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0656 SOUTH MAIN STREET
(� wc�:�. rr1 a.� r' S� r: ,��. -� �. � {!T ;', �� <. i. .. .; ti. Ei'? � .. i� � i ' _ :. - _ - ,. � s r �! a� �. - v � - � _ � - it i - �. e � - 4 � �. ., o .. f 9 p � i B. - � � € _ ¢ h - i L �.' .. � _ - - ,. � d t E �� .. _. u .. 7 o-; o, , p ,. _ -' o ,. .. _ _ �—--.: .. .` " . 001 t 3., ,`U,f Iv • • s d .. ... .: i .. .. .......-.—_ v..._.._ .. ' .. r .. I b b: . . f ..., _. Architcctural Innovations, P.G. (39C N,:,r d,oe Avenue Fittwfnrcl,.E�( w York 14534 OF N1P'. 1 i x� 00 __ _ ----- - -t - - , �. _. ..r.. ...- ..... ....•..: ..:, ....� .. ..... �• ..ram ..�. 2.wr.•-.. ' .. .�w��i�: . •��..��: ._.c�•+�•:.-ram. '�—��:,�.•� ,.��.._ ._. :.. ...�.�rr�..wr�.�• jjj c• • - �'�� .ter V,. `\ ..• r .. N No \ _ :. /`rchitccfi r�:l 1 m~oval0hs, P.C. 69.0 Mcn ao Avenue Pittsford, N w York 14534 ... �.. . ... �a�TN OF tAASSbG Rev, 1 a 3o a,3 a U DEPARITMENTOFHOMELANDSECURITY ELEVATION CERTIFICATE OMB No. 1660-000s Federal Emergency ManagemontAgency Expires March 31,2012 National Flood Insurance Program important Read the instructions on pages 1-9. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name Jon&Jean Tobin. Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P:O.Route and Box No. Company NAIC Number 656 South Main Street City Centerville State MA ZIP Code 02632 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) Assesor Map 186 Parcel 040 A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.)Residential A5. Laliude/Longitude:Lat.41 38-19 Long.70-21-10 Horizontal Datum: ® NAD 1927 ❑ NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 3 A8. For a building with a crawispace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawispace or enclosure(s) 1950 sq It a) Square footage of attached garage 459 sq ft b) No.of permanent flood openings in the crawispaoe or b) No:of permanent flood openings in the attached garage enclosure(s)within 1.0 foot above adjacent grade 15 within 1.0 foot above adjacent grade NA c) Total net area of flood openings in A8.b 2,000 sq in c) Total net area of flood openings in A9.b NA sq in d) Engineered flood openings? ® Yes ❑ No d) Engineered flood openings? ❑ Yes ❑ No SECTION B-FLOOD INSURANCE.RATE MAP(FIRM)INFORMATION Bi_NFIP Community Name&Community Number B2.County Name B3.State Barnstable 250001 Barnstable MA B4.Map/Panel Number B5.Suffix' B6.FIRM Index 87.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone 0016 D Date Effective/Revised Date Zone(s) AO,use base flood depth) July 2,1992 July 2,1992 A10 11.0 B10. Indicate the source of the Base Flood Elevation(BFE);data or base flood depth entered in Item B9. ❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other(Describe) Bl 1. Indicate elevation datum used for BFE in Item 159- 0-NGVD 1929 ❑ NAVD 1988 ❑ Other(Describe) B12. Is the budding located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? El Yes ® No. Designation Date ❑ CBRS ❑ OPA SECTION C,-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: ❑ Construction Drawings". ❑ Building Under Construction' ® Finished Construction , `A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,AR/A,AR/AE,AR/Al-A30,AR/AH,AR/AO. Complete Items C2.a-h below according to the building diagram specified in Item AT Use the same datum as the BFE. Benchmark Utilized RM27Vertical Datum`NGVD 1929 Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawispace,'or enclosure"floor)9..3 ®feet. ❑meters(Puerto Rico only) b) Top of the next higher floor 13.9 ®feet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N.e [I feet El meters(Puerto Rico only) d) Attached garage(top of slab) 11.3 ®feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building see.comments ❑feet ❑meters(Puerto Rico only) (Describe type of equipment and location in Comments) K 0 Lowest adjacent(finished)grade next to building(LAG) 9.0 ®feet. ❑meters(Puerto Rico only) ` g) Highest adjacent(finished)grade next to building(HAG) 11.0 ®feet ❑meters(Puerto Rico only) h) Lowest adjacent grade at lowest elevationi of.dec k or stairs,including 9.0 ®feet ❑meters(Puerto Rico only) structural support SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. I car*that the information on this Certificate re presents presents my best efforts to interpret the data available.1 understand that any false statement maybe punishable by fine oriaWdsonment under 18 U.S.Code,Section f 001.❑ Check here if comments are provided on back of form.• 'Were latitude and longitude in Section A provided by a licensed land surveyor? Yes ® No rPM 11 s Certifier's Name Peter Sullivan PE License Number 29733 � Title Civil Engineer Company Name Sullivan Engineering Inc. .� Addy r Ro City Osterville State MA ZIP Code 02655 Signature Date Oct 25,2010 Telephone 508.428-3344 NO. CWIL TOWN Or B RNSTABLE 2010 P-OV -8 PM !2 2 QIVISIGtq l NNIPORTA'NT: In ti>ese spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number 656 South Main Street City Centerville State MA ZIP Code 02632 Company NAIC Number SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments A8 10 smart vents rated at 200 sf per unit Coal 2,000 sf covreage A9 Garage slab is elevation 11.3 which is above base flood elevation 11.0 _CaLe) Bottom of ductwork elevation 11.2,bottom of air conditioning condensers 11.2,one stereo speaker junction box at 11. Oc.r ZS ZONO . Signature Date ❑ Check here If attachments SECTIO E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete items E1-E5. If the Certificate Is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items Ei-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑below the HAG. b)Top of bottom floor(including basement,crawlspace,or enclosure)is ❑feet ❑meters ❑above or❑ below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is ❑feet ❑meters ❑above or ❑below the HAG. E3. Attached garage(top of slab)is ❑feet ❑meters ❑above or ❑below the HAG: E4. Top of platform of machinery and/or equipment servicing the building is ❑feet ❑meters ❑above or❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized.representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my,knowledge. Property Owner's or Owner's Authorized Representative's Name Peter Sullivan PE Address 7 Parker Road City Osterville State MA ZIP Code 02655 Signature Date 10/25/10 Telephone 508-428-3344 Comments ❑Check here if attachments. SECTION G-COMMUNITY INFORMATION(OPTIONAL) = The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9. 'lx' G1.❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.❑ The following information(items G4-G9)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued' G7.'This permit has been issued for: ❑New Construction ❑Substantial Improvement G8. Elevation of as-built lowest floor(including basement)of the,building: ❑feet ❑meters(PR)Datum. G9. BFE or(in Zone AO)depth of flooding at the building site: []feet ❑meters(PR)Datum G10.Community's design flood elevation ❑feet ❑meters(PR)Datum Local Official's Name" Title Community_Name Telephone Signature Date Comments „ 1-1 Check here if attachments TOWN aFBARNSTABLE �r 20110 NOV -8 PM 12: 52 DIVISIO ASSESSORS REF.: OVERLAY DISTRICT: Map 186 L. AP - Aquifer Protection District Parcels 040 �—<\ ZONE: IQ RD-1 FLOOD ZONE: Area (min.) 87,120 SF (RPOD) Zone A10 (el 11) Frontage Width (min) (min) min) 125'20' y Community Panel No. Setbacks: #250001 0016D July 2, 1992 Front 30' Side 10' Wetland Resource Line Rear 10' as Flagged by ENSR ^1I -January 4, 2006 BAW BVW3 '\1X B BvwB BVW5 `lei / BVW4 j j OO, Former �Bvws Garage i i i Lot 10 17,700±SF(uplond) 103.2- 8,156fSF(wetland) ti 25,856±SF(total) G\0 20.2 �Z X o i i i i i i i #656 evwni New Concrete Former — E1=11.9' Dwelling O Foundation Top h( tx O ��VW12 - -- - - - - -- - - D, / 30.4' k ` v 39.1' ° Footing — El-5.9' 9A� D BVW13 1 � O�O EI=4.8' Basetx Q�9�?� ��..` ti�� ♦ �` ��' SECTION "A" �► Q'QZe-%, e 9VM\ �� N evxq ' e �a BVWI6M. AAO 0� K SH �'�i,���, I certify that the foundation � o ,HARED , , shown hereon conforms to o -HEURUr:R. '` the setback requirements of 034312 the Zoning Bylaws of the PLOT PLAN goFEs,\ town of Barnstable. At 656 South Main Street y�y BARNSTABLE - D 7 Aar � Professional Land urveyor Dot (Centerville) NOTES MASS, DATE: 031AUG109 SCALE: 1"=30' 1.) The structures shown were located on the ground 0 15 30 45 60 FEET by conventional survey methods on (or between) 05/JAN/06 and 03/AUG/09. PREPARED FOR: Jon & Jean Tobin 2.) The property line information shown hereon was 23 Fall Meadow Road compiled from available record information. Pittsford NY 14534 3.) This plan is not for recording and is not to be PREPARED BY: CapeSury used for construction layout or deed description purposes. 