Loading...
HomeMy WebLinkAbout0140 LITTLE RIVER ROAD ver R t �l DIME 1p Town of Barnstable *Permit# p Expires 6 months fro 'sue date Regulatory Services Fee , • BaxrrsrnsLZ • Richard V. Scali,Interim Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY � t Valid without Red X-Press Imprint Map/parcel Number V (�'l Property Address ��� %�rC, /'/&E04- Ac0*9'.?) , C_ -W,(7— BIResidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name �/ 5, � ' Telephone Number Home Improvement Contractor License#(if applicable) 0'�6-9�0 Email: a a Construction Supervisor's License#(if applicable) t59WIX-7 X-PRES5 PERi IT ❑Workman's Compensation Insurance O C T 15 2013 Check one: tiam a sole proprietor am the Homeowner TOWN OF BARNSTABLE have Worker's Compensation Insurance Insurance Company Name C�LK,�. Cf/�Ze✓`7"'� ° Workman's Comp.Policy# 06'%V6—t12, 4.,R Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) A�L-17W Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town departnent regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Ho mprovement Contractors License&Construction Supervisors License is regmVd. ' — SIGNATURE: �V� Q:\WPFILES\FORMS\building permit formS\EXPRESS.doc Revised 061313 Yte Commoritswah*of"Vassachusefts Deparftnent ofIrdmstrialAccidents 0YWe o,f 1mlestigations 600 Washington Street Boston,MA 02111 wwo masigovIdia x Workers' Compensation Insurance Affidavit:Builders(Contractors/Eiec-tricians,Mumbers Applicant Information Please Print Legibly Name ahtsme�o ganizationaavidwi)_ Address.- t� �C (e City/Statr/Zip_ r `7J`' Q�fC` 1r Ph..4- Are you an employer?Check the appropriate bow T . of o'ect(required): A-. I am a contractor and I 3'I� ln° ] (c'9 '�= 1 A I am a employes with ❑ 6- ❑New comstnic# employees(full andlarpadAime}* have sub canficactozs. 2_❑ I am a sole proprietor or partner- listed on the attached sheet 7_ ❑Remodeling ship and have no employees These sub-contractors have g ❑Demolition w for me in an capacity- employees and have workers' °�� Y � �- 9_ ❑Buildsng addition [No workers.' camp.insurance comp-insurance.l required-] 5.,❑ 'We area corporation and its 10_❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officm have exercised their, I l_.❑Plumbing repairs or additions myself[No workers'romp- right of exemption per MGL 12_ Roof repairs nsxanrt required-] e_152,, 1(4},and we have na cuployees_[No worims' 13_ fltber /�d✓6i �cZ Comp,insurance required-j agptiant that checks box t must also fillout section below shawm.Thenwodceis'compettsatiampolicyinfflrmatiori Homeowners who submit this of id.=inKcsting they are domg all wow an,d then hug outside contmuors nmst submit a w affidsrit indicsth�suc �traciors d at check this box mast sttached as additional sheet showing the name of tie sdb-ca aft2ctors and state whether ornot those eIIifies have employees. If the sub-countractors here employees,they nnist piavide their workers'comp.policy number. I am are employer that isprm idbq tt�orkers'congmLsafion lumiraricefor my empLaym. BeZoty is the poM7 and job site infOrmatiolL /y Insurance Company.Name: L.l� 1r,1A16W1?M Policy 9 or Self-ins-I_ac_4:&n j�(�� ����/�/�f� d� 7�� Exptratxon Date: Job Site Address:!� �/�r �l�C�t- City,StatdZip: CV{2Xl�i/ 0y. S� Attach a cop} of the workers'compensaffim policy declaration page(showing the policy number.and erpn-ation.date). Failure to secure coverage as required under Section.25A o€MUL c, 152 can lead to the imposition ofcriminal penalties of a fine up to$1,500-00 andlor one-yearimprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine: of up.to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage w rifiration_ I do l;emb certify tha pain lr panaldes of pi jury that the in or'matian pnn ided abm is hue and correct Si tare: I}ate: l / Phone#: liftrciat use onty. Do not wriiff in this area,to be completed by cfty or town official City or Town: PerruitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hue, 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 ina 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 Iocal 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 auy applicant who has not produced acceptable evidence of compliance,with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states`"Neither the commonwealtli 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-contractor(s)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 insu=e coverage. Also he sure to sign and date the affidavit. 