corporation and its 10.®Blechicaalrepairs or additions �j officers have exercised their 11. additions 3.❑ I am a homeowner doing all work ❑Ph�bing reP�or Mysam [NO w0exers,comp. right of exemption per MdL iasvzaace l t c.152,§1(41 and we have no I3❑OffMr airs loyees.(No�wcrkera' camrp.insurance revive j *Ray hhpplir�aRtbat dmb box t1 nmst also i ll oats s dau beiow shovft t>wrworI=e comj=ndw pdky fno-t»>a = 1 t Homeowaas vMbe sabmlt this affidavit luditatg they=doing all wahit and titan We oOW&amdnctors mast stibmitanaw affidavit inM-ffng SaeL. �['.oidract -—a d d63ctbis bm must anwhed w addidow sheet shov ag Eta tam of tut sub-comttsdats and state vpbedw or nattmse=MM bm =*aye=Mho ors have mogas,they mot provide flair wot=e comp.policy=mbm . I am an employer that is provift workers'con =m6n insum=for my mploymA Below is the poluy and job site Wom dion. h]sarHDM CompanyName: u rc n eff a f7c M . Po7icy#orSelf-ms.isc.#: i�$xpin�fi6�D� ® _ 0 rJ � -/ Job Site Addres. �rK/ e12vV Ikk ro a*01 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date Fag=to secure coverage as required undea Section 2SA of M(3L a 152 can lead to fire imposition of gal penalties of a . fine up to$1,500.00 and/or one-year meat,as well as civil penalties into firma of a STOP WORK ORDER and a figs of up to$250.00 a day against the violator.Be advised that a copy oftl b stat mat maybe fxwm&dto#lie Office of Investigations of the DIA for ir=ance coverage yeriSicatioa I do hereby the a nd penaNa of perjmy drat the informadon provided above is true axd correct: S- Data- fVPhone t7,UIdd use only. Do not write to ft area,to be completed by a ty or fawn offdd City or Town: PerfnitlUcense# Issuing Author*(circle one); L Board of Health 2.Building Department 3.CiWTown Clerk 4 twh cal Inspector S I'Im bing Inspednr_ 6.Other ContactPerson; Phone#: -. ��B T(.d7J10J10I1[I/CfLIlJL 49VAU a - ' Office of Consumer Affairs.&Bus�eess RegulaUo won yy j fqr jndividual;u=e-only ` - HOME IMPROVEMENT CO iii NTRP.0 N + ceffie exp�> ion date it found cetum to TYPe won'•, " ()tfl of Consumer Afia�rs and.Business Regulation } _ �{ i atior Expiration s�� 10 plaza Suite 5170 — =°=18D304 10/29/2018'A r h MA i 6 t 8os4on� h < FUf Distinctive CarRr Y r-pF :+ F p w L. !.•. Fabio Nunes ;x � ��c� -- r 28 stone ciff Rd,.r + E Cesi[ennlle;MA 02632 a$y- wFt ra �e11 utl.touti Sig �l t Undersecretan Rr 4 rom:AIM 781 221 4650 09/27/2018 10,56 *862 P.001/001 r i� I r �co o® CERTIFICATE OF LIABILITY INSURANCE °"s � °"g" 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 pol)cy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 01688-D01 RQMLAcT Branch lies-1 McShea Insurance Agency Inc PbcNNo• • (508)420-9011 �pX" 1645 Falmouth Rd EMAIL IUC.ao.: (5oB)420-9010 Suite 1D ADDRESS: Centerville,MA 02832 e IN gER A, AJ.IVL Mutual Insurance Company:I INSURED V F Distinctive Carpentry Corp INSURE B 28 Stoney Cliff Rd INSUR En Centerville, NA 02632-0000 INSURER Q V. INSURERIDS Y i'11 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ((pp I�SR TYPE OF INSURANCE IIN POLICY NUMBER MMh% MNwoCDryYYY LIMITS TR GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABILI TY DAWiG EM SE TU R EN T EDur nc $ CLAIMS-MADE OCCUR MED EXP(My one person) S PERSONAL B ADV INJURY $ GENERAL AGGREGATE S ENNl AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ UCY 0. OC AUTOMOBILE LIABILITY COMBINED NGLE U I $ accident) ANY AUTO BODILY INJURY(Per person) S ALL OVNJED SCHEDULED AUTOS AUTOS BODILY INJURY(Per sec denq $ HIRED AUTOS NOWOAUTOS - P ERTY DAMAGE $ Per n S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS MADE AGGREGATE S yyp�KD�EpDg Cp��REETTpETN�TIIONN s $ pA�N.ryD ERMOP�LOYETRpSR€�LqIA�BrILNIETYg/��� Y� .