7 Parker Road Osterville MA 02655 DWG #. C247_4gl FIELD BY. RRL/MLL (508) 420-3994 / 420-3995fox t REScheck Software Version 4.1.4 Compliance Certificate Project Title: PETER COLLINS Report Date: 11/06/08 Data filename: Untitled.rck Energy Code: 2000 IECC Location: Barnstable, Massachusetts Construction Type: Single Family Glazing Area Percentage: 10% Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 656 S.MAIN ST BARNSTABLE,MA Compliance:28.0%Better Than Code m Maximum UA:735� Your UA:529 Ceiling 1:Flat Ceiling or Scissor Truss 1310 30.0 0.0 46 Ceiling 2:Flat Ceiling or Scissor Truss 1820 30.0 0.0 64 Wall 1:Wood Frame,16"o.c. 3580 19.0 0.0 191 Window 1:Metal Frame:Double Pane with Low-E 356 0.370 132 Door 1:Solid 42 0.250 11 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 680 38.0 0.0 18 Floor 2:All-Wood Joist/Truss:Over Outside Air 200 38.0 0.0 5 Floor 3:All-Wood Joist/Truss:Over Unconditioned Space 1310 19.0 0.0 62 Furnace 1:Forced Hot Air 90 AFUE Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2000 IECC requirements in REScheck Version 4.1.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: PETER COLLINS Report date: 11/06/08 Data filename:_Untitled.rck Page 1 of 4 REScheck Software Version 4.1.4 Inspection Checklist Date: 11/06/08 Ceilings: ❑ Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: ❑ Ceiling 2:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1:Metal Frame:Double Pane with Low-E,U-factor:0.370 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Solid,U-factor:0.250 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-38.0 cavity insulation Comments: ❑ Floor 2:All-Wood Joist/Truss:Over Outside Air,R-38.0 cavity insulation Comments: ❑ Floor 3:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:90 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are 1)Type IC rated,or 2)installedr inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials. If non-IC rated,fixtures are installed with a 3"clearance from insulation. Vapor Retarder: ❑ Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. ❑ Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Project Title: PETER COLLINS Report date:.11/06/08 Data filename: Untitled.rck Page 2 of 4 Duct Insulation: Ducts in unconditioned spaces are insulated to at least R-5. Ducts outside the building are insulated to at least R 6.5. Duct Construction: All joints,seams,and connections are securely fastened with welds,gaskets,mastics(adhesives),mastic-plus-embedded-fabric,or tapes.Tapes and mastics are rated UL 181A or UL 181 B. Exceptions: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in.w.g.(500 Pa). The HVAC system provides a means for balancing air and water systems. Temperature Controls: Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Service Water Heating: Water heaters with vertical pipe risers have a heat trap on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. Circulating hot water pipes are insulated to the levels in Table 1. Circulating Hot Water Systems: Lj Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. Project Title: PETER COLLINS Report date: 11/06/08 Data filename: Untitled.rck Page 3 of 4 riii - - 1 Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature(°F) Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-169 0.5 0.5 1.0 1.5 100-139 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes , Piping System Types Range(°F) 2"Runouts 1"and Less 1.25'to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) Project Title: PETER COLLINS Report date: 11/06/08 Data filename: Untitled.rck Page 4 of 4 PROJECT °n NAME: ADDRESS: SDIL�"Tr� MAz Aj Sr . PERMIT# PERMIT DATE: t It'-d1 M/P: Igac> LARGE ROLLED _PLANS ARE IN: BOA 82 SLOT Data entered in MAPS program on: BY: a/wn fi l es/archive AUG/18/2008/MON 03: 12 PM C-0-MM WATER DEPT. FAX No, P. 002/002 Centerville-Osterville-Marstvns MiUs Water Department P.O.BOX 369-1138 MAIN STREET OSTERVILLE,MASSAC USETTS 02655 www commwater.com OFFIC13 01F WATE R )3OARD OF WATER CONMSSIONERS WATER SUPERINTENDENT DEPM TEL.No.509 419-6691 rvs FAX.No.509-428-3508 August 18, 2008 Town of Barnstable Building Dept. 367 Main Street Hyannis, MA 02601 Re: Account#553 Jon&Jean Tobin 656 South Main Street Centerville,MA Gentlemen: On Friday,August 15, 2008 we disconnected the water service at the curb stop for the property mentioned above. It is our understanding that the house will be demolished and a new water service will be installed at a later date into the new house. If you have any questions,please call our office at 509-428-6691. e ..} aY 00 J Very truly yours, : Craig Ciocker Superintendent CC/jw A i yy 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel o4o 1 Permit# Health Division 10 ,3414 3 ,1� \ ate Issued 6 h5"`0 S Conservation Division Application Fee Tax Collector �� Permit Fee Treasurer lb P %V7 `IC �Y 'TE MUS T SE WAL Planning Dept. 01N C��9�Li p � � A�+lf��., WITH TITLE 5 Date Definitive Plan Approved by Planning Board QI ENVIRONMENTAL CODE AND Historic-OKH 'Preservation/Hyannis \ 1"OWN MULATIONO Project Street Address _��Co .S��f-� M!4 J3 �5 - Village Owner . 95Te7e 10 f Dec) _ y ` aL , Address as b oo�=Z ul f f� 05v o�I Telephone fZcPL-44cE �,u►.JDA,T7 one=Dc� To �- Permit Request PV, 13 K ( ZCA CAE VPTn2 vEce=iz� 18z 4E3r tie�5 Qw Ta Bu.m p6L.,y_rya►,>ezo .U��- Square feet: 1st floor: existing 1 proposed I 4' 2nd floor: existing LICO proposed 300 Total new 404- Zoning District Z 5�7 Flood Plain W E� Groundwater Overlay o ,Project Valuation Construction Type Wcop �2►4m Lot Size e4-6 } 5 Grandfathered: O Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family )< Two Family O Multi-Family(#units) Age of Existing Structure 1%'S0 Historic House: 0 Yes Mo On Old King's Highway: 0 Yes Basement Type: ❑Full jg Crawl XWalkout ❑Other Basement Finished Area(sq.ft.) t-J a 1°V6�__ Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Z-- Half:existing ( new Number of Bedrooms: existing new" Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel:XGas 0 Oil ❑Electric ❑Other Central Air: ❑Yes kNo Fireplaces: Existing New Existing wood/coal stove: l(Yes ❑No Detached garageX. existing ew size Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:O existing knew sizetk�2*Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization 0`Appeal# Recorded❑ Commercial O Yes Alo If yes,site plan review# Current Use 15:i, N G(c--FAM N ��n S0Proposed Use BUILDER INFORMATION Name V t.c-- I opaA- ' Telephone Number Address License# (f)D 26 a-7 U= S L Home Improvement Contractor# 1 (5;5c>Z Worker's Compensation#jen-u(3'+.-o2L37!2 ©� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE c._)� I ASSESSORS REF.: OVERLAY DISTRICT: Map 186 L. AP — Aquifer Protection District Parcels 040 ZONE: Q, RD-1 FLOOD ZONE: y Area (min.) 87,120 SF (RPOD) Zone A10 (el 11) Fronta e (min) 20' CommunityPanel No Width (min) 125' Setbacks: #250001 0016D Front 30' July 2, 1992 Side 10' Wetlond Resource Line Rear 10' as Flogged by ENSR htx January 4,,2006 eVw? 0 1 tx .. SM `BVW4 �°° Former �evwv Goroge a. i i Lot 10 17,700±SF(uplond) 103.2'1 8,156±SF(wetlond) C/1 ti 25,856±SF(total) 20.2' � evnol ,. �s4 ,L Os�Oi i � }z, i X6, i i i #656 New Concrete Former O — EI=11.9' Dwelling Foundation Top tK O�� �evwil N �eC — EI=8.9' a Step ``. 30.4' ` 39.1' ° Footing EI=4.8' A�� ti .N Base tx •`\♦ ��� SECTION "A" =A,Q 9c N BVV k i W� ` v BVW76 i 0 � SNafsgc,, I certify that the foundation . ?.�KARD `ir 1 shown hereon conforms to R. INEUREUX NV,the the setback requirements of 0302 Zoning Bylaws of the PLOT PLAN of Barnstable. - At 656 South Main Street 90FEss�o Q` �, ., 07 BARNSTABRLF Professional LOnd urveyor Dat (Centerville) NOTES:- .f MASS, DATE: 03/AUG/09 SCALE: 1"=30' 1.) The structures shown were located on the ground 0 15 30 45 60 FEET by conventional survey methods on (or between) 05/JAN/06 and 03/AUG/09. PREPARE'FOR: Jon & Jean Tobin 2.) The property line. information shown hereon was 23 Fall Meadow Road compiled from available record information. Pittsford NY 14534 3.) This plan is not for recording and is not to be PREPARED BY: CapeSury used for construction layout or deed description purposes. 7 Parker Road Osterville MA 02655 DWG #: C247_4g1 FIELD BY: RRLIMLL (508) 420-3994 / 420-3995fox r Town of Barnstable P�oFz Tp � o R.egulatory Services > xslAsrE Thomas F. Geiler,Director MASS. 1639. ,�� ]wilding Division pTfD ItiW`t A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print , DATE: JOB LOCATION: number street village "HOMEOWNER". name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and. to allow homeowners to engage an individual for hire wlio does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER i or is intended to which the re s on w Person(s)who owns a parcel of land on which he/she resides or intends to reside, , be, a one or two-family dwelling, attached.or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with:the State Building.Code and other applicable codes,.bylaws,rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note:.Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit.is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a.person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,- Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems;particularly when the homeowner hires unlicensed persons. In this.case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting.as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,' that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You.may care t amend and adopt such a form/certification for use in your community: Q:\WPFLLES\FORMSthomeexempt.DOC . OF THE r Town of Barnstable Regulatory Services ' BARNSTABLE, Thomas F. Geiler,Director f 6_19..�Q Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder 10 ( � ; as Owner of the subject property to act on m behalf, rize hereby autho z'✓'' / s Y in all matters relative to work authorized by this building permit application for: (Address of Job) S' n o 'er Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORNIS:OWNERPERM ISS ION r Massachusetts - Department of Public Safety Board of Building Re�"ulations and Standards Construction Supervisor License License: cs 3420 Restricted to: 00 PETER J COLLINS I, PO BOX 494 GREEN HARBOR, MA 02041 Expiration: 9/9/2011 I Cunm1issi III er. Tr#: 2338 l r OR 7.TxTT= r-TITV rE.7= N GRANITE STATE INSURANCE COMPANY 0024435-00 WC 007-43-4577 --------------------------------------------- 13102 013-66-o6o9-oo P J COLLINS REALTY TRUST P 0 BOX 494 GREEN HARBOR, MA 02041-0000 EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 I.D# MA Ul#w EASTERN INSURANCE GROUP LLC WORKERS COMPENSATION AND EMPLOYERS 233 W CENTRAL ST LIABILITY POLICY INFORMATION PAGE NATI CK, MA 0176o-3133 INSURED IS PREVIOUS POLICY NUMBER TRUST RENEWAL 007429570 OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF ITEM 1. OF THE INFORMATION PAGE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insured's mailing address FROM 06/21/09 TO 06/21/10 REM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident.$ 100,000 each accident Bodily Injury by Disease $ SOO.000 policy limit Bodily Injury by Disease $ 100.000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC2003o6A D. This policy includes these SEE EXTENSION OF ITEM 3.D. OF THE INFORMATION PAGE - WC990612 ' ITEM 4 The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Remuneration n Premium aClassifications Code Number mue at on Annual 3 Year .a Annual 3 Year SEE EXTENSION OF ITEM 4. OF THE INFORMATION PAGE - WC7754 i EXPENSE CONSTANT(EXCEPT WHERE APPLICABLE BY STATE) $159 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $500 If indicated below, interim adjustments of premium shall be made: Semi-Annually Quarterly Monthly DEPOSIT PREMIUM ' 06/03/09 ASSIGNED RISK 66 �i Issue Date Issuing Office Authorized Representative WC 00 00 01 39967 (Rev'd 04/08) The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianS/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/lndividual): �r a, fJ l"����S ���` Z�6 Address: �lL� c /r��� A-a-i Z0. City/State/Zip: M&_,J• Are ou an employer?Check the appropW6,� Type of project(required):' 1. I am a employer with general contractor and I * hired the sub-contractors,. .. . 6: New construction _..' employees (full and/or part-time). 2-0 -1 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 mein any capacity., employees and have workers' 9. ❑ Building addition comp.insurance. [No workers comp. insurance 10.❑ Electrical`repairs or additions required.] 5.❑ We are a corporation and its , 3.El 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 13.❑ Other r employees. [No workers' 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. 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 thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: e " /-" " Job Site Address: Z, li e 'i!�reeZX — /f'/l i�oil� ity/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 i er the pains and enalties of perjury that the information provided`above is true and correct. \ Gud Date: Signature: /- ' Phone# `,S1� Official use only. Do not write in this area, to be completed by city or town official City or Town:' Permit/License# 'f Issuing Atithority(circle one): ' 1.Board,of Health 2.Building.Department.3.,City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#:' Information and. lnstructi6P's Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant,to this statute, an ernplo�ee is defined as "...every person,in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,_corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the • ich dwelling house dwelling house of another who',employs persons to do maintenance,constniction or repair work on s� g shall not because of such employment-be deemed.to be an employer." or on the grounds or building appurtenant thereto MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence'of compliance with the.insurance coverage required." •Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), addresses)and phone number(s)along with their certificates) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees;a policy is required. Be advised that this affidavit inay be submitted to the.Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license.is being requested,not the Department of Industrial Accidents. Should you have any,questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below,"Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as,a.refdence number.. In addition,an applicant that must submit multiple permitflicense applications in any given year, need only.submit one.affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each elated to any business or commercial venture year. Where a home owner or citizen is obtaining a license or permit not r (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext,406 or 1-87.7-MASSAFE Fax 4 617-727-7749 Revised 4-24t7 www.inass.gov/dia TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map °/5� Parcef" Application # Health Division C'��rTr�v r'l/r� Date Issued LiLe 0 Conservation Division/'4,r?,�r��;//� cam/ Application FeeP Planning Dept. Per Permit Fee lS�� Date Definitive Plan Approved by Planning Board 'Al Historic - OKH _ Preservation/Hyannis Project Street Address .5� Village Owner � �vr � �., ,'�v / ��Ted Address ,� � � o��� Telephone Permit Request t dI Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay w = CD Project Valuation Construction Type z r� C Lot Size 9, ; F_4� Grandfathered: ❑Yes ❑ No If yes, attach supportingdocumentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) j Ln Age of Existing Structure eela) Historic House: ❑Yes XNo On Old King's Highway' ❑VeS ❑ No Basement Type: ❑ Full XCrawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ,,;Z©6�5 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 `Y Heat Type and Fuel: X Gas ❑ Oil ❑ Electric ❑Other Central Air: VYes ❑ No Fireplaces: Existing New _X 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) Name � �1L'A•ti S Telephone Number Address �� o x License# lr eeHl &I- Home Improvement Contractor# Worker's Compensation # W6/2l�'7- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER . DATE OF INSPECTION: FOUNDATION dos 5ItS�a a x FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 0 6 DATE CLOSED OUT ASSOCIATION PLAN NO. r &PLO- TOWN OF BARNSTABLE BUILDING PE IT.APPLICATION Map `LJ Parcel l A I' n# " Health Division ate ssued o c � Conservation Division Application FeeQzry2v,tn 1'(3z> CO Tax Collector Permit Fee �0 Treasurer V J K 1116162 . Planning Dept. Q Date Definitive Plan Approved by Planning Board F Historic-OKH Preservation/Hyannis Project Street Address Villager' Owner Address Telephone Permit Request 4- �,�� Z. c Square feet: 1 st floor:existing proposed 2nd floor:existing proposed /90 Total new s:z- Zoning District Flood Plain Groundwater Overlay Project Valuation c Construction Type , sal e Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. v Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes >I(No On Old King's Highway: ❑Yes XNo Basement Type: �$Full ❑Crawl ❑Walkout ❑Other L"asement Finished Area(sq.ft.) Zle Basement Unfinished Area(sq.ft) Number of Baths3�_Full:existing new 3 Half:existing new / Number of Bedrooms: existing new Total Room Count(not including baths):existing . new_7 First Floor Room Count QHeat Type and Fuel: WGas ❑Oil ❑ Electric ❑Other Central Air: Yes ❑No Fireplaces: Existing NewyJ— Existing wood/coal stove: XYes -..A No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size AttaAed garage:❑existing new sizeZ Shed:❑existing ❑new size Other: o` . Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ co —. Commercial ❑Yes ❑No If yes,site plan review# - r Current Use Proposed Use BUILDER INFORMATION Name ilk Telephone Number Address License# r ,�i� ���✓�,�i'���5 diva / Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C//�d1ls4S1^ SIGNATURE DATE /,e� --,2?,3 3 r S FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED r- MAIt/PARCEL NO. 'ADDRESS, VILLAGE OWNER r DATE OF INSPECTION: j FOUNDATION ® �I� F FRAME 5KAt4t I z/�r oQ ' �iss INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL F GAS: ROUGH FINAL FINAL BUILDING az /J//oJ/6w I a DATE CLOSED OUT ' ASSOCIATION PLAN NO. S Town of Barnstable Regulatory Services 9ARNSfABLE Thomas F. Geiler, Director 9 MASS. g F 6J9, Building Division , Thomas Perry, CBO,Building Commissioner ^ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: —rolb k h Map/Parcel: Project Address 65"(1 56,4 Si. Builder: FeAer Cc )1 ;,, The following items were noted on reviewing: lJ o 2Er e_ C � �y4""t'►u'y. COY-~t; i c � -' �aS- a.l�nwe-� , We3 erc ii (s/kb� Wr f ( it Q �-tS"t7Lip 'T C'� T'C�i�IOa� LAe etl 0.� 11h9©CG'1--0V% _ u K� Reviewed by: Date: .Q:Forms:Plarvw Town of Barn-stable r a Regulatory Services BARNr a r STas.B1 E nia r Thomas F.Geiler,Director TFDMA'Ia Building Division Tom Perry,Building Commissioner.. 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 J Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If UsinLy A Builder* as Owner of e subject property, hereby authorize QC ` act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) AL Sig tur f er Date Print Name "k If Property Owner.is applying for permit please complete the Homeowners -License.Exemption Form on the reverse side. Q:FORMS D WNERPERMISSION r,. Town of Barnstable OF THE 1p� Regulatory Services �P O y T r • satuNszasLE. : Thomas F.Geiler,Director KAes. 059• .�� Building Division ATED MA'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings'of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. ` DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all'such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of Barnstable-Build ing Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonn/certifi cation for use in your community. Q:forms:homeexempt Nov 21 08 09:59a Jon Tobin 585 924-0779 p.1 NOV-18-2005 13:46 NATIONAL GRID 508 394 5019 P.001/001 nationalgrid 127 Whites Path South Yarmouth , MA 02664 November 18, 200$ FAX: 585-924-2328 ATTN: John Tobin RE: 656 South Main Street, Centerville This is to confirm there is no natural gas service to the above address. This was verified by a nationalgrid representative on November 18, 2008, If you have any questions,please call me at 508-760-7481. Susan McMullin Field Coordinator nationalgrid TOTAL P.001 78IF8W765 NSTAR SUM SW3161 10:33:57 a.m. 08-13-2008 2/2 SMINSTAR , One NSTAR Way EL,EC TR/C Westwood,Massachusens 02080 GAS August 13, 2008 Jon & Jean Tobin - 23 Fall Meadow Drive Pittsford, NY 14534 RE, 656 S. Main St., Centerville Dear Jon & Jean Tobin: At NSTAR, were committed to delivering great service. This letter serves as confirmation that, as of 08/12/08,,the electric service to 656 S. Main St., Centerville, has been removed. Based on this information, there is no electric power at this address and you may proceed with the demolition., If you have any questions, please contact me at (781) 441-3040. Sincerely, Marion Feeney New Customer Connects , Aug 20 08 08: 38a COMM Water Dept. 508-428-3509 p- 1 Centerville-Osterville-Marstons Mills Water Department P.O.BOX 369-1138 MAIN STREET OSTERVILLE,MASSACHUSETTS 02F51. www.commw?cer.com OFFICE OF v WATER� F BOARD OF WATER COMMISSIONERS WATER SUPERINTENDENT DEPT. Jg • S>o d'• TEL.No.508-428-6691 rvs FAX.No.508-428-3508 August 18, 2008 d. Town of Barnstable Building Dept. 367 Main Street Hyannis, MA 02601 Re:Account#553 Jon & Jean Tobin 656 South Main Street ` Centerville, MA. Gentlemen: On Friday, August 15,t2009 we disconnected the water service at the curb stop for the property mentioned above. It is our understanding that the house will be demolished and a new water service will be installed at a later date into the new house, If you have any questions,please,call.our office at 508-428-6691. Very tmty yours, i Craig Crocker Superintendent CC/jw ...' r.._.;.2.. .' 7 Nov 16 08 12:29p Jon Tobin 585 924-0779 p.7 ACORD,; CERTIFICATE OF LIABILITY INSURANCE °�ozsi2oo' PRODUCER 508-428-0440 THIS CERTIFICATE IS ISSUED AS A !MATTER OF INFORMATION MARK SYLVIA INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 771 MAIN STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. OSTERVILLE, MA 02655 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURER A: UNITED CASUALTY&SURETY INS CO JON TOBIN INSURERS: 23 FALL MEADOW DRIVE INSURERC: PITTSFORD, NY 14534 INSURER D: INSURER E: " COVERAGES 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 4bR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS: _ INSR DD POLICYEFFECTIVE POUCYEXPIRATION LIMITS T POLICYNUMBER DATE lMM!DD/YYl GENERALUABILITY E ACH OCCURRE14CE i_$ DA REN'fE COMMERCIAL GENERAL LIABILITY PREMISES Ea ocemencel �$ CLAIMS MADE FI OCCUR MEO EXP(Any one person) $ PERSONAL$ADVINJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COhIPlOP AGG I$ POLICY Fj PRO- LOC - 4 AUTOMOSILELIABLITY I COMBINED SINGLE LIMIT I$ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY - SCHEDULED AUTOS _ (Per person) -_ $ HIRED AUTOS BODILY INJURY. NON-OWNED AUTOS - (Per adldenl) PROPERTY DAMAGE 3 (Per acdden!) GARAGELIABIL17Y AUTO ONLY-EA ACCIDENT $ ANY AUTO ! OTHER THAN EA ACC S AUTO ONLY: qGG I S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE--i$ ^ OCCUR U CLAIMS MADE AGGREGATE !$ - - b DEDUCTIBLE $ RETENTION S 8 VJC STATU- OTH- WORKERS COMPENSATION AND R� EMPLOYERS'UABILRY I - E.L.EACH ACCIDENT ,$ ANY PROP RIETOR,PARTNER/EXECUTIVE OFFICERI'MEMBEREXCLUDED7 E.L.DISEASE-EAEMPLOYEE;8 It es,desorlhe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT I.$ OTHER A STREET BOND NEW fSSUE 1 W312008 10/23/2009 $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS, FOR PROPERTY LOCATED AT 656 S. MAIN STREET CENTERVILLE, MA 02632 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN TOWN OF BARN STABLE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL BUILDING DEPARTMENT IMPOSE NO OBUGATION OR UABILRY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 367 MAIN STREET REPRESENTATIVES. ova HYANNIS, MA 02601 AUTHORIZED REPRESENTATIVE ACORD 25 f20011011I VACURn CORPORATION 1988. a J ' iVk! _ ��'lie (�a7x7om�uea o rid✓ adaacicuaetla ndards -Sta .. oard of 13uildin Regulaho�a Construction Supervisor License `f • 1 .:.. ljcensec.CS 3420 Birti4ke o 9/9/1944 E Viraton 9/2009' Tr# 3359 Restriction" 00€' k wmi? et� PETER,1 .COLLINS ' F'O BOX 494 ` 1�'�.' �1 GREEN HARBOR,MA 02041. Commissioner 1 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations • d 600 Washington Street Boston,MA 02111' www.mass.gov/dia Workers}Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers lkp licant Information Please P ' t Le ibl Name(Business/Organization/Individual): _ Address City/State/Zip;;, Phone.#: Are you an employer? Check the appropriate bog: . ;Type of project(required)-.. 1•❑ I am a employer with 4..[� I am a general contractor and I mP Yer 6. ❑New construction . employees(full and/or part-time).* • have hired the sub-contractors 2. I am'a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• Q Demolition workin for me in an capacity. employees and have workers' g Y P ty $. 9. ❑Building addition [No workers' comp.insurance comp.•rosurance• required.] 5• ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbin repairs or additions ' '3.❑ I am a homeowner doing ill-work . ❑ . g_ P • myself.[No workers'comp. right of exemption per MGL 12.[]Roof repairs insurance.required]fi A152, §1(4),and we have no c employees. [No workers' 13.❑Other_ 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. tCont mctors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must providb 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: Policy#or Self-ins.Lic.#: Expiration Date: lob Site Address: 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 IDIA for insurance coverage verification. 'do hereby certify un hepains aitdpenal 'es of jury that the information provided above is true and correct. Si afore: Date: ���� _ Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: ' ' Bermit/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#: Information and Instructions Massachusetts General Laws chapter,152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer:" MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an.LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' _compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in__(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-8.77-MASSAFE Fax#617-727-774:9 Revised 11-22-06 www.mass.gov/dia JN.ov 1T 08 12:26p Jon I obin Do 1/-4-ui is P.i B k '209 14- F",c?3 �2269 �3n DEED McLaughlin Real Estate Holdings, LLC; a Massachusetts 1.1mited Liability Company, of Scituate, Massachusetts (MaiV1 Address: 31 Curtis Street, Scituate, MA 02066) 1 for consideration in the amount of ,Three Hundred Forty . Thousand ($340, 000) Dollars paid, ' grant to Jon S_ Tobin and Jean Tobin, husband and wife, as tenants by the entirety, both of Pittsford, New.