HomeMy WebLinkAbout0042 JILLIANNS WAY 0
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JOB# 97-343 L-5
CER TIFIED PL 0 T PLAN
LOCATION `: LOT 5 JILLIANNS WAY PREPARED FOR:
COTUIT, MASS. ED POLACZAK
SCALE: 1" = 40' DATE: JUNE 30, 1998
REFERENCE PLAN BK. 533 PG. 41
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I HEREBY CERTIFY THAT THE STRUCTURE ��`1H
SHOWN ON THIS PLAN IS LOCATED ON THE o� AR NE
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CIVM ENGINEERS
LAND SURVEYORS
p99 main sL y rmouth, ma 02676 DATE REG. LAND SURVEYOR
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Western Surety
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LICENSE AND PERMIT BOND n
a For County, City,Town or Village Only-Not Valid for Bonds Required by the State.Not Valid for Contract, ;
Performance,Maintenance,Subdivision,Agent to Sell Hunting and Fishing Licenses or Utility Guarantee Bond. y
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KNOW ALL MEN BY THESE PRESENTS: BOND No. L&P-4 2�9 0 55 81
That we, DONALD PAIRES ,
of the CITY of MARSTONS MILS State of MASSACHUSETTS , as Principal,
and WESTERN SURETY COMPANY, a corporation duly licensed to do business in the State
of MASSACHUSETTS , as Surety, are held and firmly bound unto the
TOWN of RARNSTABLE , State of MASSACHTISFarrs , Obligee, in the amount
(Valid only when a County,City,Town or Village is named as Obligee)
of SEVEN THOUSAND TWO HUNDRED DOLLARS ($7200 ),
(NOT VALID FOR MORE THAN$25,000)
lawful money of the United States, to be paid to the said Obligee, for which payment well and truly
to be made, we bind ourselves and our legal representatives,jointly and severally.
THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has been
licensed STREET PERMTT, Lot- #5 .Ti 1 1 i ans Wad Cntui t- r MA
by the Obligee.
NQ,W MFORE;�if the Principal shall faithfully perform the duties and comply with the laws and
or i rf ,,R. %.clu g®all amendments), pertaining to the license or permit, then this obligation to be void,
o1sept�0re _ ' n full force and effect for a period commencing on the g th day of
..�►= J,% = ,1 9 9$ , and ending on the g day
4 +„� 4"11,M1Pn e ca a R , unless renewed by continuation certificate.
nay he -rminated at any time by the Surety upon sending notice in writing to the Obligee and to
tlg '.nclpal, the Obligee or at such other address as the Surety deems reasonable, and at the expira-
tioi� ®� °'rty L ) days from the mailing of notice or as soon thereafter as permitted by applicable law,
i which' 'this bond shall terminate and the Surety shall be relieved from any liability for any subsequent
acts or omissions of the Principal.
Dated this 8-Lb day of ,
j Principal
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Principal
Countersi ed WESTERN S Z ETY.—�C O A N Y
W By By .-
Resident Agent President
ACKNOWLEDGMENT OF SURETY G
I STATE OF SOUTH DAKOTA l ss (Corporate Officer)
County of Minnehaha f
On this une
8 th day of , 1998 ,before me,the undersigned officer,personally F
wl ate ,who acknowledged himself to be the aforesaid officer of WESTERN appeared Stephen T.P G
SURETY COMPANY, a corporation,and that he as such officer,being authorized so to do,executed the foregoing ;
instrument for the purpose therein contained,by signing the name of the corpoptipn by himself as such officer. ;
rt IN WITNESS WHEREOF, I have hereunto set my hand and official se y
G
J. RHONE
G �� NOTARY PUBLIC
G S 116 SOUTH DAKOTA sE n L C
otary Public, South Dakota
My Commission Expires 6-12-2004 Western Surety Company • 101 S. Phillips Ave.
G Form 849-A—12-97 Sioux Falls, SD 57104 • 1-605-336-0850 '
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ACKNOWLEDGMENT OF PRINCIPAL
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On this day of ,before me personally appeared
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known to me to be the individual_ described in and who executed the foregoing instrument and
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My commission expires
Notary Public
> ACKNOWLEDGMENYOF PRINCIPAL .