[�,N� X TORY UNITS OER A OFFICER/NEMBER EXCLUDE07 �I N U NIA AWC-400-7029767-2018A 9125/2018 9/25/2019 E.L.EACH ACCIDENT $ (Mandatory In NH) 'r�s���� ��� E.L DISEASE-EA EMPLOYEE $ DESCRIPTION 6F OPERATIONS bel. EL DISEASE-POLICY LIMIT S 600,000.00 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,AddlUonal Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable 200 Main Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Hyannis,MA 02601 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. I AUTHORIZED REPRESENTATIVE ®1988.2010 ACORD CORPORATION.All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD 4- ... � t'`����R���� `. �• �M �� ,tea s_, �` ' r�N� :i°r a, 1 °M .:•. '� � A is ,a ;, �' �a ?F.R4.,: + i ■, ^�,._ ,�s`- r ..: .y " . .; "�_ � r#yis�'r9,Gf Y-.a , "_��`"�:.,°„. �" �? .�,,,t _ as�t.� ,• „�, °r '. ■M erg r '� �i rti v ' m ' { we i V Y •� � �3 � x � '���i� t kG,k� FY�� ' 4rMr�� A,.- sa l , � +• — y+�A.i. r w 1 R'aWV,C1� y s3•, s jai,c Y ar � n-� R ��� �a'r. � � ,k.�' �:.; $fie .1`",+'S'k's •�r{�,� 4E µ W'1jy`� V�_ yF°w Y'? ` � � � ::b ��-:t���:•Y r► �R� ail"3�Z '� . At 16 E 54 ll r guu I n � dd lay a 1 y�} i=r r a r r � s �.', �- � yo- r IV it Ilk' 77 Fk Tm ;p nc Ate..". ,. r • _ � _.^ i .uj R, F x � �IE! , Iry fi 1 } _- � s r f , ._ _ le •� &.. m'' P• 11�1 qpqp lit A alx, - is 1 �^ aA � �� '�^+„•.. 6,- nte� *��• ��� I : I commonwealth or Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Consfirrf` iSp�rvisor CS-095345 5 ires:07/31/2020 MATTHEW R ANT 73 OLD FIEL06.RO SANDWICH M1�i366.3. Commissioner C Construction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic ureters)of enclosed space. Fallum to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(SM 7273200 or visit www mass,gov/dpl ' L Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only r� TYPE:Supplement Card before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation "iffF180304' 10/29/2018 10 Park Plaza-Suite.5170 -_ =-- i Boston,MA 02116 VF DISTINCTIVE=6AROENTRY CORP MAT MEW ANTON=:%@= _s - 28 StDne Ciff Rd:� `G_='== Centervi0e,MA 02632 F Undersecretary Not valid without signature . o Application number... /. ...a 3� .Date Issued.............�..�...... ..... ........... JUL 19 2010 sag. Building Inspectors Initials.......... 1.Map,Pprcel..... .. c �J. ..... TOWN OF BARNSTABLE EXPEDITED-PERMIT APPLICATION: .ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: O(a 0¢ piw t, &Ateryi !l e. NUMBER' STREET VILLAGE Owner's Name: / e-r Phone Number v�3- Email Address: Cell Phone Number Project cost$ (��� Check one Residential Commercial .OWNER'S AUTHORIZATION As owner of the above property I hereby authorize &&ZL& y to make application for a building permit in accordance with 780 AIR Owner Signature: See- alCi�r-A-d Date: TYPE OF.WORK ED Siding ❑ Windows(no header change)#-, insulation/Weatherization © Doors (no header change)# Commercial Doors require.an inspector'sTeview ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name J11yjvb e ZCI: a� _Cste Home Improvement Contractors Registration(if applicable)# / attach co Construction Supervisor's License# (6 attach copyj Email of Contractor G Phone number ALL PROPERTIES THAT HAVE UCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. Z I 1 *WOOD/COAL/PELLET STOVES Manufacturer#_ Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand P re the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date IC � T'S SIGNATURE Signature Date (� / All permit applications are subject to a building official's approval prior to issuance. i i f The Commonwealth of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type Of project(required): 1.