-York : (Mailing address : 23 Fall Meadow Drive, Pittsford, NY 14534111 with Quitclaim Covenants, The premises commonly known as 656 .South Main Street, Centerville, includ-ng the land.-,.,--jith the improvements thereon situated in Barnstable (Centerville) , Barnstable County, Massach-.asetts, bounded and described as follows : A. Beginning on 'the Westerly side of South Main` Street at a po-nt Four Hundred and forty=tw6 and 18/1'00 (492. 18) feet to a M.H . B. at the Southeasterly ,co:rner of lard now or formerly of John W. ,fi7r ght et ux .as 's`hb`wff on a plan hereinafter mentioned; c thence Nortr. .4.� degrees 4.4 ' 1-5' W ;By land .now , or ,,:formerly of said Johnvl.,; Wright et :ux,-, Eighty-nin,e and: 55%100 (89..55) feet to a post; thence in the same course by; saidoland now or formerly o'f said John W_- `Wright etaux, one hundred ten and 45/100 (110 . 45) feet to a point; thence North 42 degrees Q9 ' 4f0" E. ' by other "land- now o'r, formerly of said John W.rWright et ux, One Hundred and twenty-four and 17/100,- (124 .'17) feet to a corner az Lot 2, as s:nown o.n said plans wF: thence S . 47 degrees 43 E. µ:by.. Lots 2 .and 1 as;.shown on said plan, Two hundred (200j ,feet. to,"South Main ;aStreet; thence S . 42 degrees 17100" W. by said South Main Street, One Hundred and- thirty-four Land, 56/100 (134 . 56) 'feet to a corner which is the poirit -of, beginning - f fvo\"16 08 12:27p Jon lobfn DOC) yL4-U//y p.L Being shown as Lot 10 on a plan entitled . "Subdivision of Land in Centerville-Barnstable,- Mass: As.- surveyed for Joan VJ. . and Eva M. Wright . Scale l .inch equals 50 Ft. - February 25, 1948 . Bearse & Kell,oggr Civil Engineers . " which plan is duly filed _n the Barnstable Ccunty Registry of Deeds in Plan Book 82, Page 43. For title, refer to deed dated February 26, 2003 and recorded w_th the Barnstable County :Registry of Deeds in Book 16490, Page 62 . In Witness Whereof, Neil McLaughlin,, has hereunto set his hands and seal, as 1. a�xager of Mcl�aughlin Real Estate E�oldings; LLC, as of this day day of Apr i, t2G06 . McLaughlin Real Esta e oldings, LLC By I Nei McLaughlin, nager. Duly Author zed - Cc.m�ar-��r 1 t-i of classachusetts; F ss . Cn this � 6"dy of April, 2006 'before me the undersigned notary public, persofially appeared 'Neil McLaughlin, to me known to be the person whose name is signed on the preceding or attached document, , and acknowledged to me that he signed. it . -,-, voluntarily for the stated purposes as Manager of McLaughl ;;;r� t`< Estate Hcldings, LLC . - s,(l,J: k U1>.,,�►„� �� fi BARNSTABLE COUNTY REGISTRY OF DEEDS ASSACHUSETTS STATE EXCISE TAX ;�,;�., 1 � .„., �I '.�'�• � "`�0. Date; 44-14-2406 IE];2Ean Ct1a• 405 Doc': 22695 Tlml y Public Fee: 81►162.80 Cons: #340r000.00 Commission, Expires : �.„ <<, BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS .Date: 04-14-2006 i3 10:23am Ct1T: 405 Doc': 22695 Fee $775.20'. Cosa s _t340 r1)00.i ) BARNSTABLE REGISTRY OF DEEDS �J No�"'16 08 12:27p Jon Tobin ouo yL4-UIIy p•3 DECLARATION OF RESTRICTION We,Jon S. Tobin and Jean Tobin,of 23 Fall Meadow Drive Pittsford New, York 14534,34 being the owners of Lot 10, as shown on a plan of land recorded with the Barnstable County Registry of Deeds in Plan Book 82, Page 43,hereby impose the following restriction upon said land,which said restriction shall run with the land and be binding upon our successors and assigns thereto: The structure constructed or placed upon the Premises shall contain no more than four(4) bedrooms unless and until (a)such structure is connected to the public sewer system, or(b)the Board of Health of the Town of Barnstable permits otherwise. Property Address: 656 South Main Street, Centerville, Massachusetts For title,see deed recorded with the Barnstable County Registry of Deeds in Book 20914, Page 93. WITNESS our hands and seals this day 2 06. n S ip I f/K - Jean To STATE OF NEW YORK z County of Ontario On this 14th day of September 2006, before me,the undersigned notary public, personally appeared Jon S. Tobin and Jean Tobin,proved to me through satisfactory evidence of identification, which were driver licenses to be the persons whose names are signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose_ �- ✓'7' �/281�8 Public y Commission E3 es: ' 1 plide dftlnn Y�Rr My Csn� hsfon Bnires ka►e.RD.o,? i\ f i . E oy ." " > : _ ' jr 4 4 � jpp�Olz LOADS pal 3�J, a , _ 3-lam es pf�OV t p K s. r NO f Y t A i z !_ _ r 1 Engineering & ; Sulli'van , coi,suIting, Inc. (508)428-3344 • P.O. Box 659 • 7 Parker Road,Osterville,MA.02655 seci@sullivanengin.com • www.suilivanengin.com June 29, 2015 Mr.Thomas Perry Building Commissioner Town of Barnstable 200 Main Street Hyannis, MA 02601 RE: 1 729 South Main Street, Centerville Dear Commissioner Perry, As you are aware, renovations have been ongoing to die existing dwelling located at 729 South Main Street in Centerville, and landscape modifications are now beginning. As a follow up to our discussions, attached is an Existing Conditions Plan documenting die Building and Lot Coverages as they were pre-renovations. To die best of our knowledge, these conditions have existed since 1996/97 when the garage was added. We trust this submittal to be sufficient documentation of Coverages as they are believed to have existed on November 6, 2009, as may be required for any future projects subject to the District Regulations. I trust this meets your present needs. If you have any questions please feel free to call. Very truly yours, Jo in O'Dea Sullivan Engineering& Consulting, Inc. I Cc: James F. & Susan A. Mattie ° i Bk 209116 Ps 36 T22817 4 04-14-2006 & 02 =23R Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands • �s< WPA. Form 5 - Order of Conditions SE 39. Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided ded b by y DEP And Chapter 237 of the Code of the Town of Barnstable A. General Information Important: From: When filling out forms on Barnstable the computer, Conservation Commission use only the tab key to This issuance if for (check one): move your cursor- do ® Order of Conditions not use the return key. ❑ Amended Order of Conditions VOD" To: Applicant: Property Owner (if different from applicant): Jon Tobin c/o Han-Tek McLaughlin Real Estate Holdings LLC Name Name 100 Rawson Road 31 Curtis Street Mailing Address Mailing Address Victor NY 14564 Scituate MA 02066 City/Town State Zip Code City/Town State Zip Code 1. Project Location: 656 S. Main Street Centerville Street Address Village 186 040 Assessors Map Number Parcel Number 2. Property recorded at the Registry of Deeds for: Barnstable 30VIq093 County Book Page Certificate(if registered land) 3. Dates: APR 1 1 2006 February 3, 2006 March 28, 2006 Date Notice of Intent Filed Date Public Hearing Closed Date of Issuance 4. Final Approved Plans and Other Documents (attach additional plan references as needed): Proposed Improvements 656 South Main Street 01/19/2006 Title Date Existing Conditions 656 South Main Street 01/19/2006 Title Date Title Date 5. Final Plans and Documents Signed and Stamped by: Peter Sullivan, P.E. & Richard Lheureux, P.L.S. ; Name 6. Total Fee: $500.00 state fee+$75.00 town fee =$575.00 total fee (from Appendix B:Wetland Fee Transmittal Form) BWPAForm5.doc•rev.921/05 Page 1 of 7 i ry Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands WW ST"� WPA Form 5 - Order of Conditions SE3-4494 ASS `0g Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings Findings pursuant to the Massachusetts Wetlands Protection Act: Following the review of the above-referenced Notice of Intent and based on the information provided in this application and presented at the public hearing, this Commission finds that the areas in which work is proposed is significant to the following interests of the Wetlands Protection Act. Check all that apply: ❑ Public Water Supply ❑ Land Containing Shellfish ® Prevention of Pollution ❑ Private Water Supply ❑ Fisheries ® Protection of Wildlife Habitat ❑ Groundwater Supply ® Storm Damage Prevention ® Flood Control Furthermore,this Commission hereby finds the project, as proposed, is: (check one of the following boxes) Approved subject to: Z. the following conditions which are necessary, in accordance with the performance standards set forth in the wetlands regulations, to protect those interests checked above. This Commission orders that all work shall be performed in accordance with the Notice of Intent referenced above, the following General Conditions, and any other special conditions attached to this Order. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, these conditions shall control. Denied because: ❑ the proposed work cannot be conditioned to meet the performance standards set forth in the wetland regulations to protect those interests checked above. Therefore, work on this project may not go forward unless and until a new Notice of Intent is submitted which provides measures which are adequate to protect these interests, and a final Order of Conditions is issued. ❑ the information submitted by the applicant is not sufficient to describe the site, the work, or the effect of the work on the interests identified in the Wetlands Protection Act.Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides sufficient information and includes measures which are adequate to protect the Act's interests, and a final Order of Conditions is issued. A description of the specific information which is lacking and why it is necessary is attached to this Order as per 310 CMR 10.05(6)(c). General Conditions. (only applicable to approved projects) 1. Failure to comply with all conditions stated herein, and with all related statutes and other regulatory measures, shall be deemed cause to revoke or modify this Order. 2. The Order does not grant any property rights or any exclusive privileges; it does not authorize any injury to private property or invasion of private rights. 3. This Order does not relieve the permittee or any other person of the necessity of complying with all other applicable federal, state, or local statutes, ordinances, bylaws, or regulations. BWPAForm5.doc•rev.9/21/05 Page 2 of 7 i Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands • BARNSTABLF. • WPA Form 5 - Order of Conditions SE3-4494 MAM Provided by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) 4. The work authorized hereunder shall be completed within three years from the date of this Order unless either of the following apply: a. the work is a maintenance dredging project as provided for in the Act; or b. the time for completion has been extended to a specified date more than three years, but less than five years, from the date of issuance. If this Order is intended to be valid for more than three years, the extension date and the special circumstances warranting the extended time period are set forth as a special condition in this Order. 5. This Order may be extended by the issuing authority for one or more periods of up to three years each upon application to the issuing authority at least 30 days prior to the expiration date of the Order. 6. Any fill used in connection with this project shall be clean fill. Any fill shall contain no trash, refuse, rubbish, or debris, including but not limited to lumber, bricks, plaster, wire, lath, paper, cardboard, pipe, tires, ashes, refrigerators, motor vehicles, or parts of any of the foregoing. 7. This Order is not final until all administrative appeal periods from this Order have elapsed, or if such an appeal has been taken, until all proceedings before the Department have been completed. 8. No work shall be undertaken until the Order has become final and then has been recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land upon which the proposed work is to be done. In the case of the registered land, the Final Order shall also be noted on the Land Court Certificate of Title of the owner of the land upon which the proposed work is done. The recording information shall be submitted to this Conservation Commission on the form at the end of this Order, which form must be stamped by the Registry of Deeds, prior to the commencement of work. 9. A sign shall be displayed at the site not less then two square feet or more than three square feet in size bearing the words, "Massachusetts Department of Environmental Protection" [or, "MA DEP"] "File Number SE3 -4494 2 10. Where the Department of Environmental Protection is requested to issue a Superseding Order, the Conservation Commission shall be a party to all agency proceedings and hearings before DEP. 11. Upon completion of the work described herein, the applicant shall submit a Request for Certificate of Compliance (WPA Form 8A) to the Conservation Commission. 12. The work shall conform to the plans and special conditions referenced in this order. 13. Any change to the plans identified in Condition #12 above shall require the applicant to inquire of the Conservation Commission in writing whether the change is significant enough to require the filing of a new Notice of Intent. 14. The Agent or members of the Conservation Commission and the Department of Environmental Protection shall have the right to enter and inspect the area subject to this Order at reasonable hours to evaluate compliance with the conditions stated in this Order, and may require the submittal of any data deemed necessary by the Conservation Commission or Department for that evaluation. BWPAForm5.doc•rev.9/21/05 Page 3 of 7 i a ' Massachusetts Department of Environmental Protection DEP File number: Bureau of Resource Protection - Wetlands • BARNfT"M _. WPA Form 5 - Order of Conditions SE3-4494 MAM ,e$ Provided by DEP . Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) 15. This Order of Conditions shall apply to any successor in interest or successor in control of the property subject to this Order and to any contractor or other person performing work conditioned by this Order. 16. Prior to the start of work, and if the project involves work'adjacent to a Bordering Vegetated Wetland, the boundary of the wetland in the vicinity of the proposed work area shall be marked by wooden stakes or flagging. Once in place, the wetland boundary markers shall be maintained until a Certificate of Compliance has been issued by the Conservation Commission. 17. All sedimentation barriers shall be maintained in good repair until all disturbed areas have been fully stabilized with vegetation or other means. At no time shall sediments be deposited in a wetland or water body. During construction, the applicant or his/her designee shall inspect the erosion controls on a daily basis and shall remove accumulated sediments as needed.The applicant shall immediately control any erosion problems that occur at the site and shall also immediately notify the Conservation Commission, which reserves the right to require additional erosion and/or damage prevention controls it may deem necessary. Sedimentation barriers shall serve as the limit of work unless another limit of work line has been approved by this Order. see attached Findings as to municipal bylaw or ordinance Furthermore, the Barnstable hereby finds (check one that applies): Conservation Commission ❑ that the proposed work cannot be conditioned to meet the standards set forth in a municipal ordinance or bylaw specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation Therefore, work on this project may not go forward unless and until a revised Notice of Intent is submitted which provides measures which are adequate to meet these standards, and a final Order of Conditions is issued. ❑ that the following additional conditions are necessary to comply with a municipal ordinance or bylaw, specifically: Chapter 237 of the Code of the Town of Barnstable Municipal Ordinance or Bylaw Citation The Commission orders that all work shall be performed in accordance with the said additional conditions and with the Notice of Intent referenced above. To the extent that the following conditions modify or differ from the plans, specifications, or other proposals submitted with the Notice of Intent, the conditions shall control. BWPAForm5.doc•rev.9/21/05 Pape 4 of 7 f SE3-4494 Name Jon Tobin Approved Plan= January 19,2006—Site Plan (2 sheets),by Peter Sullivan Special Conditions of Approval I. Preface Caution:Failure to comply with all Conditions of this Order of Conditions can have serious consequences. The consequence may include issuance of a stop work order,fines,requirement to remove unpermitted structures,requirement to re-landscape to original condition,inability to obtain a certificate of compliance, and more. The General Conditions of this Order begin on page 2 and continue on pages 3 and 4. The Special Conditions are contained on pages 4.1,4.2 and 4.3 if necessary.All conditions require your compliance. II. Prior to the start of work,the following conditions shall be satisfied: 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein,General Condition number 8 (recording requirement) on page 3 shall be complied with. 2. It is the responsibility of the applicant,the owner and/or successor(s) and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors prior to the start of work. Barnstable Conservation Commission Forms A and B shall be completed and returned to the Commission prior to the start of work. 3. �General.Condition 9,on.page"i{sign-requirement) shall be-complied with.. 4. ' -The Conservation Commission shall.receive.written notice-1 week in advance of the start of.work. The work limit_lineshown_on.the_approved.planshall.be staked in.the field by the project (-surveyor/engineer. 