'llic 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/licensenumber which will be'lised 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 Commonweal&of Massachlise s Depai4ment Qf Industrial Accidents Office of Mvestigatious 640 Washington st=t Boston,MA 02111 Tel.A 617-727-4940 CA 406 or 1-9 MASWE Revised 4-24-07 Fax#617-727-7749 www.mass;gov/dia RightfaX C3-1 . 8/28/2013 9:02:35 AM PAGE 2/002 Fax Server CERTIFICATE OF UABILITY INSURANCE I ATE IM9WDU"IM FICATE IS IWUF-0 AS A MATTM OF 19FORIM- L RS NO 11314TS UPON TRE C CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IS'SUB40 INSURERS),AUTHORIZED KTAIWE uC TH MPORTANT:If thecerUllcate holder is art ADDITIONAL INSURED,the pollcy0m)must be andorsW. If SU8ROCA710M IS WANED,subjtttD p tarms and CandiKons of the polls%certain policies may raquu'e and endorwamen'L A s6rfrment an this certft de does not confer rights UD e certiBrate holder in lieu of such endomm s PRODUCEIt CONTACT NAME. HORGAN INS AGCY TNC PHONE FAX PO BOX 250 (ABC.No.Ei* WC.NON F MAN HYANMS,MA 02601 N AoaRRE9s: 2$J03F INSURERS)AFFORDING COVERAGE LAIC A gElINR® INSURP,�t A: CONII awAL CASQALTY cmeANY A I EN ERPIUSBS INC INSLIRl3t B: _ I Rl3t C: i r. .. - INSURER D: PO BCX 2036 INst1RBt COTUIT,MA 02635 RI3t F. COVERAGES GEKTIFICATE NUMIMM REWSON HLONSM w T'EO� NOTYNITNBTAlmelO ANY RAT.TwA OR CON IN ION OF ANY CONTRACTOR Wn*9t DOCUMENT WITH R12MIC T TO VACH TM CW FICATE MAY BE D OR WY PMTADL THrn=RANCE AFinRDED BY THE POUCISS Ds�ED�M S I CT TOALL TN�TEWM5,EXCLUSKWSAND CONOMMS OF SUCH POLICES.UWIS NiNOW MAY HAVE BOW f16ti41CID eY PAD CLAMlr. MR ADD POLICY E F DATE POLICY ETG CATE LTR TYPHOFINSURAMM L R POUCYIe MM IINBDOIYYM (IDADd1YYYY} EAMA Limm GMERALLIAINUIT RRENCE, $ COMIAERGIAL COAL UABI f TY RCLJJAAS MADEar Ea vccuffwm),rp� $ &ADV INJURY�AGGASEWE LIMIT APPLES P GGREGATEPDLIcr PRDJECf tpc .COMPIOP AGG S . AUTOMOBILEMMUTY � x MBNED$WOLE s ANY AUTD y, IMR(Ea aodrtent) ALL OMSD AUTOS ,..« rZAn RY S SCREW S AVT06HIR»AWW R'YWON-OV4rED mffosAMAI 3 TABRLim OCCUR. RRENCfcERi M LIAB CLAIMS-MADE 1 WDRKENSCOMPR3M71ON AND ATUTORY OTHER > 'L.QY9R'S LYLBLITY YMU&M78M7a2.13 07M& 013 W1=14 &W ESOdMWO �I ®WA r y E.L EACH A=DENT 8 500,000 0FF�are+IM H , E,L DISEASE-EA EMPLOYEE $ 500.000 Tyr&daaffft UVW CSBCRIPnON OF CPSRATKW bokm.. ` EL D4SEASE-POLICY LI MIT S 500.000 DESCMPTION OF OPMTIDNSILOCATiONSJVi�UGUBSi,M7MC710NSBPBCiAL ITEMS 7=RME AM ANY 1'B=CBLLTTMCAM 155IM TO 7EE CHR'IMr.ATB HOi:IM AFHHCM;O WOUnI3 COW COV'SBAM CERTIFICATE HOLDER CANCELLATION 6: TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBM POLICIES BE CANCELLEW BEFORE TION DATE T EREOP.NOTICE WILL.BE DHJVERED 20D MAIN ST IN ACCD E WITH THE POU" 'HYANW:5'MA 02601 - 1 name o an reg ma of . . 1 ftNafesemed. iceanvnwa2caecc�/�a- a°°arc License or registration valid for individul use only Office of Consumer Affairs&Busif�ess Regulation j before.the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR I Office of Consumer Affairs and Business Regulation. egistration 109606 Type 10 Park Plaza-Suite 5170 xpiration`: —.9121Y2014 Private Corporation Boston,MA 02116 �,. C A I E ERPRISE$ IN; { PETER POMETTI 140 LITTLE RIVER RM " g COTUIT, MA 02635 "" `=' ```} Undersecretary t _ Not valid without.signature . Massachusetts,-Department of Public Safety Regulations and Standards Board of Building. c�is(�r Construction Sup .. ' License: CS-050.457,. PETER M POMETTI 1 PO BOX 2056 COTL IT MA 02& 5 ��I + Expiration 04N 912014 Commissioner a x� °FmE Tom, Town of Barnstable ti Regulatory Services BARNSTAB9 LF� Thomas F.Geiler,Director �p 1639. �� - rFn r3ai" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the ero subject l p P riY