�✓ I am a employer with 16 employees(full and/or part-time).* 7. New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] ❑3.7 I am a homeowner doing all work myself. 9. Demolition[No workers'comp.insurance required.]' 10 Q Building addition 4.71 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. 6.F�We are a corporation and its officers have exercised their right of exemption per MGL c. 14.�✓ Other INSULATION 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box 41 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. 1 am an employer that is providing workers'compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins..L(iicc.#: XWO(19)58867158 Expiration Date:6/8/19 Job Site Address: // T �f Q / S Ve . City/State/Zip: /' Attach a copy of the workers' compensation policy declaration page(showing the policy number and expirati n date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u d ain a p lti s f perjury that the information provided above isa and correctSi afore: Date: Phone#:508-567-4240 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 Contact Person: Phone#: ACORO® DATE(MMIDD/YYYY) �. CERTIFICATE OF LIABILITY INSURANCE F06/11/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may-require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - NAME: Anthony F.Cordeiro Insurance Agency t A/CNNo Ext: 508-677-0407 A//C,No): 508-677-0409 171 Pleasant Street ADDRESS: HSouza@Cordeirolnsurance.com Fall River,MA 02721 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURERC: Ohio Casualty 2 Lark St Fall River,MA 02721 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POL CY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any oneperson) S 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL&ADV INJURY• $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY❑PRO- ❑ JECT LOC PRODUCTS-COMP/OPAGG S 2,000,000 OTHER: I S AUTOMOBILE LIABILITY OMBINEDtSINGLELIMIT $ 1,000,000 ANYAUTO BODILY INJURY(Perperson) S B OWNED X SCHEDULED Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS X HIRED �/ NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY /� AUTOS ONLY Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/08/18 06/08/19 AGGREGATE $ 1,000,000 DED RETENTIONS I I S WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTEANY PROPRIETOR/PARTNER/EX ER C OFFICER/MEMBER EXCLUDED9ECUTIVE❑ N/A XWO58867158 06/08/18 06/08/19 E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES-(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liability is a followinq form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT f F ©198 -2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Siv rat t fi crrl tr�i±a� upe sol s, V F f P � iCk1 k, °+ .,a ow,f/ a An O/Z77-/ - ' Office Of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improverne*s;�tractor Registration Type: Corporation ALTERNATIVE WEATHERIZATION,INC £r/ Registration: 175683 2 LARK ST Expiration: 05/28/2019 FALL RIVER,MA 02721 ....... � 3 y Update Andress and return card. Mark reason for change. _._......_.. _..._... _...._.._.............