6. Staked,strawbales.backed.by.trenched-in siltation fencing shall be set along the approved work limit line. Effe`cti've sediment controls shall remain until the site is stabilized with vegetation. f 7. , A:,�equence of color_photo�aphs showing the undisturbed buffer zone shall be submitted to the �Conservation'Commission: Note: the strawbales and siltation fence must show in the foreground _ p.4.1 (or bottom of the photographs. III. The following additional conditions shall govern the project once work begins. Note especially special condition no. 14, requiring verification of the locations of the foundation and strawbale line. 8. General conditions No. 12 and No. 13 (changes in plan)on page 3 shall be complied with. 9. General condition No. 17 (maintaining sediment controls)on page 4 shall be complied with. 10. The work limit shown on the approved plan shall be strictly observed. 11. There shall be no construction disturbance of the site, including cutting of vegetation, beyond the work limit. 12. The Conservation Commission,its employees,and its agents shall have a right of entry to inspect for compliance with the provisions of this Order of Conditions. 13. This permit is valid for 3 years from the date of issuance, unless extended by the Commission at the request of the applicant.Caution: a future Amended Order does not change the expiration date. 14. Upon completion of the foundation,the project surveyor or engineer shall verify in writing or by plan to he] �.rCommission the correct location of the foundation and work limit line and note any discrepancies from the �S (approved plan If verification is in the form of an as-built plan,the plan provided shall be drawn at the same scale as the approved plan. 15. Any fill used for this project shall be clean fill. Fill shall contain no trash,refuse,rubbish,or debris. 16. No CCA-treated materials shall be used for decks. 17. Construction shall conform to the requirements of the State Building Code and the Town of Barnstable Zoning By-law Flood Area Provisions for construction within the coastal floodplain. Work shall ensue oruy/ after consulting with the Building Commissioner. g1918.7Drywells orgraveled-trenches alon,T e drip linesshall be installed to accommodate roof runoff. The proposed removal of the garage, apron;and fence shall be implemented.l' 20 The,choice_of planting material for the restoration area shall meet with the advance approval of the CC6nservation Agent. 21. During construction,no area shall be left unmulched or unvegetated for more than 30 days.All areas disturbed during construction shall be revegetated immediately following completion of work at the site. Mulching shall not serve as a substitute for the requirement to revegetate disturbed areas at the conclusion of work. p.4.2 22. All proposed lawn areas shall be underlain with a minimum of 6 inches of loam. 23. Herbicide,pesticide and fertilizer use is discouraged on lawns within Conservation Commission jurisdiction. If fertilizer is used,only slow-release low-nitrogen fertilizer(with 30-50%water insoluble nitrogen or `W.I.N') shall be applied. Over-fertilizing shall be avoided(not-to-exceed limit= 1 pound of nitrogen per 1,000 sq. ft.of lawn per application).Ensure that no fertilizer is spread on hard surfaces like driveways and sidewalks. 24 'Work limit markers(wood stakes)shall remain until a Certificate of Compliance is issued for this project. 25. A split rail fence(or approved alternative) shall be constructed and maintained along the work limit line.,_ This condition shall continue over time. IV. After all work is completed,the following condition shall be promptly met: 26. At the completion of work,or by the expiration of this Order,the applicant shall request in writing a Certificate of Compliance for the work herein permitted. Barnstable Conservation Commission Form C shall be completed and returned with the request for a Certificate of Compliance. Where a project has been completed in accordance with plans stamped by a registered professional engineer,architect,landscape architect or land surveyor,a written statement by such a professional person certifying substantial compliance with the plans and setting forth what deviation,if any,exists with the record plans approved in the Order shall accompany the request for a Certificate of Compliance. At the time of the request for a Certificate of Compliance, an updated sequence of color photographs of the undisturbed buffer zone shall be also submitted. p.4.3 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: • ��_� WPA Form 5 - Order of Conditions SE 1'� peg Providedded by DEP Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 And Chapter 237 of the Code of the Town of Barnstable B. Findings (cont.) Additional conditions relating to municipal ordinance or bylaw: This Order is valid for three years, unless otherwise specified as a special condition pursuant to General Conditions #4, from the date of issuance. Date This Order must be signed by a majority of the Conservation Commission. The Order must be mailed by certified mail (return receipt requested) or hand delivered to the applicant. A copy also must be mailed or hand delivered at the same time to the appropriate Department of Environmental Protection Regional Office (see Appendix A) and the property owner (if different from applicant). Signatures: On Of Day Month and Year before me personally appeared �NAJIJ ( E 6 v L e- to me known to be the person described in and who executed the foregoing instrument and ackn dged th he/sh exec the same as his/her free act and deed. "!z 6 Notary Public My Commission Expires This Order is issued to the applicant as follows: ❑ by hand delivery on Date by certified mail, return receipt requested, on APR 11 20M Print Name Signature Date BWPAForrn5.doc•rev.9/21/05 Page 5 of 7 T °F Massachusetts Department of Environmental Protection DEP File Number: Bureau of Resource Protection - Wetlands • ��� WPA Form 5 - Order of Conditions SE3-4494 °tED►AP+� Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP And Chapter 237 of the Code of the Town of Barnstable C. Appeals The applicant, the owner, any person aggrieved by this Order, any owner of land abutting the land subject to this Order, or any ten residents of the city or town in which such land is located, are hereby notified of their right to request the appropriate DEP Regional Office to issue a Superseding Order of Conditions. The request must be made by certified mail or hand delivery to the Department, with the appropriate filing fee and a completed Appendix E: Request of Departmental Action Fee Transmittal Form, as provided in 310 CMR 10.03(7) within ten business days from the date of issuance of this Order. A copy of the request shall at the same time be sent by certified mail or hand delivery to the Conservation Commission and to the applicant, if he/she is not the appellant. The request shall state clearly and concisely the objections to the Order which is being appealed and how the Order does not contribute to the protection of the interests identified in the Massachusetts Wetlands Protection Act, (M.G.L. c. 131, §40) and is inconsistent with the wetlands regulations (310 CMR 10.00). To the extent that the Order is based on a municipal ordinance or bylaw, and not on the Massachusetts Wetlands Protection Act or regulations, the Department has no appellate jurisdiction. D. Recording Information This Order of Conditions must be recorded in the Registry of Deeds or the Land Court for the district in which the land is located, within the chain of title of the affected property. In the case of recorded land, the Final Order shall also be noted in the Registry's Grantor Index under the name of the owner of the land subject to the Order. In the case of registered land, this Order shall also be noted on the Land Court Certificate of Title of the owner of the land subject to the Order of Conditions. The recording information on Page 7 of Form 5 shall be submitted to the Conservation Commission listed below. Barnstable Conservation Commission BWPAForm5.doc•rev.921/05 Page 6 of 7 f Town of Barnstabler�►5 Conservation . CommissionHARNSrAB `E$ 200 Main Street °jEo,Nr� Hyannis Massachusetts 02601 Map Parcel: 186040 MCLAUGHLIN,RUTH'& ' Property Loc 656 SOUTH MAIN STREET 24 ANDREWS RD, Date: Friday,.September 19,2008 MILTON MA 02186 Our computer