(Corporate Officer)
STATE OF
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County of
On this day of ,before me,
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personally appeared , who acknowledged himself to be the
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of , a corporation,
and that he as such officer being authorized so to do, executed the foregoing instrument for the pur-
poses therein contained by signing the name of the corporation by himself as such officer.
My commission expires
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Engineering Dept.(3rd,floor) Map 67 Parcel 620 Oe . Permit#-' 31 �"D q
House#, `�� Date Issued - (9 1
Board of Health(3rd floor)(8:15 -9:30/1:00- 6) '7�z Fee c; //,
Conservation Office(4th floor)(8:30-930/1:00-2:00) �¢ le�
Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SYST �� BE
TALLE I NCE
Definitive�Plan Approved by Planning Board 19 �^
ste4 `'"!/�--I �ENVII� AND
®' TOWN OFBARNSTABLET N RE Ns
Building Permit Application }
Project Street Address 13
Village 6/
Owner i' Q C ~ ~x Address D e o t ^'/8
;Telephone 2�y
Permit Request 111_46A,11 26;e::22A__
First Floor square feet' Second Floor 00 square feet
Construction Type Fe— ` {
Estimated Project Cost $ (o S Opp
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type:, Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes La-Ko
Basement Type: &'1~ull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0
Number of Baths: Full: Existing New -2 — Half: Existing New I
No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: as ❑Oil ❑Electric ❑Other
Central Air DO es ❑No Fireplaces: Existing New I Existing wood/coal stove ❑Yes -a<
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) -Z2)L'?4 ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ,�No If yes, site plan review#
Current Use Proposed Use
Builder Information
Name (IMA Ln P�4 � Telephone Number
Address �,1�� A 17?,�A: 061 I—IV License#
Home Improvement Contractor# I
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO p 4/4—
SIGNATUR /lei. DATE
BLJILDING PERMIT DBWIED OR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY _ "p
PERMIT NO.
DATE ISSUED. + ► '
MAP/PARCEL NO.
ADDRESS VILLAGE
'-
OWNER
DATE OFINSPECTION:+
FOUNDATION Tl
FRAME �V _
INSULATION
FIREPLACE
ELECTRICAL: ROUGH ' ` FINAL ,
PLUMBING• i ROUGt. a FINAL
GAS: 11 O A-LG - FINAL i i •. -i - y
FINAL BUILDING � tip '• •
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DATE CLOSED;OJTr ® 0 + ¢
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ASSOCIATION PLAN NC ;
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MAScheck/ COMPLIANCE REPORT _
Massachusetts Energy Code Permit. #
MAScheck Software Version 2 . 0
Checked by/Date
CITY: Hyannis
STATE: Massachusetts
HDD: 5973
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance) }
DATE: 6-11-1998
DATE OF PLANS : 6/11/98
TITLE: DON PIRES -
PROJECT INFORMATION:
5 JILLIANS WAY
COTUIT MASS .
COMPANY INFORMATION: e
M-A.P. INSULATION
COMPLIANCE: PASSES
Required UA = 971
Your Home = 675
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
-------------------------------------------------------------------------------
CEILINGS 1474 30 .0 0`.0 52
WALLS : Wood Frame, 16" O.C. 5353. 13 .0 0 .0 440
GLAZING: Windows or Doors 276 0 .320 88
GLAZING: Skylights 10 0 .340 3
DOORS 63 0 .350 22
FLOORS : Over Unconditioned Space 1484 19 .0. 70
HVAC EFFICIENCY: Furnace, 90 .0 AFUE
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans, specifications, and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the. Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
sections 780CMR 1310 and J4 .4 .
Builder/Designer Date
DEPARTHBNT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Nuaber: Expires:
Restricted To; 00
DONALD d PINES
-n @rAo, 192 SEUNENET RD
CENTERVILLE, NA 02632
HOME IMPROVEMENT CONTRACTOR
f Registration 105741
Type - DBA
Expiration 07/20/98
DONALD 3. PIRES BUILDING & RE
y�onald I. Pires
15 Cameron Road
,�Mwisr�+�R Marstons Mills MA 02648
MA-Scheck INSPECTION CHECKLIST
Massachusetts Energy Code
MAScheck Software Version 2 . 0
DON PIRES
DATE: 6-11-1998
Bldg.