__................._...._....... _......._....... .... rj;i1,flG../lffh.f,'��.: . office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:C=oratjon before the expiration date. H found return to: �1 i f ion �iration Office of Consumer Affairs and Business Regulation , _ 175,E 05123/2019 10 Park Plaza-Suite 5170 ALTERNATIVE W6T4ERi7ATION,INC. /q, MA 02116 TIMOTHY CABRAL 2 LARK ST FALL RIVER,MA 02721 Undersecretary flt Ot7t S➢ i tuire Permit Authorization saw Form site f affs ; i+....,..._«-..� �f M .�Y3 .,�.,...�„�,�,�.m.•tf�ract4a�filktajk'KrpttTyt+bt��dliet: Onn btl&*to A"Ry94 snv "4M bw*n a w to Wfam ta158&O—wl of 6T'4w@a�! Dew po Nam: PWO, a-741 ALTERNATIVE WEATHERIZATION Date: O �� Town of Barnstable 200 Main St. Hyannis,MA 02601 Re:Permit# o � Village: :, _C,&Z2**?fl✓/�/ `�' . The insulation/weatherai-ation work at �U has been completed n accordance with 7$0C -R. Regards; Timothy Cabral, President CSL-105454 . t 58 DICKWSON STREET ( FALL RIVER, MA 02721 (508) 567-4240 I ALTERNATIVEWEATHERIZATION@GMAILCOM TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ` iAI"iionA. Health Division F'€ '`' F'S J%Jpate-Issued �. 4z Conservation Division Application Fee Planning ' ' Dept.p � ` Permit Fee �� ``/ •. ; �.. Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 14q If>i 4 d f Pi ncs /4v(- Village Owner O-1 4 Kcrr� �{•�� Address /W Trowbr,0l Z (,n SIinotjsbum, MA Telephone 5 2 3 - S3 2. 04c",,-L4 � (�IS4S Permit Request 2 16kw h�c inS �.e ry 6"�.r��s�er /ff® �xTCi /,0A todRK JO- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay S Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) y Name FU!id vpi Telephone Number S�fr"523-,C332_ Address License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE it, ,/Y .r t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED j MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME � �?-d�of E INSULATION ?�a FIREPLACE ELECTRICAL: ROUGH FINAL `F PLUMBING: ROUGH FINAL L GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i . i i , X L — i F ecT ---- 2 1 ' t • r i • dr 0F MASS40, GAR z �j o- ro - Pv B so R�. (N - r PROPOSED MODIFICATIONS MICHE.LE CUDILO, P.E. Consulting Structural Engineer Centerville, Massachusetts 02632-1979 (508)771-7601. Drawn By: MC Date: 08/24/15 Drawing 149 POINT OF PINES n g CENTERVILLE, MA Scale: AS NOTED Rev. o —File Name:KENT Project No.2015-179 r d F O R T E MEMBER REPORT Level Roof, Wall:Header PASSED r IG 2 pieces) 13/4" x 9 1/4" 2.OE Microllam® LVL Overall Length: 12' 0 0 12 All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. >of iiaa Dv,irm/ir,//iiirr imrr✓ia/ ii ioiia�i / /,/bi n Results/ ,�� �acwai C� bott i/////�//,Allowed/ /�2esuit//,/ // _, / ' Comt�Inahow(Fatlem%O/%r%/ System:Wall.. Member Reaction(Ibs) 1113 @ 1 1/2" 7613(3.00") Passed(15%) -- 1.0 D+0.75 L+0.75 S(All Spans) Member Type:Header Shear(Ibs) 924 @ 1'1/4" 7074 Passed(13%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 3201 @ 6' 12884 Passed(25%) 1.15 1.0 D+0.75 L'+0.75 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.082 @ 6' 0.392 Passed(L/999+) -- 1.0 D+0.75 L+0.75 S(AII Spans) Design Methodology:ASO Total Load Defl.(in) 0.184 @ 6' 0.587 Passed(L/768) 1.0 D+0.75 L+0.75 S(All Spans) Deflection criteria:LL(L/360)and TL(L/240). Bracing(Lu):All compression edges(top and bottom)must be braced at 12'o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability' /i eeanng /% s to Su //- i /'�� .i,c,,,a.,,,, //._,/ .,:r .////✓i,,,/.//."Y// .vim// �// / 7 /,/, ///, / ,/ p / o,%/../�� 0� %// �j or1S �/ -mg/ . !/i % j/D p / Total AvallOblei RegYu D2ad % .vo�jir�Ovr�,//T 1/j/ ,aecessones �// 1-Trimmer-SPF 3.00" 3.00" 1.50" 618 ' 240 420 1278 None 2-Trimmer-SPF 3.00" 3.00" 1.50" 618 240 420 1278 None OTn./b/iitary. i/ ,Devi Uve/ Ai iwvv IN�j%���� 1.Oat1S location; ,'//wraen,r /�% 0�?0/MltS`ME 1-Uniform(PSF)• 0 to 12, 2' 10.0 20.0 - ATTIC. 