records indicate that an Order of Conditions- File# SE3-4407 issued to BILODEAU,PETER on 8/3/2005 for the following activity on your property: ATTACHED GARAGE, FRONT PORCH, 13X17 ADDITION ON PIER has expired without a Certificate of Compliance from the Conservation.Commission having issued. Please check your records. If a Certificate of Compliance or a currently valid extension permit has already been issued,please contact us at(508)862-4093 and we will gladly update our file. If neither a certificate nor a currently valid extention permit has been obtained, please initiate the compliance certification process within 1 month of this notification by contacting your engineer,surveyor,attorney or consultant. Please call us should you have any questions on the process. The Certificate of Compliance is a necessary and final aspect of the wetlands permitting process. It, like your order of conditions earlier,will be recorded against the deed on your land. We thank you in advance for the anticipated cooperation in the closure of the wetland permit presently in force at your parcel. Sincerely yours, Fred Stepanis,Conservation Assistant UeW ��/O�/A) 5Z-3- OY9�)' -,4, 40 do Town of Barnstable Building Department - 200 Main Street R * saxrrS'rAsLE. = Hyannis, MA 02601 9 MASS Fna. (508) 862-4038 certificate of - Occupancy Application`Number: 200805948 CO Number: 20100170 Parcel ID: 186040 CO Issue Date: 111,12110 Location.r 656 SOUTHWAINASTREET Zoning Classification: RESIDENCE D-1 DISTRICT Proposed Use: ACCESSORY LAND WIIMPROVEMNTS ti Villager -CENTERVILLf Gen Contractor: COLLINS,,PETER Permit Type: RC00. l' CERTIFICATE OF OCCUPANCY RES Comments: Buil Vinkepar/tment Signature - Date Signed TOWN -OF --BARNSTABLE _THE� BUilding Application Ref: 200805948 * - Permit BARNSTABLE, Issue Date: 01/16/09 9 MASS. s639• �� Applicant: COLLINS,PETER Permit Number: B 20090080 nor fD��p Proposed Use: SINGLE FAMILY HOME Expiration Date: 07/16/09 Location 656 SOUTH MAIN STREET Zoning District RD-1 Permit Type: REBUILD HOUSE AFTER TEARDOWN., Map Parcel 186040 -Permit Fee$ 2,040.00 Contractor COLLINS,PETER Village CENTERVILLE App Fee$ 100.00 .License Num 3420 Est Construction Cost$ 400,000 r. Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND NEW HOUSE,4 BED, 3.5 BATH,2 CAR ATTACHED GARAGE THIS CARD MUST BE KEPT POSTED UNTIL FINAL, INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: TOBIN,]ON S 8L JEAN BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 23 FALL MtADOW DR INSPECTION HAS BEEN MADE. PITTSFORD, NY 14534 4 Application Entered by: JL _ . Building Permit Issued By: ; THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY;STREET;ALLYDR SIDEWALK OkAN ART.-ITHEIWWMER TEMPORARILY OR PERMANENTLY: ENCROACHEMENTS ON PUBLIC PROPERTY;NOT,SPECIFICALLY-PERMITTED.UNDER;THE BUILDINGCODE;MUST BE APPROVED BY THE'JURISDICTION. i STREET OR ALLY;GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC;WORKS..' u ; THE ISSUANCE Of THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM,`THE CONDITIONS OF ANY APPLICABLE SUBDIVISIONTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&-PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4. PRIOR TO COVERING STRUCTURAL MEMBERS(READY-TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). �„*.,fix, s .y. a. ,a• a „ � a: � - "`. .A BUILDING INSPECTION APPROVALS PLUMBING INS PECTION APPROVALS ELECTRICAL INSPECTION APPROVALS it 1 5/+6/*7 1� 12- 0 s 1 � Co 1 a 2 a kCd� 57171,O [1N�S� c 2 � 2 r09 at 3 � � l��lD 1 Hating`I�nspection provals Engineering Dept S Fire t r 2 Board of Health 7� F f LO G.Ii.i See Note 4(Typ.) 9�'Min. G.10.5 Finish Grade Tee or ...-. Baffle Compacted Fill ---' Filter 4"0 Perforuted h t 9.05' Toe El.8.5 .�^ Fabric PVC Pipe ; • x 8.85 15 O GI. 8.6 .5 N . -1/8%1/2' - (H-20) 8.5 25.15 0 14.0' O y Pea Stone , . e, Adjusted Groundwater Ft.IS - Double Washed If Encounted Remover Replace All Stone Unsuitable Soils Within T of The 7 " Outer Perimeter of The System. - DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM r'-s" 21'-0' 1'-9" Not to Scale s f� LEAC:NING BED SECTION Not to Scale 4-d' 21'-0" t2�*'U l r a t) ,�\\ 7 12' Driveway10,0 1 , r ♦.'.. r•:• . 10.25cV opo well r♦.; got T.5 - 4• s S - - // ,�r✓GriO' \erg �,. p '.. Exist - - --- O \ C,rods� -Ad lusted Groundwater El.3.5 %/ L�1 \ �, SECTION A-A r� , y to / evwi`- Not to Scale �}�rr• �r8 r '1 ' �R yb/ �•\\ \ s�Or 37.3" Locus Map QP¢� �svwe r_• �"''--------- -�:`.-.-.� � Scale: 1"=2.000t' �\\\ FteM p►�t tq \ \ Lot 10 / 17,700±SF(upland) i .n`' s \. s �. �, 40 \ I \ Lt �o �, X' l 8,156±SF(wetland) -YC `\ 25,856tSF(total) �,, i; o\ Wetland Resource Line ! : \ \\ '+ y0 sly\. � ' de\ as Flagged by ENSR /evwro 50. �a\ January 4. 2006 _ :._ I �7" Pf '4 C X `. 8! a i b I fir ` WWII ti 9i �\ I t �)4' t1 ,f, 61 / o, /�• itsPI Z}- yf'/ it ,l tr�yaG' 16 4. W `/ '• p / % r \\• '.. \ � � Via ; :,: / �♦.� ♦ : i � L. PLAN VN EVV Scale:l 20 DESIGN DATA RLVSL'�Tl.dNiY)pIQ!'lALat�iT 9a \. \ "'�`q f+T�� Single Family4 Bedroom % 4 No Garbage Grinder 4494 Daily Flow= 4 x 110=440 gpd Septic Tank,440 gpd x 200%=880gpd S�trk'ib / Use a 1500 Gallon Septic Tank.(H-20) AttttcANrSNAM JON TOBIN LEACHING AREA 656SOUTH MAIN ST. i 440gpd/0.70=,629%.f.Required rttouec-rt oG►zzoN CE NTERVtLLE,MASS. Bottom Area:21 x 30 =630 s.f.Provided ��`� \' / LEACHING BED DESIGN �p� Mdxpmjaethasdm �im,mmoWaarConditions ® • i i ti \p��` r At I Piping to be Schedule 40 PVC Perforate#With Ends Capped Usrt 8-4 0 Distribution Lines in oOR � \ tQ ,�0 21 x 30 Washed Stone Bed, sly y\t eo 5 1SiepLsw111baccmidaedan taw 8vwt6�� ae NOTES 1. Water Supply For This Lot is Municipal Water. 0 -rms-r NCLH No.t L. -7. O 7'RS'r HOL.G,- No•2 IiLL. -7,Cf `gyp 2.Location of Utilities Shown on This Plan Are Approx. 0 L0AIM --ORGAt4kc O ' LWAM= oa�ANtc At Least 72 Hours Prior to Any Excavation For This ` � Project The Contractor Shall Make The'Re uired 1 L� Notification to DIG SAFE-1-688-344- 233, t$' 23 i=1 t`I- 3.The Contractor is Required to Secure Appropriate Permits From Town Agencies For Construction 9 Ys.L•ISN �R�• t"oA�Y � Y�I:1sN �r:tv; Lop.My Defined bYThisPlan. SAND ►O`/R 5/& SAND MYR s/4 „ pZ 4.install Risers to Within 6 of Finished Grade 81 if Located L"►• y�l_15H C3t2N Mtct7 L"r,`tW.>'tswt pRN Map in Pavement Instal I Manhole Frame a Grate to Grade.H-20 -76 C 5A1.11a Z.VY 4/3 ry�, C St\NA 2,5 Y G�3 , �Rou Np WA-re.R(C� /2" ,, 5.At Structures Buried Three Feet(3,)or More or GROUND"/A'rSR CM ts.2. Subject to Vehicular to beH-2.0 Load ing. P ,rf-,. 4/ k4/o1 6.Septic System to be Installed in Accordance With L7A1'E'. 4/2 y!O to GRO�t.IpwATl�ri ADS uSrMCt�YS rj%P-r w t -4 a" 310 CMR 15.00 Latest Revision And The Town of Barnstable Board of Health Regulations. - �v: 9ut..l.ava.N�NcrlN�McztNa INc, 7. All Piping to be Sch.40 PVC. GRO�1NpWAT6R on E1 1,0 SOILR.VA�yp.-FOrZ`..J'ONt�1 O'Dmx Six, I N S?aRx�NI5Li.•', M 1\N 2ci `zOty�.A \/�/1TNFs58: C),IJ'ESMAC�AtS Toa,,pra,µ, I �� S.Depth of inlet Tee Below Flow Line s 10 Min. A1DSusrMMN-r. 1.-7'APR{L ZOO(. PERG. RATE Depth of Outlet Tee Below Flow Line 14"Min. AoauG^reDGRoutto\A/AZ-W,R EL, 75,50 1�:"rO CI" H MIN/It�tCH COnc Depth ofOuteas Saff tT s. �I" To 6' fe M\N/IhICN Headwall Directions: From Hyannis-Take Main Variance to Code of the Town of Barnstable Street to West End Rotary;Follow Chapter 360 On-Site Sewage Disposal Systems West Main Street' Take a left onto Article I Section 360-1.Location to water bodies Required: 100 feet �;, Pine Street,which turns into South Requested:75&97 feet from BVW to system a�� I Main Street;Property will be on the There is no proposed increase in flow therefore; 1.? fight,#65b. The work is not new construction as defined by Title 5.15.002 I "New construction shall not include the replacement of an existing building ' totally or partially destroyed or demolished if there is no increase in flow" DEP Policy#:BRP/DWM/Pep-P00-6 use of the B HorizonKIM State Title 5 Variances Required F" .�')7 310CMR2.55(2)requires that the breakout wall be 10 from the edge of the leaching 33UAL Four(4)feet is provided at the closest point®� Wall to be waterproof,no weep holes and constructed out of concrete.. r cant 08.' MODIFIED i"'OoTFRINT PF0wP-%- MCI 7- Headwall Ft6Y151a11 12�27�06 MOOVIFI ,P.FOGTPPk%-r01= Dwgl.L1N6 Title: PREPARED FOR: PREPARED B Y.- Jon Tobin Sullivan Engineering, Inc. CapeSury PROPOSED IMPROVEMENTS C HAN- TEE PO Box 659 7 Parker Road 0sterville, MA 02655 0sterville MA 02655 656 SOUTH MAIN STREET 100 Rawson Rd, Bldg 220 .IV CENT ERV 1 L L E MASS. (508)428-3344 (508)428-3115 fox (508) 420-3994 (508)420-3995 fax Victor NY 14 564 PSullPEOcol.com copesurvOcapecod.net p N 20 0 10 20 40 60 Comp./Draft: MJD Field: WHK/JPM Date: January 19, 2006 Scale: AS Sh0W/1 _ I Review: PS Comp./Draft: RRL _ ---___-- Proj. # 25043 Drowin_. --- g # C247_4g1