hereby,authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. *nature o Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOI:S 62012 THE� Town of Barnstable y� Regulatory Services RARNSTABLIF Thomas F.Geiler,Director rt km 9��Ent3�u�•+"`0� 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 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,prrovided'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 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 persons)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. C:\Users\decollik\AppData\Local\Microsoft\VTindows\Temporary Internet Files\Content.Outlook\QRE6ZUBN\EXPRESS.doc Revised 053012 ` TOWN-OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 24 -1 T � � G. S , BLE Permit# 751P53 Health Division 's �0 7 `� �23is � Date Issued 0 al a Z3 (�`� ,:^Y }�u? � � Ai`i $ � Fee o Conservation Division of 00 4 ,per Tax Collector '" �� '� V'- Treasurer , ` ""---- SFPTBC 5Y5TEM NUS : . i 1 �T .ED IPt MPLI�►N Planning Dept. _ ;TME5 E 3� �AP�MEMTAL.CODE AN") Date Definitive Plan'Approved by Planning Board TOWN PEGUU-71 0%71 Historic-OKH Preservation/Hyannis Project Street Address Village 007vl% ' r Owner`. ! Ttn- 577 Address 007V-1.r Telephoned Permit Request 4,Dy�) �d 4 X /7 �JZ ,? AM /400,L c 475� . Square feet, 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfatfiered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family' Two Family ❑ Multi-Family(#units) t , Age of Existing Structure Historic House: ❑Yes 6d No On Old King's Highway: ❑Yes allo Basement Type: M Full ®'Crawl ' ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new 1 Total Room Count(not including baths): existing new D First Floor Room Count Heat Type and Fuel: r3Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Q<o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ®'No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage: Bexisting ❑new sizeA�`X•14" Shed: ❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address 2 A License# 6Q7-U4r A­61- 02-&�S-_ Home Improvement Contractor# Worker's Compensation# �S5�U�7�f�7�fo'�CP5��3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,y/�/ SIGNATURE DATE J/a ��b FOR OFFICIAL USE ONLY PERMIT NO. DAlt ISSUED F r MAP/PARCEL NO. ' ADDRESS VILLAGE t OWNER DATE OF INSPECTION: FOUNDATION o k 313 a f a H 't FRAME 101 L/holob INSULATION - FIREPLACE " ELECTRICAL: ROUGH FINAL' PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL FINAL BUILDING A- { 49 iV)f NG S (o c rs wi nl G 6vv 2, pwt t ry ?trIm 3iF Q- r" DATE CLOSED OUT 2 ASSOCIATION PLAN NO:3 ; tw L _ °f•ZHE A The Town of Barnstable MENSTABMAS& g Regulatory Services Eo;o. Thomas F. Geiler, Director Building Division Elbert Ulshoeffer,Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. I Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost A0,my-d Address of Work: Owner's Name: ����� X4 617 Date of Application: �� o I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTOR FOR ARBITRATION E RAT ON PROGRAM OR GUARANTY FUND UND R MGL c.142A. ACCESS TO GNED ER PENALTIES OF PERJURY I hereby a ply for a pe a agen f e owner: co Registration No. Date Contractor .5Z-9_��Zo� Ow el Date 's Name q:forms:Affidav r The Commonwealth of Massachusetts Department of Industrial Accidents Office offayesaffatioos 600 Washington Street Boston,Mass. 02111 — Workers Compensation Insurance Affidavit name ���/�✓�- �� location / 4�17?LG1 A941) crtv �477/6 7� � 1� -),& hone# ❑ I am a homeowner performing all work myself. ❑ lam a sole r rietor and have no one working in anv ca acity rovidin workers' co ensation for my employees working on this job. �J 1 am an employer p .:. ..... .g mP . comnanv name address 'w"'y ` XX cltw phone, oL ># insurance co. ❑ I WE am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have ' compensation polices: rs .. >:......:<;:>::><:< >:< :: e following X. works P ti...,p_. ::::::. com an name.. _ 77 X.wx .... ...... ............ .............. ................. ......::. ..... ..... x. <:>.. lnsnrarce ca <': - . . ......:... .. X. ........... ..... an name: c ....::... X . address.. ..... ....::. ..... . ;:.. .. ...::. ... ho ct . ......... XXx insurance co.; :::� Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a line up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Offlce of Investigations of the DIA for coverage verification. I do hereby certify a pains d nalties jperjury that the information provided above is taw.and coned Signature Date. Print name v '� Phone# d�' official use only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: ❑Licensing Board use is re uired ❑Selectmen's Office ❑cheekif immediate repo q ' ❑Health Department contact person: phone#; � ❑Other 0evyed 9/95 NA) Information and Instructions 2 section 25 requires all employers to provide workers' compensation for their Massachusetts General Laws chapter 15 s qui 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 retained 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/licease number which will be used as a reference number. The affidavits may be retained to 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 Office of IBVOStl9811003 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 i BARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Nu"S 0.50457 3 ` I3iognya9 xRrrS �12 04 Tr.no: 19942 R Irf G �,< PUTER M POME 11 ri j PO 150)(205.6 COTUIT, MA 02635 'a-- Administrator ✓� ' tom 2l of u�➢tlr g• egutatto `a mid 9CONI4?IIikNI�N3 f�tT1�TE3 t. ,cue tt- i bhO tee= ib1�s��� RESIDENTIAL BUILDING PERNIIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE ,ZZ) square feet x$96/sq.foot= A b x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus frombelow. (if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as newbuildingpermit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck 1 x$30.00= 30 0 (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) /S 7 r7 Permit Fee ,. f IMF The The Town of Barnstable SARNSTABLE. Department of Health Safety y and Environmental Services _ T MASS. Building Division 367 Main Street,Hyannis,MA 02601 ice: 508-862-4038 508-790-6230 PLANT REVIEW Owner: T e r `0 Mz- 4'k Map/Parcel: D57Y 02.' Oa 1 Project Address: y 0 `� 'C' i*4 c F� Builder:d'WN E R The following items were noted on reviewing: ' a� 1 , c 0r Reviewed by: Date: 3�301�� Engineering Dept. (3rd floor) Map Parcel , �< d,�)/ t# 2-0 03 9 House#,; �`� Date Issued 1 -31 —9 Board of Health,(3rd ,floor)(8:15%9:30/1:00-4:30)�%It yV ! -30- f7 Fee Conservation Office(4th oo)(8:30-9:30/1:00-2:00) t Planning Dept.(1st floor/School Admin. Bldg.) Ft r Definitive Plan Approved by Planning Board 1911 , - INSTALLED ANCE WIT TOWN OF BARNSTAB TOWN REGULATIONS 9 vE AND ' Building Permit Application . Project Street Address /,�Zd G/ Village i ' 4,on1/T - t - Owner ! / T�� M�7-7-1 Address T?D• 3Ir aCS79 CCU/� lt�i9• Telephone' Permit Request © D(f5-V 4 First Floor j w square feet Second Floor e, square feet Construction Type �— Estimated Project Cost $ �� ®DD• D 0 Zoning District /e,�' Flood Plain AJO Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family I� Two Family ❑ Multi-Family(#units) Age of Existing Structure D /lSs Historic House ❑Yes @/No On Old King's Highway ❑Yes UkNo Basement Type: ❑Full ❑Crawl ❑Walkout @/Other 6�nzo�Cvctiv� f� �nGi�, 614--4 Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New Half: Existing / New No:4f Bedrooms: Existing_,3_New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other l Central Air ❑Yes ❑4lo Fireplaces: Existing i2. New Existing wood/coal stove ❑Yes UdQo Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) (Attached(size) 02 X ?J'z oe ❑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 771 Telephone Number Address `z: O• jC License# 0(7 V,5'-7 � 1077U/?'i A61-, D L Home Improvement Contractor# 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 o�•?,Q�v�/z S�v�G SIGNATURE DATE__ e�� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE, OWNER DATE OF INSPECTION: l FOUNDATION-: ' "► . _. - t �� FO - . FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH '' FINAL'-,- uj PLUMBING: ROU —FINAL, ; GAS: ADUQU FINAL FINAL BUILDING <,;r3 I� !7 rV a z DATE CLOSED OUP r LAN ASSOCIATION PNo'g `=x � T The Town of Barnstable Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner occupation Re ' Home Occup gis=tion Date: Name:_ . 