2-Uniform(PSF) 0 to 12' 2' 12.0 - 35.0 SNOW+DRIFT 3-Uniform(PLF) 0 to 12' N/A 50.0 WALL WT,AVG. ✓/. / / / / / / /,.. / ,.u.:We.erhaeuser Notes ,/ „, �--. ,.:,::.,�j/ �/. �..// y- ., -... SUSTAINABLE FORESTRY INITIATIVE ._ . /�._ .:. ,,. ::.. �...: :. /�.:�:.,..,/�.............✓�i vi�icsi.:////,-. � �/���.,.,/ � �/_......./�✓�/,ruj/i._..� Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values. l - Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,-builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry,standards. The product application,input design(bads,dimensions and support information have been provided by SITE REVIEW s 0f MASS40, - o MCG�O�L RPM �n • � S�RUC���Qa W AfGIS��P �\ A9�FESSIONP� •l Forte Software Operator -- „ ' Job Notes 8/25/2015 9:35:49 AM _ _ MICHELE CUDILO KENT RESQ.MOQiFICATIONS Forte v4.6,Design Engine:V6.1 A.5 MICHELE CUDILO;P.E. 149 POINT OF PINES AVE, 2015-179kent.4fe (508)771-7601 C E NTE RV ILLE.MA mcudilo@comcast.net g 1 • , Page of 1 Town of Barnstable *permit# Expires 6 mon 1 from issue date Regulatory Services Fee Thomas F.Geiler,Director Building.]Division 1 Tom Perry,CBO, Building Commissioner /ll) 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-4038 Fax:508-79)-62'30' EXPRESS PERAYIIT APPLICATION - RESIDENTIAT,ONLY ii Z h —7 Not Valid without Red X-Press imprint Map/parcel Number d J V I t Property Address /Residential Value of Work -t 5000 Oy Minimum fee of$25.00 for work under$6000.00 _ Owner's Name&Address Contractor's Name �'�`���— 1� I Telephone Number 1`Q 7 Loy) Home Improvement Contractor License#(if applicable)�d �j 1 Q Construction Supervisor's License#(if applicable)_ . ❑Workman's Compensation Insurance X-PRESS PERMIT Che one: Iaam a sole proprietor ❑ I am the Homeowner N O V 19 2013 ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE Worlman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) g old shingles) All construction debris will be taken to VRe-roof(strippin I"1 Dts Q ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum 44) *Where required: issuance of this permit does not exempt compliance with other town department rcgulatiions,i.e:Historic,Conservation,etc. ***Note: Property weer t sign Prop rty Owner Letter of Permission. A cop of the H I ov ent Contractors License is required. SIGNATURE: Q:Forms:exP mtr g Revise061306 ♦. -�* °O� y�y 7He, 'I'OW)a Of Barnstable: Regulatory Services M MNSTAHLE, Maw Thomas F. Geiler,Director AIfD ,�b Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 "'W-t o wn.b arnstab l e.ma.us Office: 508-862-4038 Fax: 508=790-6230 Propel Owner Must ConvIete and Sign This Section If lUsirig A Builder �_� as Owner of the subject property berebyauthorize Vi Wee to act on my behalf, in all matters relative to work authorized by tbis building permit application for: ( Address of Job) - 1 Signature Owner Date hint Name ; QTOR.MS:OWNE ERMISSIGN ®ealseCast-ade Double 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP - Roof Beam\RB01 Dry 11 span I No cantilevers 0/12 slope October 26, 2018 13:48:22 BC CALL®Design Report Build 6536 File Name: BC CALC Project Job Name: Description: Designs\RB01 Address: 149 Point of Pines Specifier: , City, State,Zip:Osterville, MA Designer: , _. Customer: Company: Code reports: ESR-1040 Misc: �° ' . 12 15-00-00 BO _ B1 Total Horizontal Product Length= 15-00-00 Reaction Summary(Down/Uplift) (lbs) Bearing Live Dead Snow Wind Roof Live BO, 3-1/2" 1,141 /0 2,138/0 B1, 3-1/2" 1,141 /.0 2,138/0 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115%. 