Dept .
Use
CEILINGS :
[ ) 1 . R-30
Comments/Location
WALLS : F
[ ] 1 . Wood Frame, 16" O.C. , R-13
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] 1 . U-value : 0 .32
For windows without labeled U-values, describe features :
# Panes Frame Type Thermal Break? [ ] Yes [ ] . No
Comments/Location
SKYLIGHTS :
[ ] 1 . U-value. 0 .34
For skylights without ,labeled U-values, describe features :
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
DOORS :
[ ] 1. U-value: 0 .35 y
Comments/Location
FLOORS:
[ ] 1 . Over Unconditioned Space, R-19 <Q
Comments/Location
HVAC EQUIPMENT EFFICIENCY:
[ ] 1 . Furnace, 90 . O AFUE or higher v
Make and Model Number
THERMOSTATS :
[ ] Adjustable thermostats required for each HVAC system:
AIR LEAKAGE:
[ ] Joints, penetrations, and all other- such openings in the building
envelope that are sources of air leakage must be sealed. Recessed
lights must be type "IC rated and installed with no penetrations
or installed inside an appropriate, air-tight assembly with a 0 .511
clearance from combustible materials and 3" clearance from insulation.
VAPOR RETARDER:
[ ] Required on the warm-in-winter side of all non-vented •framed '
ceilings, walls, and floors
MATERIALS IDENTIFICATION:
[ l Materials and equipment must be identified' so that compliance can
be determined. . Manufacturer manuals for all installed heating
i
and cooling equipment and service water heating equipment must be
..,p_ ,provided. Insulation R-values, glazing U-values, and heating`
, equipment efficiency must be clearly marked on the building plans
or specifications .
DUCT INSULATION:
[ ] Ducts in unconditioned spaces must be insulated to R-5 .
Ducts outside the building must be insulated to R-8 .0 .
DUCT CONSTRUCTION:
[ ] All ducts must be sealed with mastic and fibrous backing tape.
Pressure-sensitive tape may be used for fibrous ducts . The HVAC
system must provide a means for balancing air and ,water systems .
TEMPERATURE CONTROLS:
[ ] Thermostats are required 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 shall be provided.-
HVAC EQUIPMENT SIZING:
[ ] Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in sections 780CMR 1310 and J4 .4 .
MISC REQUIREMENTS :
[ ] Refer to 780 CMR, Appendix J for requirements relating to swimming
pools, HVAC piping conveying fluids above 120 F or chilled fluids
below 55 F, and circulating hot water systems .
----NOTES TO FIELD (Building Department Use Only) ---------`-----=----------
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� TOWN OF BARNSTABLE Z
CERTIFICATE OF OCCUPANCY I�
PARCEL ID 000 000. 114 GEOBASE ID I
ADDRESS 42 JILLIANNS WAY PHONE
COTUIT ZIP -
i
LOT 5 BLOCK LpT SIZE
DBA DEVELOPMENT DISTRICT
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PERMIT 35239 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#31604) i
PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY 1
I
CONTRACTORS: Department of Health, Safety
ARCHITECTS: and Environmental Services
TOTAL FEES: ptr'TNE
BOND $.00
CONSTRUCTION COSTS $.00
756 CERTIFICATE OF OCCUPANCY * ELAMSTABI.E,
ibtAss.
MA'S i
39.
BUILD DIV N
BY
DATE ISSUED 12/08/1998 EXPIRATION DATE
t BDILDTNC •PEI MIT
PARCBT, Ili 000 000 114 GROBASE ID _.
'ADDRESS 42 JI:LLIANNS WAY PHONE
COTU PT" Z I P
LOT T41 6 BLOCK LOT SIZE
DfA — I7FTTa3PMT DISTIT
PERMIT DESCRIT?`IOj VW
i� ,3BDPM SING VAM HGME GEW.P'T#98- 362e
PERMITTYPE ' BUILD �'I{�`T��t r�.' RXISIDENTI.AI., BLDG PMT
C{)NTFtmt� 'JRS: P r y, 1� iNAT1T3 Department of Health, Safety
ARC;HI.>_ECT S« r
andEnvironmental Services
TOTAL FEES:
BOND - : .00
CONSTRUCTION COSTS $155,006.00
101 SINGE' FAM HOME DETAC;gVD J. r PRIVATE P 1
MAS& �►
1639.