6/ yG �' Phone #• `�°Z`� �G Address: Type of Business: ,t` lC�/ Map/Lot. INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no incrense in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located i within that dwelling unit. • Such use occupies no more than 400 square feet of space. • Tliere are no external alterations to the duvelling•which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke.dust or other particular matter, odors.electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupanon,and not within the required from yard. • There is no exterior storage or display of materials or eqt ipmeat. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on-the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating;the Customary Home Occupation. I • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,Maud agree. a above restrictions for my home occupation I am regis4plir-znt- Date: n C r �? m L, C. 1 7 2 8 7 N06'47'13"E D V1 NI 43 25 L.C. 16535 `m 0 - ,LC:172 7 92 LITTLE RIVER 0 10°29'43"E ROAD N08°35'23"E i — -v - 0 �� 268.29' 33' WIDE 389.52' PUBLIC) .:_..� N06° m v - :n I� I ; � 121,23' N08°35'23"E 92,68'•., .... N08°I9'33"E 125,65' _ m°' um, i / 28.7T''`' 2. 3 6 nco3.91' I� 1 CD A CD I- 0 JI Co 2 N— X T ,0� r D .) z D �^ 11 O Iai NO3'02'01' v� I — �� 1p vW 45.00'-- '� NmN I c°to 1 ^I �9 cn Nr I m m� D CA CAcmn n0i m 0 / Ng� \ _ _ _--- 1 �r Z }o 0 1 w— 0 -N 0 0ts�s�c� 0 \r cn 70 2 \ 0 0 0. OS 41W p; OD NO 0 A .1 10 at DQr 6? \ 1 D J \ 1 I x V` = I I Z VJD n Z CD rn v 0 I > J `pO c 1 , m 1 290.54' 144 23' 252.65' S03057'05"W 687.42' bo 'p 1 P a MARY P. 8 DAVID GALLOWAY 7. PLA BK 402 PG 8 ok V 6/7 ON lie EPARTNElp PUBZjC SAFjFr CONSTRUCTION SUP eTtricted 70" 00 Number OR LICENSE Expires. 00 None: Birth Restrdate; 911998 a - masonry only oj� 0411911949 557 12 famil y Homes failure to 0 FTI Hassachu Possess a current edit, PO BOg Massachusetts 20 6 State Buillding Code of the 's cause for r.re I Vocation of this license, nVy YK M6, ti RX �MINim- I'llig �77 ot The Commonwealth of.41assachiiserts Dcpurityienl of Industrial Accidents Office oflnvesilgollons .,\ "'• ; ' 60011ushin�;lonStreet = BON1O11, Ma.v.v. 02111 Workers' Compensation Insurance Affidavit �ppltcant information• Please PRINT Isdi�l r " ` — ' ......... ......._....__... _ ....._ name: P6T�� C',Yt-GG77-7 _._...._ location: 140 L/-,67TZ4,- /1l/6-7't• ' city G'07VI-rr /t-t//q' ,QL0-1 S— nhonc# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity . .. ;.s- n—•--.71.....• TrX r••�.!�+r.-•�+rt7.rs.:r•y`�.r^�•_7'.++..Rr'a!•'a+.�1^.++..w!grw�..�.•.......-.u'►+....�s���.•F-•.+...� ...tv.._�......_.. .... ❑ I am an entplover providing workers' compensation for my employees working on this job. compare• name: address: city: Phone#• insurance co. Policy# I am a sole proprieto general contractor, r homeowner(circle one)and have hired the contractors listed below who have t e o owina workers o icessue�, company name: atldress: �l'0 3 r D JG-ram-. `,666 cih•: t1�E7Z!r< i���, �/�' phone#• insurance co. C/�Cy �i c�U�jZi /i(/S • C'O Policy# r.. .. .. •.t.rf'r:•:!:... !1�tf•.._..-...- -.�•�••. :....�:�_^'�r,^-'�r""�"sY-i'.�..�.�:�iT'r .:.. �,T....,. .V.-�..,..__.....p.y..;..�....._...-.�. ._. ._/�l:.o.���iu./_.... ..j... _...: .r:1�V,'.,,r...p.J�lr�lr.rr:.-_-��f.l} _ . 1 ....��11..1►rs�J.:r.L�3� compare' name: address �? FXJX al ct- cih: 1G��Gl / hone#: insurance co. Gar tom/ x-1 11olicv# ( c41 5 �s 7A11ach additional sheet if ricccssa - i ' _� 'T- "• rc• �:':"''^` E"' _ •—•-r __. '-._..... ....___._....__._�.I... �a.:.:R 'r........r. :N.:�3.�' aafu�i ...�':M�Vu�...�•...