160% 125% - 1 roof Unf.Area(lb/ft^2) L 00-00-00 15-00-00 - 15 30 09-06-00 - Controls Summary Value %Allowable Duration Case.- Location Pos. Moment 11,554 ft-Ibs 72% 115% 4 07-06-00 . End Shear 2,805 Ibs •38.6% 115% 4 01-01-00 Total Load Defl. U198(0.879") 90.7% n/a 4 07-06-00 Live Load Defl. U304 (0.573") 78.9% n/a 5 07-06-00 Max Defl. 0.879" 87.9% n/a 4 07-06-00 Span/Depth 18.4 n/a n/a 0 00-00-00- %Allow %Allow Bearing Supports Dim.(L x W> Value Support Member Material BO Wall/Plate 3-1/2"x 3-1/2" 3,278 Ibs n/a 35.7% Unspecified B1 Wall/Plate 3-1/2"x 3-1/2" 3,278 Ibs n/a 35.7% Unspecified Cautions For roof members with slope(1/4)/12 or less final design must ensure that ponding.instability will not occur. For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow surcharge load. t Notes Design meets Code minimum (U180)Total load deflection criteria. Design meets Code minimum (U240) Live load deflection criteria. ' Design meets arbitrary(1") Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALCO analysis is based on IBC 2009. ' Design based on Dry Service Condition. Page 1 of 2 ®Boise Cascade Double 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP Roof Beam\RB01 Dry 1 span No cantilevers 1 0/12 slope October 26, 2018 13:48:22 BC CALC®Design Report Build 6536 File Name: BC CALC Project Job Name: Description: Designs\RB01 Address: 149 Point of Pines Specifier: City, State, Zip:Osterville, MA Designer: Customer: Company: Code reports: ESR-1040 Misc: Connection Diagram Disclosure b —d Completeness and accuracy of input must be verified by anyone who would rely on a N, output as evidence of suitability for • r• • particular application.Output here based on building code-accepted design c properties and analysis methods. 1 Installation of Boise Cascade engineered • • wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call a minimum=2" c=5-1/2" (800)232-0788 before installation. b minimum=3" d = 12" BC CALC®,BC FRAMER®,AJSTM, Calculated Side Load=427.5 Ib/ft ALLJOISTO,BC RIM BOARD- BCI®, BOISE GLULAMT ,SIMPLE FRAMING Connectors are: 16d Sinker Nails SYSTEM®,VERSA-LAM®,VERSA-RIM PLUS®,VERSA-RIM®, VERSA-STRAND®,VERSA-STUD®are trademarks of Boise Cascade Wood Products L.L.C. 260,E 78, EXTEND WALL 31 6' 58<" 228 —� W2730 W2730 W3030 3DB30 3DB30 SB33 ' DISH-IQ6 3DB 5 r M REMOVE wAL A D SUPPORT Double Trash A } Toe Kick', O r y« o Lite Valance- - Soffit face a B18L ,3DB30. Fillers = N OoJ Panels O ��N Refrigerator Side Panels 000aooa Touch Up with Putty Stick 0 Scribe t Post 108 8„ Island Apron (0 .. e M REMOVE WALL ,. TCL278212 FHB243412 FHB243412 W24302. W24302 W361524 a�- 84" 37 3 11 2 3" 4 1021 FRAME PART TION 2064 3811 16 IDEAL KITCHENS 16 Lancaster Street N M- West Boylston, MA 01563 Phone: 508.835.6767 DESIGNED FOR: Kent -- DATE: August 13, 2015.. CEILING HT: 84 SCALE: 1/2'' = 1' -- DESIGNED BY: DINO SIMILIA `AWft "°"' ASSESSORS MAP NOTES: TEST HOLE LOGS PARCEL: 70 FLOOD ZONE! C t.� �U I L �VA�UA tUl1: Yt �.h� G'y� l) 'I'lie insltson shall comply with'l itle Va►Rd'l own of Board of - WITNESS : 11 " MMIVJ I lealtli I nations. a �30U�4 /6573 f �'��'� 2) The insAr shall verify the location of tdiiies,sewer inverts and septic r REFERENCE_ DATE: �', - I' -� tom? c5f' � PERCOLAT a0N RATE: � 2 �V(11�t•I, I componai�s prior to installation and settig lase elevations. _ 3) All graviLIKEeptic piping to be 4 inch Sc1tIF,#PVC at 1/8 per foot. Tire first two feet of of the d-box to the leaching 611 be level. ��_�,L► _______ _______�_. .