!, F
BU1LI)1NJG•,VVVjY�ISIO
BY
y DATE I9SUIKffi 06-/ 6/'1998 EXPIRATION DATA
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN— s
F CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR
r ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS '
tT% PERMIT DOES NOT RELEASE—1 HE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED
FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE
1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE 'REQUIRED FOR
2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH—
(READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS.
3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE.
4.FINAL INSPECTION BEFORE OCCUPANCY.
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
3 1 EATIN19 INSPECTION APPROVALS EN INEERING DEPARTMENT -Xv-32
• � L� I
7� fv 2 BIARD OF HEALTH
QTJiER 11: iT jPLAN REVIEW APPROVAL
WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS
THE INSPECTOR HAS APPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY
VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA-
TION. NOTED ABOVE. TION.
BUILDING
PERMIT
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N o lac
Town of BarnstableREcE1PT
MASS 200 Main Street, Hyannis MA 02601 508-862-4038
Application for Building Permit
Application No: B-17-3860 Date Recieved: I1/6/2017
Job Location: 42 JILLIANNS WAY,COTUIT
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: ARMEN SAFARYAN State Lic. No: CSSL-106102
Address: Hyannis, MA 02601 Applicant Phone: (508) 776-2900
(Home)Owner's Name: POLACZAK, EDMUNUM& NANCY P Phone:' (508)420-9116
(Home)Owner's Address: 42 JILLIANNS WAY, MARSTONS MILLS,MA 02648
3
Work Description: Re-roofing C�_
Total Value Of Work To Be Performed: $15,000.00
Structure Size: 0.00 0.00 0.00
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers'-Compensation.Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Qffice;and that a sole proprietor ofabusiness is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit,is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best,of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Armen Safaryan 11/6/2017 (508)776-2900
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $15,000.00 Date Paid Amount Paid Check#or CC# 1 Pay Type
Total Permit Fee: $76.50
11/6/2017 $76.50 i arm{-X) -Xx}IX- Credit Card
(............... ..8664
.............................................................................
Total Permit Fee Paid: $76:50
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`EVE r The Town of Barnstable
SAE.MASS Department artment of Health Safety and Environmental Services
9 . g
059. .0
'�FDMP+p Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection P
Location C-v� Permit Number 0
Owner , TLeii Builder r 2 e_
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
•
we
0
�l.,t, C r v V) o
Please call: 508-790-6227 for re-inspection.
(
Inspected by
Date 9 ( �
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VIA p,, The Town of Barnstable
BARNSTABLE. 'MASS. Department of Health Safety and Environmental Services
039
�fD,an+e Building Division
367 Main Street,Hyannis,MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection
Location �+ c_J - ��� >?;,�;l Permit Number
Owner Builder a li
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
t ' - !
z
t
Please call: 508-790-6227 for re-inspection.
Inspected by -�✓, �; -- ��ti ,
Date C 1 "
The Commonwealth of Massachusetts
Department of Industrial Accidents
-= Office offolvestigadons
600•Washington Street
Boston,Mass. 02111
/ /r��rarorr�r rrrrarrrrarrrrrrrrr� Workers'Com ensation Insurance Affidavit
name CWAU
location PS>
city shone# �( U 90!�rs�
❑ •I am a homeowner performing all work myself.
a sole pr rietor and have no one working in any ca acity
❑ I am an employer providing workers' compensation for my employees working on this job. '
company name:
address:
city phone#:
insurance co. P01icV#
/ %/ //////////i///%G////
o general contractor. o homeowner(circle one)and have hired the contractors listed below who
have
the following workers' compensation polices:
- owl
tom anv name:
address: `
city
�.
phone#r �
-�
insurnnce co.. T �:'; oiicv
com anv name:
address (O 14- 401V
cttv-fi� // �/ phone#: to . ;.� 9. :.