•y. Failure to secure ctti•er:tCe as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 and/or one years'imprisonment as%tell as civil penalties in the form of a STOP WORK ORDER and a fine ofS100.00 a dap against me. 1 understand thnt n cope of this statement mac be fonrnrded to the Mee of In•estirations of the DIA for coverage verification. I do herehr cenijv u► ter to is an penal ' s of prrjun that the information provided above is true and correct. Sicnature �' �� Datc 11)4-47 Print name ����. D �i�7 Phone k / C/�// 1l offcial use unly do not suite in this area to be completed by city or toisn official r Y� citi•or totrn: permit/license# OBuildinp Department - OLicensing ttitard O check if immediate response is required OScleetmen's Office 011ealth Department contact person: phone N: 0011ter f. I recued i,"15 111\I .• The Commonwealth of Afascachusctts Deparmietil of Industrial Accidents : 4 _ iWirOffice oflnyestlyatlons :.=:=r 600 !!achiti;rort Street Boston, Alusc. 02111 Workers' Compensation Insurance Affidavit �1pp11�tnf information• Please PRINT lebi�lv name: location: cih• phone# O 1 am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �.'.•...� Y T.^^•^.��tnvr' +rT,TiT^•e+'R+'��1rT.t7.:w%P`f!p':l".^`�.�.q.'R'=a'!�I�^.^'�++17'�T.'^`_""^'Y�.'.'^_1t �+r•�._. v....��. .... .. __.... G:_ .-� ....w. .—_cAu.v .L Y! .3. .13.�.��r,.1.+.a.. -`ar;a.-�:• 'r_i.334� ..._ ._......_�._......._�_ I am an emplover providing workers' compensation for my employees working on this job. conrtmnv name: address: cih•• Phone#• • insurance co. nolicy# �c I am a sole proprietor, eneral contracto , or homeowner(circle one)and have hired the contractors listed below who have the followina workers' compensa ion polices: comm m• name: CDGOnr� �ycGB�-/ C ' atltlress• ?�' 0 �� �o / cih•: C� / phone N• insurance co. ���� /�C policy# l/1/ .. ._. -- _... .. .•e..r.:.•-_.. yt.--..-..._- .._.t•:�...;,'..r..,.�..-:r-.._�r�-^sr.�,?n;��art�r•'+ .:..s f•....::'•.... -r y-:. -_ •.n,r.,. _.. _ __..__:a..._ ..__.__.—_._._...__ ._�_a".--.a:._.�.._.w_.a:.-..._a_.::a..� .. .::e...a.L.L..':c� +n� .- .�*• .,. .. -•Tj'G. �.�c. i..���+-i.�_� cam anv name: �CC�T`✓ �'7G�d'Y C�/U/�✓eSL�C� Ls�./�2(�iY ✓b✓��l/1� address: phone#• insurance co. �� /`�U/�` �`'� polio'# 3L-S7� _,_..__ ... _� T. _ — ��_, Attach additional sheet tf It ccssa -,r..., - : •:�,: 1i�j. — _ r ,r".;� _'` w• ^: -"%'E'" . %:si �•ea�i._ =y��•,'•Seu--••`•••'•• �..persu�al:riav�iy.i .s...in•;:...w Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to 51.500.00 andiur one wars'imprisonment as well as civil penalties in The form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 tlo herehv certift•antler the pains and penalties of perjun•that the information provided above is true and correct. Sicnature Date Print name Phone# T . official Ilse onlyY do not write in this area to be completed br city or town official y� city or town: permitAicense# oBuilding Department . [jLiccnsing Board check if immediate response is required oseleetmen's Office 0I1callh Department contact person: phone#: 001hcr . tte,.sad 31115 et:v The Town of Barnstable • L►arsr,+are, • 9e� 9. Department of Health Safety and Environmental Services 'tips' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL,c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: a/�/y Est.Cost, Address of Work: 1410 41,177,1C Owner's Name Date of Permit Application: Ild I!F7 I hereby certify that: Registration is not required for the-following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I here b apply for a permit a agent owner: / 90 -7 Date Contractor Name Registration No. OR Date Owner's Name a'"'f g�a,e ---r.lo P�F F'•rrFs�C'�- 'ya r�.cT 2.I:5� I m Ib•a.� W�rr�pL ow I d-0' �-0' 1 L.•o�..vve �a p� .wv ti.l.x,w•To r'Apr+ �.+o� �---.. .._..-'�'' �--- - IL � �----- \� Id.�r Ilya. µ( Quvr.rm iw .4i ° 14 8I/ c 1 rf r r+ 1 I' `. � u4u I•ao.ho ��tr. � ucu' i,,IoJ rq c(I.. n�t1. I 3-, i�}-�* 'II i i I ... II• I� exl M.10 WPp `('�, "�`(�' — usE E,usT a HlcaNet na+ — Is w,Iow �—— au P_.K Ev 4.yuc+o�Y.SEr 4' d-e ucc <.m Y' � �I w.-.tv PH.i I 9 1` .�... . . f I U...W. A HM.��Iltz �GOp ` I i I N '�LINE OF �cks�l`IC� �or� A%PIE . �40 �qplgV-I.P. J` -4��e � susPr.lca �"r'F - Fxv-sfptLi FFa^'r�F 1r Wp{•-I I I I'L 12 r N �or-+r map i . s� LEA �I�E ELEVATION _ �� l.w+e op FxW�l�y F-IWE L I I au� CgogocaE I-•y Rcui aP_o•+E f POr j ffl--VAF10�,1 r-- +- - 4l-— --1 I NSW hiq� - SIDE ��aTION / Lwa vF 6u--rT. fuooE r 7—T P / 7l �1NGa 00-V-S AFV ER.Ftzrl � r-- 1rT .