___ � �- 1- - - 4) This plans riot to be utilized for property6rre determination nor any other "aW R/L A �� IA LOAM4 *419 purpose der than the proposed system intAlation. d ►qy A I t �t 10 IL�}l i 5) All septi mponents must meet Title V�xifications. 0 00 t ° .Db 1�1 �t419 6) Parking del i not be constructed over H l tlmptic components. — - " 'r up - l �, t� cle, ' HIV 12(0 G 7) The propsty is bounded by property corny%and property lines. 4 1!� + ✓ o owner shall review desi �Milerations to approve of total o►� YALIV6 ow3 8) The pr pdv gr► LOCATION MAP design flay and number of bedrooms to beconsidered for design. Receipt 3�o0 16, Ntl �N� �jF��yA of payrnat or the plan and installation bwd on the plan shall be deemed tz approval#the design flow by the owner. ill. r Ql t C 9) The exisig leaching or cesspools shall btr,nnped and filled with material within theproposed SAS shall nment procedures. •I1� per Title�bando p Lr{QM - 4�o Yl O1^� ` - ' be remov�,iilon with contaminated soiliml replaced with clean sand per Title V speti. k 11��E ob0jINJ Rf/4• _O�/1`l ,—_ /� �, c 10)System components to be 10 feet from war line. ewer lines crossing the V i._ 14 V 9 trit/�iY� 1$ �d-�4� VIA, water linahall be sleeved with 4 inch St�Y+O PVC with ends grouted if 4, '� t .-- -> - `�t'� 0?�JG w/ applicable 1'he proposed SAS is being inialled below the water service nj Q L �'i'(rtW��j• _ line. Thc&e is to be sleeved as aforemedoned and maintained in place. - SEPTIC SYSTEM DESIGN 1) If a garbage grinder exists it is to be remape�.1 and is the responsibility of the { owner to usare such. Pn FLOW ESTIMATE 12)The instalir is to take caution in excavatita round the gas line if such O'N 1 exists. P �� ?J_BEDROOMS AT 110 GAL/DAY/BEDROOM - GAL/UAY 13)'flre instalk shalLverify the location,quality acid elevation of the sewer ONESA - lines exitig the dwelhngpnor to the insl�ation. �,pt SEPTIC TANK 14)This planirepresentative only that a systm can fit on a property meeting ♦►•�•' _L �� _ 'Title V rea�irements. LOT � GAL/DAY x 2 DAYS - GAL ,y5o 6 ',4- SE � GALLON SEPTIC TANK( 0 - -- _ _W Nab 01 L ABSOR T I ON SYSTEM �i 't'2 1-11ri�� 10 REQ, 2� �QtD t3 V1�1'.1 `'`� _". � r-1 �1� J��t >+ �� t'►A.I�� � !1'M_ E-�L` ;"T� '� — - - - _:�!. -r;� �,��r1 Q!�.1/�/',�9vIL_�,�%�1' Z,� � �e ?' !.� �,►w;�jrt. . /�,�, �i ;v .. ..�. � v � .;/+•r�- �Q•• Of �+�1W L �jPhC� l:. �iL�i�. �`f y�IL'i FHr,: lo'�Gt� 4 -?aoF 6.5 V+ II1 ° � a 21 qNRS �' x . 3 = 9�,b �pnc �KjR -rCU o : to ��q) V I r r PC • � � 11 �n"�K� 0%Vq ; lb' P-Q• j V�Cl/�. -4 r YO4 CE ' .�, •, �,q owe c9u�c,�r-E • .�6 7U =, •' . ,. ,� � � � __ _ - ./ Z/Z �� ;�. awn, w �' y���� __. __ lk SEPTIC SYSTEM ' SECTION � � ` • . •.' p Aso,• M b� o WOE- r �NsPcG7iD►-r-rag- Ile � 31s.Z V r 00 - PF ,- -,;; L0T " °°• ,Z� mug J7 -U=BO� .I &/o-r��ow/T� �v Se✓ �iGC+�iLl.1L17 s `�'�• �'' - - �6 AL TANK , . ©�. D Ft.c,� cr�4••/ • „iii"-„i" ,,,,,,ii'-,iis-'�ii �_--„ '- �� ��L ASS ♦ �J {��.A , -- --a---• .. _ o EPHEN - J. o�I )4V, 50% 3 — IL�1�W (REC) •"i1gr�� 'fib $E �-1Z0��Y6�T� � 37559 - SITE AND SEW ;E PLAN V2, � I� I�5 �`� °• '9,S LOC/ I ON : • /`�9 �o/ 4f l�1 '� �11/L� c C��'�rLv M165 G'✓��'W__ �b t''�U t���j E°0 o o� ---- ------=-- --- ---- _ _ _ V\N%OF s or.�`'`" PREPARED FOR : J(11 �- �F �I✓�lL VA Ote6��� �� �� ._ . _ � AVID sq�y �:• � to ,, o. e c c., �:• WEQUAQUET SCALE 0�� DAV I ® B . MASON'RS DATE: 2 Il 01' V I RONMENITAL DESK INS LAKE �! W,d Zt �.;; , ,VCAST SANDWICH . MA . DATE HEALTH AGENT ( 5 8l 833- 2177