�....:.: .. Zs
, oifcv#
• �
insurance co:
Failure to secure coverage as required under Section 25A of MGL 152 can Ind to the imposition of criminal penaltiesof a Use up to 51.500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tlne of SI00.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereb ce ify un a and penalties of perjury that the information provided above it true and eorcree
Date 0
Sigtiatur
Print name C0 `
Phone# G�d
114111
official use only do not write in this area to be completed by city or town official
city or town: permit/llcense 0 QBuilding Department
Qlicensing Board
❑checkif immediate Immediate,
is required QSdectrnen's Office
QSealth Department
contact person: phone#!• []Other��
(reysea 9i95•P1A)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", 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 section 25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
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. The affidavits may be returned ib
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you 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 ,k
Office of Investlgadens
600 Washington Street ?
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
SEPTIC PROFILE= TEST HOLE LOGS
ACCESS COVER TO WITHIN 6' OF FIN. GRADE (W To SCALE)
ACCESS COVER (WATERTIGHT) TO ENGINEER:
WITHIN 6" OF FIN. GRADE
MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM Will NESS: I,_J !
------ RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE I DATE: .--.,
FOR nRS7 2' hl z
PROPOSED 3' MAX PERC. RATE
GALLON SEPTIC SOILS P# 1-+�,
,
TANK (H- 10 tic
GAS CLASS
BAFFLE 1::1 E7j a 0 1::1D a C:3 r--1
Isle
-7 C11 El F-� 0 C-1 EE:3 F-I 1:1 1l;fvAkP_1
X SLOPE) 6' CRUSHED STONE OR MECHANICAL 0 0 0 C3 r__1 C3 F-1 ELEV. ELEV.
_j7i
DEPTH OF FLOW —COMPACTION. (15.22. [2]) 2' 0" Cr
TEF SIZES: SLOPE) SLOPE) 3/4" TO 1 1/2- DOUBLE WASHED STONE V— _t�4
INLET DEPTH -
OUTILET DEPTH 2LOCATION MAP SCALE 1 rz�
-.7
LEACHING PARCEL
FOUNDATION- SEPTIC TANK D' E30X FACILITY 'Y- ASSESSORS MAP t2
�, ZONING DISTRICT: � (Occ,�,j
YARD SETBACKS:
FRONT =
SIDE =
REAR -
I�A PLAtq REF.
FLOOD ZONE:
/It
S:-,
H:) NOTE
1 . DATUM IS .1 f-4 1:� i I ez- :.e
SEPTIC DESIGN: (CARWE DISPOSER IS t-Ao
s% )ESIGN FLOW: BEDROOMS (jj2_GPD) GFb k
_GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8- PER FOOT.
USE A A±L
SEPTIC TANK: -�4, GPD 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-
5. PIPE JOINTS TO BE MADE WATERTIGHT,
USE A GALLON SEPTIC TANK
6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS.
LEACHING- ENVIRONMENTAL CODE TITLE V.
7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
SIDES: USED FOR LOT LINE STAKING.
BOTTOM:
8. PIPE FOR SEPTIC SYSTEM TO SCR. 40-4" PVC.
TOTAL. S.F. GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED
Ap b + / ry�t% �. u��, k-V� FROM BOARD OF HEALTH.
7
jj'�, I I- !212ri 10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR
)K TO COMMENCEMENT OF WORK,
C\ J � // ,,I I `I � 1! 'l�Gr .ems. �7�j'e'.�{ (y/� !�.r i _ . �lL `'T Yi�iF.^L� ���y�.
LEGEND
SITE AND SEWAGE PLAN
PROPOSED SPOT ELEVATION OF
1 00xo EXISTING SPOT ELEVATION
IN THE TOWN OF:
L 7-
A --b Flo � PROPOSED CONTOUR
0_0 L0___10
S� loo — — EXISTING CONTOUR PREPARED FOR:
C I �� \� ,�'If 0
BOARD OF FIFALTH
MA
SCALE: DATE:
AP OVED DATE
off 508-362-4541
fox 5W 362-9W
'14
down cape engineering, inc.
CAMLA
2"
CIVIL ENGINEERS s
LAND SURVEYORS
OP
939 main st. yarmouth, ma 02675
A RAIE H. OJALA, L.S. DATE
J 4