- I . Hc*- —T FF-4 14� LgTL-M F'n-f- 6-p-hr a C II2LI9� ,At V: ley.11 Oo ,` <} The Town of Barnstable BARMU'� Department of Health, Safety and Environmental Services " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner October 25, 1994 Mr. Peter Pometti 385 Wakeby Road Marstons Mills, MA 02648 Re: 140 Little River Road, Cotuit, MA Dear Mr. Pometti Lots#2 and#3 located at 140 Little River Road, Cotuit, MA(Assessors Map 054 parcel 024) as shown on"Plan of Land in(Cotuit)Barnstable, Mass. for Georgia M. Park", dated July 9, 1990, are in compliance with Town of Barnstable zoning. Sincerely, Ralph M. Crossen Building Commissioner RMC/km „v 0 17'-5 1/2• .- 17'-5 1/E• 5, 51 5• S. 7 _ • 5'-e°y14• 5'-g J4• - 5'.8 8/•M • • r zi IPgR.DOgIUp OYl � dppL POOIp[L_M. � � O • - O U N - d.b.. SCREEN PORCH 7 - EXISTING M OROOM K IIfl C new m a ABOVE _ �� / KITCHEN - SCREEN PORCH m .., z OVCN9 RffRIO. ®. r 10 _ Q a 3'-101/2' 2's s'-1• -r 5'_1• - DININ.G ROOM - t - _ _ I (p new - b '+ PERGOLA •u I - I - BRICK PATIO - -- -- -- msnxe Psreul¢ iP�aw.�TTM lx 1, 6 .. menxe PJaeswe - - IPDu.eolmrm I j b '- .. - /: -- ---=c—o—Win_---_..-- ,. - ----------- oll , - - - PERGOLA gw BRICX PATIO Y FIRST FLOOR PLAN FOUNDATION PLAN CNgeW o.clESJ'QIIfiJg9T51 ^T [ - - - 0 •, WG•O.C.NT TO-” SECOND BOOR IM'fA%PLmT.,RUDDDt , - _ IL ROOFR161 Ix4 OB]VNSON LOP PlA1E - .. � P.T.WOOD PORCH E 0. - .•- - x �' .- H ��• Q FRANr WITH 4 COUAL SCREENCO 5EC MS SCREEN PORCH - o + W W CL ` O NR4 2xA PM[R 9nlD WPL9 • C 3E O. _ WIM IM'PLYWD.x 2x10 P.T.PLR.JODTB FlR$i 0.00R • - - W.C.9nINe1PD TO MRTOI DCDT. .. .. � Q ON DCLLPOOTIGg1 D.' ' 9'MIN.BDAv 68RD[ DATE 32 JD4 TYPICAL SECTION - - Lir.Pa - SCALE: 1/4=1•-O" _ DRAWING p: a :;.;,..., .'� .� �,.- .: � M. .... :tee �. .,.. .-d ..,.,,. .. .:. ,- - ... :.t - ^iw.:. _ .t; n.f•: «iP .xr a aM. y» . ..p.,.,.-... #,. a... .... ''Y - o , �Gu :P" k.KfskJ.M.� iATasif� ..... .. •�;'iSr�+w7.�'mirnua� .;� `lFc �.-yr1E"C.'�^xs'=. .e.,.�.w41P�„Stmttk<�.,,ha�'s,w,.�•,:+:�li?�+�:,.twAa !`1iA Ai3ie+.�aieikraw�# F+k�rrco-.+W � N�`�'�•n,�^"*.�i.$�".. a y �:"'SFr - ... _ = o TRIM 10 AfASCMHH HHHH FYIDNG" . - • SECOND 0.00R .., - r . TOP mm Q ® ® ra® • - . ® �� a 10 DIA.DOOCCOWNM b - SIOPORlMG PERGOu all . . r RRSI BOOR. - EA"G HOUSE PND GARAOE I NEW SCREBr PORCH - ,. FRONT ELEVATION - vr•To - - T I FM FEED] 10 r F .. SECOND ROORM1 TOP—MDE KO—AND DE"DETAUA- / N TRIM to-CHEMSIwG "1RIM TO MAfCN EASIWG - O a _ a � o co .. - 4 W.C.SNWGIFSYE]POOfB O FIRST ROOR FIRST ROAR _ 10 Ma1CX EMARIO -. RRSf ROOK O J d,17•-5 1/ w E]USIIN6 HOUSE NRX NEW P9d00U L 13'-I•+/- � 2' EA4mO NdISE . HEW$CRE9I PORCX - NEW SCR PORCM V O PROPOm a H RIGHT SIDE ELEVATION REAR ELEVATION Tu'•ra . vim.ro DATE 3??A4 _ SCALE 1/4-=1'4r DRAWING 0: m O 5' ' 5' 7 r - 5'-e_N4' 5'-8 ZW 5'-G 3/4• a 112 1,L 3'-1• U2' -I• 3'-I• _ Q To g0 OZ. SCREEN PORCH ABOVE EXISTING bUDROOM KIITCHEN new D — n ., . - - SCREEN PORCH. �' + - - mD'/9R9 3'-10 112 2'6 3'-I' Ll, -1• 3'-I' i� 0 - `I. O _ DINGING ROOM _ • - _ . _ -' ' W xv9nuG r1!—Door - - PERGOLA - BRICK PATIO - . - o9enuG AOSIIR oR.s*nlnuet D enamGem¢uc - 11 D Iow.9oeolu9e I PERGOLA T., - O - u ..bog 1 W BRICK PATIO ' _ .. ____= c.'D===corn=====_ .. / •� E I 1 °.. '". _ a - - ' _ �- ., .. � to •. i .. I g-0 .-�.r 1 0 amn. FIRST FLOOR PLAN yr FOUNDATION PLAN Vera w-ta ROOP DKIc: �� �.W IV IOD[OVQ116J06fl'K w in O.C.riwc.cmt�mc - LOPPIAIE F.T.wow PORCH MANE WRH 4[DUAL 5C9ePNeo S=iCN5 SCREEN PORCH urn'aa Done enlDwuu � WITH lY•RMD.a 2.10 r.T,u.IOM RM MOOR w.c.9exaOl[D ro wrm DESf. d � Ij. - DATE 32MA4 TYPICAL SECTION SCALE TN`1 DRAWING Nr Al - 2 r , n o�ewa.e�se9;mK. ,•a'! ,. 1 • �s�ti^18e"' laRi�4-�. '. ., �.... �. .. x_'�'R,,�, :. ,- ,.. . ' -; �...�'_ '.s��' _ ?�` ,�"�`�R`t'�`e...' 2??..�.a�s_,,.�!P�? e'rYk"5?s•�. ., '>�r_` a.��� c+ 4' ,'' z'�+$�".i"�'! J�.�+}�,�,. ��" �t,� e��.- .rs"�.. _e ,...ar?x'*'is�"? _.'u'd'"' ?��x., .4�"�°�"`�r "t�d°.a""'"r'�'"'�r#":'� wc d DECK DUA10AND r a Q - TRIM tO MgiCH FJ6AWG - - _ - • r SECOND MOOR TO-D PIAIE SIR - - 1 1 ® GI� 1p'DIA.DGI W R a '. PORIMG K PERGOU j / ®u RRS ROOK ' E.SHNG-m AND GARAGE I NEW SCR..PORCH --ED - �# FRONT ELEVATION :r Nllh RDlo / SECCND ROOK SECOND ROOK � S` ° . _ iOPPUIE i. TOP PUiE Q y - _:_-.:- ® ® DECC DETAILSAND DECK ND iW tR1M LO MALCN EwSnNG M i?-MATCiCH OOSMO , UX ` W.C.SHINGEFS®EwND51RR. ..■ � Q IO MATCH ECpIING i FIRS BOOR __ FIRST BOOR t FIRS BOOR 19 L' y+ C UJ d J ' EwsnNc HousE varx NEW PaIGou 13'-I`+/- i' -. _ 17'-5 1/2° EwSMG noug � W NEW SCREEN PORCH - - _. - NEW SCREEN—CH i PROPOSm RIGHT SIDE ELEVATION p REAR .ELEVATION a 1/r=IV - - DATE MM4 SCALE 1/4"-1'-V A' - _ - DRAWING#:Nov: s A2 - 2 SYSTEM PROFILE TEST HOLE LOGS TOP FNDN EL, 45.6' ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT �0 SCALE) AH OJALA, PE ACCESS COVER (WATERTIGHT) To ENGINEER WITHIN 6' OF FIN. GRADE 4 .O MINIMUM .75' OF COVER OVER PRECAST % SLOPE REQUIRED OVER SYSTEM 42.5' - 43.0' WITNESSI DAVID STANTON 3 ,� 2 RUN PIPE LEVEL 2' DOUBLE `DASHED PEASTONE DATE. 11/2/01 a c k < 2 MIN INCH A 42.4' FOR Flasr 2• 3' MAX. PERC. RATE = / EXIST PR❑POSED L;�QQ_ I4� GALLON SEPTIC 40.75' ITEE 40.5 CLASS 'SOILS P# � 41.0' TANK (H- 10 ) GAS LOCUS OLD POST ,_� 39.7s oM 0 EDaoFI BAFFLE 39.96 39.67 0 M CO C3 0 E D M M Ci '`i' 4' AROUND � ELEV. ( 3 SLOP t6' CRUSHED STONE OR MECHANICAL o Q 0 0 4� COMPACTION. (15.221 L2)) $ 2 0 ED EI 0 0 Lam`0 � 0 , op 37.67 A 1 DEPTH OF FLOW = 4' ( 9 7. SLOPE) ( 1 % SLOPE) ' 'I TEE SIZES, 3/4 TO 1 1/2 DOUBLE WASHED STONE LS 2" 1OYR 3/2 INLET DEPTH = 10 5.9' E L❑CATION MAP NOT TO SCALE OUTLET DEPTH = 14 MS LEACHING 31.70' 4" 10YR 6/2 ASSESSORS MAP 54 PARCEL 24-1 FOUNDATION 47' SEPTIC TANK 9' D' BOX 14' FACILI TY 45.1 B LS 10YR 5/6 LEGEND A + 42.5 30„ 39.70 100.0 PROPOSED SPOT ELEVATION + .3 44.0 C 9 100x0 EXISTING SPOT ELEVATION 44.6 M/C SAND 00 PROPOSED CONTOUR ` 43.4 € 3$. 14" PI E - TH 5" W.PINES 4 .8 100 EXISTING CONTOUR + 2.5Y 6/6 39.GP + 4 4 . 4 4.' + 35. 14"0 + 4 . / PAVED 35.�I 6.4 1. >�3.7 144.0 DRIVE 126" 31.70' + I NO WATER ENCOUNTERED / 3.2 43. HOLLYS NOTES,- (D �35 8 �ry / 4 4.3 d M 4 / 1. DATUM IS APPROXIMATED FROM BARNSTABLE GIS MAP rt 2 �4 4 7 BENCH MARK -- TOP OF to M p 36.0 + 4 2 - B CH 44.5 CONCRETE BOUND S 3E 'I 1 ,� �- + �! �� _ EL. - 45.1 fASSti1D_ G.i.S. B MUNICIPAL LJATEP. I_._._EX1,�1C�G _ ,..r g 45. 4 4.0 .j. I�if =1lu I T .I" _`((_., -t_ 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 , co 35, 37 LO 5. PIPE JOINTS TO BE MADE WATERTIGHT., M DRIVEWAY 'J ACCESS VIA LITTLE RIVER ROAD PA DRIVE 0) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. + 44 EXIST. DWELL. N 3 . ENVIRONMENTAL CODE TITLE V. 7. THIS (PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE __j + 36.5 USED FOR LOT LINE STAKING. 110 08, 3 . '1 S. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC. BPAna 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED ^� + 44s t 0, FROM BOARD OF HEALTH. 87.43' a , 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING CESSPOOLS. 43.2 + 43.4 TITLE .5 SITE PLAN � OF« 140 LITTLE RIVER ROAD LOTS 1 & 2A 59,499t SO. FT. IN THE TOWN OF: 1.37t ACRES (COTUIT) BARNSTABLE W _ bo 4c' PREPARED FOR: BORTOLOTTI SEPTIC DESIGN• (GARBAGE DISPOSER IS NOT ALLOWED ) iN 41.9 CONSTRUCTION/POMETTI DESIGN FLOW: 4 BEDROOMS ( 110 GPD) = 440 GPD APPROVED 30 0 30 60 90 USE A 440 GPD DESIGN FLOW ;; BOARD OF HEALTH G SEPTIC TANK: 440 GPD C 2 ) = 88Q °42.4 MA NOVEMBER 2, 2001 USE A 1500 GALLON SEPTIC TANK 110.35' 42.1 _ -+ 43.0 DATE SCALE: 1 = 30 DATE: LEACHING• SIDES: 2(33.5 + 12.83) 2 (.74) = 137 65 - ' f - off 508-362-su + boa OF Mq �tH of ^ 33.5 x 12.83 (.74) = 318 'fig ,4-41�7 fax 508 362-9880 �p H �yG �o��tA ARNE,9II�s:l1 ARNE BOTTOM. �}744.�- R0 F,D I s arms► , s H. ^ tI TOTAL, 615 S.F. 455 CIVIL OJALA �r. GPD + 44.1 OLD P�S down cape engineering, inc. No.3M2 $ No.26340 r ' USE (3) 500 GAL. LEACHING CHAMBERS, ACME OR + 429 �F9f�ISTER����`�� EQUAL, WITH 4' STONE ALL AROUND CIVIL ENGINEERS S/Qrq� LNG LAND SURVEYORS /0 t 1 _ 01--264 939 main st. yarmouth, rya 02675 ARNE OJALA, P.E., P.L.S. DATE i